Sagging skin, also known as ptosis, is the loss of skin elasticity and firmness that mainly concerns women over 40. It can cause the skin to appear Loose especially around the face and neck, Thin and fragile, less defined across the cheeks and jawline, wrinkled with deep folds and fat may collect under the chin creating the ‘double chin’ effect. It can be caused by a number of factors, both internal and external including general ageing, sun exposure, smoking, weight loss and the natural pull of gravity.
Let’s take a closer look at what is happening internally in the skin to cause skin slackening:
AGE
With the onset of menopause, the body changes. Hormone levels, especially oestrogen, decline quickly and fibroblasts stop producing the levels of collagen. In the first five years of menopause, women lose about 30 % of their collagen. However, this is the strongest protein in our body and plays the biggest role in keeping the skin looking fresh, firm, and smooth. Collagen, together with elastin, forms an elastic support structure and thus provides moisture as well as a plump and firm complexion. However, this support structure becomes weaker and weaker over the years. At the same time, less and less hyaluronic acid and essential lipids are produced during menopause, which ensure that the skin remains supple and well moisturised. This in turn leads to a decreased ability to maintain its water balance, drying out the skin and thus causing deep wrinkles to form more quickly. The loss of elastin, another protein responsible for elasticity, causes the skin to sag - resulting in drooping cheeks and bags under the eyes.
FACIAL FAT RESDISTRIBUTION
Fat pads are areas of tightly packed, subcutaneous fat cells that keep skin `filled out.’ They are found both superficially and in the deeper layers. With age these deeper fat cells reduce in size and number, leading to a shrinking of these layers and a reduction in the support of the superficial fat pads. The fat pads also become more discernible as separate ‘pockets’ of fat, rather than blending in with the overall shape of your face (as they do when you’re young). The result is a more drawn and sunken look to the skin, with flattening of the cheeks.
EPIDERMAL-DERMAL JUNCTION
This basement membrane connects the epidermis and dermis, controlling communication between them. It also acts like the soil that sustains the activity of epidermal stem cells, which generate new cells in the skin.
- Acts as an adhesive that connects the epidermis and dermis together maintaining the right shape of the skin.
- It controls the exchange of substances and nutrients between the epidermis and dermis to maintain proper skin condition.
- It nurtures epidermal stem cells which form the base of epidermal cells and maintains their stability.
Damage to the basement membrane has already begun in the late 20s due to ageing and UV rays, while the deterioration of the epidermis texture, which indicates the condition of the skin, progresses from 30’s. At the same time, damage to the basement membrane can also cause the reduction of dermal collagen, leading to signs of ageing such as wrinkles, and rough/saggy skin.
ARRECTOR PILI MUSCLES
The arrector pili muscles (APMs) are a key factor in skin sagging, and research suggests that activating them can help improve the appearance of sagging skin. The APMs are small bands of smooth muscle that connect hair follicles to the basement membrane's connective tissue. They are densely distributed in the face and resist gravity by restricting skin movement. As people age, their APMs decrease in number, which can lead to skin sagging and deformation.
GRAVITY
Gravity can worsen the appearance of ageing on the face, especially in the lower half. In an upright position, gravity can cause ptosis and vertical wrinkles. However, lying down in a supine position can restore facial volume and reduce the appearance of deep skin folds.
THE TRIANGLE OF BEAUTY
A visual reference such as ‘the triangle of beauty’ clearly shows how a loss of volume changes the shape and structure of the face in several subtle but transformative ways.
The triangle of beauty is associated with a youthful, positive appearance.
The even distribution of volume in our facial skin when we are young helps it to look more youthful. The main features of a younger looking face can be clearly seen as part of the ‘triangle of beauty.’ These include:
- High cheekbones
- Full jowls
- Smooth skin
- A lean, well-defined jawline
These features combine to create a face shape and structure that is wider at the top, tapering down to the narrowest point at the chin. The overall look is relaxed and positive.
Over time the triangle of beauty inverts and leads to a negative, sad look on the face.
As we age, the signs of a loss of volume mean the triangle is inverted. This is due to the following changes:
- A wider, slacker jawline
- Sagging skin resulting in less defined facial contours
- Flatter cheeks
- Wrinkles on the forehead and brows
- Wrinkles around the eyes, known as crow's feet, begin to deepen
- The corners of the mouth point downwards and causes marionette lines
- Hollowness of under eye area and temples
It’s the combination of these factors that equates to an aged appearance and sagging skin on the face. As is seen here, the triangle is now turned upside down with the wider area towards the bottom of the face. As volume diminishes and skin sags the perception of the face is altered.
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Lucy x
