My face has lost firmness and feels saggy
Skin laxity
Loss of firmness comes from changes at several levels at once: the skin produces less collagen and elastin, the fat beneath it becomes thinner and descends, and the bone gradually changes shape. Treatments that work on the skin improve the surface, deeper support needs a different approach, and marked laxity may be better addressed surgically.
Clinically reviewed by Dr Munroe, September 2026
what it is.
Laxity shows as softening along the jawline and the beginnings of jowls, a neck that has lost its definition, skin that folds more easily, and a face that looks heavier in the lower third than it used to. It is different from lines: a face with laxity can have few wrinkles, and a lined face can still be firm.
what causes it.
Collagen and elastin production slows with age, and this accelerates around the menopause as oestrogen levels fall. At the same time, the fat pads of the face become thinner and descend, and the bone of the cheek, jaw and eye socket gradually changes shape, leaving the skin with less support beneath it. Sun damage, smoking, significant weight change and genetics also contribute.
who gets it.
Most people notice it from their forties, often more quickly around the menopause, and sooner after significant weight loss.
the options.
Including the ones not offered here at Dr Munroe Clinic.
Collagen biostimulation
Juläine and Sculptra encourage the skin to build its own collagen, which can gradually improve firmness and support. Offered at Dr Munroe Clinic.
Skin regeneration
Profhilo and polynucleotides may improve the quality and firmness of the skin. The change is gradual and suits mild to moderate laxity. Offered at Dr Munroe Clinic.
Filler for support
Restoring volume in the cheeks and along the jaw gives the skin more support and may soften early jowling. Offered at Dr Munroe Clinic.
Anti-wrinkle injections for neck bands
Relaxing the neck bands may improve the line of the neck and jaw. Offered at Dr Munroe Clinic.
Energy-based devices
Radiofrequency and ultrasound tightening devices. Not offered at Dr Munroe Clinic.
Surgery
A face or neck lift may suit skin that has become loose enough to hang. This is not offered at Dr Munroe Clinic, and where it is the most appropriate option, we can refer you onwards for surgical consultation.
what Dr Munroe recommends.
Injectable treatments can improve mild to moderate laxity, although they cannot replace a surgical lift. A typical plan combines support in the cheeks and along the jaw with collagen biostimulation or skin regeneration, reviewed over months rather than weeks, and where surgery would be more appropriate, this will be explained at consultation.
common questions.
Can injectable treatments lift jowls?
They can soften them by restoring support in the cheeks and along the jaw and improving the quality of the skin. They cannot lift loose skin in the way that surgery can.
How does collagen biostimulation help with firmness?
Juläine and Sculptra encourage your own collagen to build gradually over the months following treatment, which may suit loss of support across the face. Treatment is given as a course, and the change is gradual.
When is surgery more appropriate?
When the skin has become loose enough to hang, particularly along the jaw and neck. This will be discussed at consultation, and we can refer you onwards for a surgical opinion.
the next step.
Every plan starts with a consultation: a review of your skin and what you'd like to change, and an honest account of which of these options applies to you.
Clinically reviewed by Dr Tiffany Munroe, MBBS MRCS, GMC 7293952.
Last reviewed October 3, 2026. Next review October 3, 2027.
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