Lax and sagging skin

Skin laxity is loss of the skin's ability to hold its shape and spring back. It shows as jowls along the jawline, a softened neck, drooping brows, hooded upper eyelids, and loose skin on the arms, abdomen and thighs.

It has three separate causes operating at once, and confusing them is why people are disappointed by treatments:

• The skin itself loses collagen and elastin, and gets thinner
• The tissue underneath - fat pads and supporting structures - descends and shrinks
• Excess skin remains after the volume beneath it reduces, most obviously after weight loss or pregnancy

The third cause is the important one to understand, because no non-surgical treatment removes excess skin. Skin that is genuinely surplus has to be excised.

What drives it

• Sun damage - the largest modifiable contributor to skin laxity
• Age-related collagen and elastin loss, accelerating from the mid-thirties
• Significant weight loss
• Pregnancy
• Smoking
• Genetics
• Gravity, over time

Being honest about what each option does

Degree of laxity	What actually helps
Mild - early softening of the jawline, some crepiness	Skin-tightening and collagen-stimulating treatments; good skincare and sun protection
Moderate - early jowls, some neck laxity, brow descent	Thread lift, or a combination of energy-based treatments; results are modest and temporary
Marked - clear jowls, neck banding, hooded lids, loose abdominal or arm skin	Surgery. Non-surgical treatment will not produce the result you are picturing.

An assessment that tells you a course of non-surgical treatments will fix marked laxity is selling you something. Equally, surgery for mild laxity is more than the problem warrants. The point of a consultation is to place you honestly on this table.

Non-surgical options

• Skin needling - collagen stimulation, in a course
• Laser resurfacing - improves skin quality and produces some tightening
• Thread lift - repositions tissue using absorbable threads; a genuine lift, but a modest and temporary one. From $4,600 including GST as at September 2024.
• Dermal fillers - restore lost volume, which can improve the appearance of descent without lifting anything
• Cosmeceutical skincare - retinoids and antioxidants, supporting rather than driving a result

Surgical options

Performed by our Specialist Plastic Surgeons.

• Facelift and neck lift - $20,000 to $50,000
• Brow lift - from $10,000
• Blepharoplasty - upper $8,000 to $12,000, lower $9,000 to $13,000, both $15,000 to $18,000
• Abdominoplasty, arm lift and thigh lift for body laxity

All prices include GST, as at September 2024, and are ranges because the operation is scaled to the person. Surgery leaves permanent scars, placed as inconspicuously as the anatomy allows.

Since 1 July 2023, a referral is required before consultation for cosmetic surgery in Australia. A cooling-off period applies before surgery is booked.

What results are realistic

Non-surgical treatment produces improvement in skin quality and, at best, a modest lift. It is repeated to maintain, and it works best on mild to moderate laxity.

Surgery produces the larger change and lasts far longer, but it does not stop ageing - tissue continues to descend from the new starting point.

Neither approach makes skin behave as it did at twenty-five. Individual results vary with skin quality, age, degree of laxity and how the skin heals.

Risks

Non-surgical: bruising, swelling, redness, asymmetry, palpable or visible threads, thread extrusion or migration, infection, pigment change after energy-based treatment, and under-correction.

Surgical: bleeding, haematoma, infection, permanent scarring, poor or delayed healing, numbness or altered sensation, nerve injury (including temporary or, rarely, permanent facial nerve weakness), asymmetry, skin loss, anaesthetic complications, blood clots, and the possible need for revision surgery.

See risks and complications of cosmetic surgery in full before proceeding.

Prevention

Sun protection does more to preserve skin quality than any treatment will later recover. Not smoking, avoiding large weight fluctuations and a consistent skincare routine all help.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form. Consultations: Cosmetic Doctor $150, Specialist Plastic Surgeon $350, including GST as at September 2024.

Related: skin ageing, deep lines and wrinkles, all skin conditions.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.