Sagging face: What does it look like, causes, prevention

Facial sagging typically arises as a natural consequence of the aging process. A decrease in collagen and elastin production in the skin leads to a loss of skin elasticity, resulting in the sagging of facial features. Excessive exposure to sunlight, smoking, frequent weight changes, and genetic factors are other significant contributors that accelerate facial sagging. This process affects the overall aesthetic appearance of the face, causing discomfort in individuals. It is possible to correct this condition through surgical interventions and modern aesthetic methods.

How Does Aging Affect Facial Structures Leading to Sagging?

The aging process causes sagging through biological and structural changes in facial structures. These changes observed in the skin, muscles, fat tissue, and bone structures lead to the loss of definition in facial features and the overall appearance of aging:

• Decreased production of collagen and elastin
• Reduced activity of fibroblast cells
• Reduction of facial fat tissue
• Redistribution of fat deposits
• Bone loss in the jaw and cheekbones
• Decreased production of hyaluronic acid
• Skin becomes thinner and drier
• Sunlight damages skin structure
• Smoking accelerates skin aging

As a result of these processes, the youthful and firm structure of the face gives way to a looser, more saggy appearance. Changes observed in the jawline and cheek areas play a significant role in the overall aesthetic balance of the face. Additionally, external factors accelerate the natural effects of aging, adversely affecting the structural changes of the face. These deteriorations in the face can cause aesthetic concerns. To prevent this, adopting healthy lifestyle habits, protecting oneself from environmental factors, and taking care of the skin are important.

What Surgical Procedures Are Available to Correct Facial Sagging?

There are various surgical procedures available to correct facial sagging. These procedures reduce the effects of aging, resulting in a younger and more vibrant appearance. Each procedure targets a specific area, supporting the aesthetic integrity of the face. Here are the main surgical methods used for this purpose:

• Facelift
• Neck Lift
• Eyebrow Lift
• Eyelid Surgery

Facelift (Rhytidectomy) involves removing excess skin in the face and neck area and tightening the underlying tissues. It corrects issues such as sagging in the mid-face area, deep lines around the mouth, and jowls. Its effects generally last between 5-10 years.

Neck Lift (Platysmaplasty) targets fat accumulation under the chin and the loosening of neck muscles. Excess skin is removed, muscles are tightened, and liposuction may be applied if necessary. This procedure eliminates the “turkey neck” appearance, defining the neck contours.

Eyebrow Lift (Forehead Lift) eliminates low eyebrows and wrinkles on the forehead. It can be performed using traditional or endoscopic methods. It especially rejuvenates the upper face area.

Eyelid Surgery (Blepharoplasty) corrects puffiness in the upper and lower eyelids. By removing excess skin and fat tissue, it provides a fresher facial expression.

How Is a Facelift Surgery Performed to Correct Facial Sagging?

Facelift surgery is a surgical procedure performed to correct sagging facial features and achieve a youthful appearance. The patient typically undergoes a detailed evaluation before the surgery, and the appropriate anesthesia method is determined. The procedure involves tightening facial tissues and removing excess skin:

• Anesthesia: General anesthesia or intravenous sedation is preferred.
• Incision Locations: Made around the temporal areas and around the ears.
• Skin Dissection: The skin is carefully lifted from the underlying tissues.
• SMAS Adjustment: In deep-plane facelift surgery, the SMAS (Superficial MusculoAponeurotic System) tissue is carefully dissected and sutured into a new position in a vertical and lateral vector.
• Excess Skin: Sagging skin is cut and removed.
• Closure: Sutures are meticulously placed to minimize scarring.

After the surgery, facial bandages are applied to reduce swelling and bruising. It is important for patients to carefully follow the surgeon’s instructions to prevent infection risks and ensure quick healing. Additionally, regular check-ups are conducted to maintain the new shape of the face, and additional support methods may be applied if necessary.

What Are the Risks and Benefits of Surgical Treatments for Facial Sagging?

Facelift surgery is an effective method for correcting sagging skin and signs of aging. This procedure is chosen to improve aesthetic appearance and make facial features look younger. However, like any surgical procedure, facelift surgery has certain benefits and risks.

Benefits:

• Aesthetic improvement
• Skin tightening
• Long-lasting results

Risks and Complications:

• Hematoma
• Nerve damage
• Skin necrosis
• Scarring
• Hair loss
• Infection
• Anesthesia risks

All details related to the procedure should be carefully evaluated before facelift surgery. The choice of surgeon can directly affect the success of the surgery and the risk of complications. Additionally, quitting habits such as smoking and meticulously following post-operative care can accelerate the healing process.

Who Is the Ideal Candidate for Surgical Correction of Facial Sagging?

Facelift surgery yields the best results in individuals who meet certain criteria. These criteria depend on various factors, from skin type to overall health status. Ideal candidates for surgery should possess the following characteristics:

• Be between 40-70 years old
• Exhibit moderate to advanced signs of facial and neck sagging
• Have jowls and deep nasolabial folds
• Possess good skin elasticity
• Be in good general health
• Do not smoke or quit smoking before the surgery
• Have realistic expectations regarding the results of the surgery

The most important feature of ideal candidates is that their skin elasticity is sufficient to adapt to the new shape after surgery. Excessive sun damage or loss of elasticity caused by smoking can adversely affect the results of the surgery. Additionally, candidates should not have uncontrolled chronic illnesses. Individuals who are medically stable tend to achieve better results from surgery and navigate the healing process smoothly.

Quitting smoking before surgery supports tissue healing and reduces the risk of complications. Moreover, supporting one’s lifestyle with healthy habits after surgery helps maintain the results for a long time. Individuals with a positive outlook and who understand the limits of the surgery become more prepared for the operation both physically and psychologically. This enhances both surgical outcomes and overall satisfaction levels.

What Is the Recovery Process Like After Surgical Treatment for Facial Sagging?

The recovery process after surgical procedures to correct facial sagging requires careful care and adherence to the doctor’s instructions. Patience is important during this period to ensure both physical and aesthetic results are successful:

• Take care of wound cleaning and maintenance.
• Follow dressing and ointment instructions.
• Keep the head elevated to reduce swelling.
• Avoid strenuous activities for the first two weeks.
• Take antibiotics and pain relievers regularly.
• Avoid smoking and alcohol.
• Protect from sunlight by wearing hats or using sunscreen.

The stages of the recovery process are as follows:

• First week: Swelling, bruising, and numbness occur.
• Second week: Swelling decreases, and returning to social life becomes possible.
• Third-fourth week: Light exercises begin, and swelling largely subsides.
• Sixth week and beyond: Normal activities can be performed, and scars fade.

To reduce swelling and accelerate healing:

• Apply cold compresses.
• Drink plenty of water and follow a diet rich in proteins and vitamins.
• Light massages may be performed (with doctor’s approval).
• Avoid blood thinners.
• Attend all follow-up appointments.

During this process, it is crucial for the patient to be patient and maintain regular communication with the doctor to ensure the quality of healing. Additionally, it should not be forgotten that psychological support may be necessary after surgery; the adjustment process to changes in the face’s appearance can vary from person to person.

Dr. Erman Ak

Plastic Surgeon Dr. Erman Ak completed his primary and secondary education in Mersin and his high school education at Mersin Science High School. He graduated from Hacettepe University Faculty of Medicine as a Medical Doctor in 2014. He started his specialist training at Istanbul University Çapa Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery in 2014. He performed many successful cleft lip and palate, congenital anomalies and jaw surgery operations at the hospital, which is one of the few jaw surgery centers in Istanbul. These difficult and tiring surgeries helped Dr. Erman Ak create his own concept in facial surgery.