Yes, loose skin is a completely natural part of ageing. Your face isn’t just skin, it’s a whole structure working together. You’ve got bone underneath, muscles, fat and collagen and then the skin on top. As we age, all of these layers change.

We lose volume because fat pads shrink and collagen production slows down. Then on top of that, the skin itself loses elasticity from factors such as sun exposure, facial movement, stress, lifestyle and just living life.

Results from sagging skin treatments vary depending on the type of treatment. Profhilo Structura typically lasts 6-12 months, with optimal results appearing 4 weeks after the first treatment and improving further after the second treatment at 4 weeks apart. Most patients benefit from maintenance treatments every 6 months to sustain results. Dermal fillers usually last 6-18 months depending on the filler type and area treated. Skin-tightening treatments like laser and radiofrequency stimulate collagen production, so results continue to improve over 3-6 months after treatment and can last 12+ months. For long-lasting improvement, a series of treatments is often recommended. The Thames Face Lift is a completely customized approach, so longevity depends on your individual treatment plan—Dr Hemming will discuss expected results and maintenance schedules during your consultation.

Sagging skin develops because the structures responsible for keeping the skin firm change over time. Collagen and elastin production reduces with age, making the skin thinner and less able to resist stretching and gravity.

Other factors can contribute to sagging skin, including:

• repeated UV exposure
• genetics
• smoking
• hormonal changes
• significant or rapid weight loss
• pregnancy
• changes in facial fat and underlying bone
• natural ageing of the supporting tissues

Hormonal changes, particularly the reduction in oestrogen around menopause, can contribute to changes in collagen, skin thickness and elasticity. The cause and depth of the laxity are important because different treatments reach different layers of the tissue.

Yes. Mild to moderate sagging or loose skin can often be improved without surgery using treatments that stimulate collagen and remodel the skin and deeper tissues.

At Thames Skin Clinic, non-surgical skin-tightening options include Fotona laser treatment, Secret RF, Secret PRO, HIFU, Laser Genesis and microneedling. Injectable collagen stimulators and regenerative treatments may also be incorporated where appropriate.

These treatments cannot reproduce the degree of tissue removal or repositioning achieved with surgery, particularly where there is significant excess skin. The aim is to improve firmness, skin quality and tissue support while maintaining a natural result.

They are related, but they are not the same thing.

Sagging skin describes skin and tissues that have become less firm and have started to loosen or descend.

Volume loss occurs when facial fat compartments and underlying structural support reduce or change with age.

The two frequently occur together. For example, loss of cheek support can allow the tissues of the lower face to descend while reduced collagen makes the overlying skin less able to maintain its shape. This is why simply tightening the skin may not always be enough and simply adding volume may not be appropriate either.

Skin laxity can occur across many areas of the body.

At Thames Skin Clinic, treatment may be considered for areas including the following:

• face
• jawline
• neck and décolletage
• upper arms
• abdomen
• thighs
• areas of laxity following weight loss or changes in body shape

The appropriate treatment depends on the thickness of the skin, the amount of underlying fat and the degree of laxity.

Yes.

There are several treatments that stimulate the skin and deeper tissues without adding an injectable product.

At Thames Skin Clinic these include Fotona laser treatment, Secret RF, Secret PRO, HIFU and Laser Genesis, depending on the area and the depth of treatment required. These technologies work differently but share the aim of stimulating tissue repair, collagen formation and remodelling. 

Medical skincare also plays an important role in improving and maintaining skin quality, although skincare alone cannot correct significant tissue laxity.

We have several technologies because there is no single ideal treatment for every type of loose or sagging skin. The treatment we recommend depends on the area, depth of laxity, amount of underlying fat, skin quality and your desired downtime.

• Fotona laser treatments can be adapted to work at different tissue depths. Fotona protocols can be used for facial and neck laxity as well as body treatments where skin tightening and body contouring are required.
• Secret RF combines microneedling with radiofrequency energy to stimulate collagen at selected depths within the skin.
• Secret PRO combines radiofrequency microneedling with fractional resurfacing where deeper collagen remodelling and improvement of surface texture are both required.
• HIFU uses focused ultrasound to target deeper tissue layers and stimulate tightening without treating the surface of the skin.
• Laser Genesis provides gentle non-ablative collagen stimulation and can be useful when overall skin quality and mild laxity need improvement.
• Microneedling stimulates a controlled healing response and collagen production and can be used on the face and body for mild skin laxity and texture concerns.
• Body contouring treatments may also form part of the plan where loose skin occurs alongside changes in fat or body shape. Thames also offers truSculpt iD as part of our body contouring options and Fotona can be used where skin laxity and body contour changes occur together.
• Injectable collagen stimulators and regenerative skin treatments may also be combined with energy-based treatments where improving skin quality and collagen support is required.”

Explore our skin tightening treatment hub page to learn more about the technologies available and how we approach different types of skin laxity.

Medical skincare can improve the quality, hydration and resilience of the skin and help protect collagen from further damage.

At Thames Skin Clinic, we may recommend ZO Skin Health as part of a wider skin-tightening programme, particularly where sun damage, poor skin quality, pigmentation or reduced barrier health are also present.

Ingredients that support healthy skin renewal, antioxidants and daily broad-spectrum SPF can help maintain healthier skin. However, skincare cannot physically reposition significantly sagging tissue or replace lost structural support. Where laxity is more established, in-clinic collagen-stimulating or tightening treatments are usually required.

Yes, particularly when laxity is mild and reduced collagen and skin quality are contributing to the problem.

Microneedling creates controlled micro-injuries within the skin. This stimulates the natural healing response and new collagen production. Radiofrequency microneedling, such as Secret RF, goes further by delivering radiofrequency energy through the needles into selected depths of the tissue. This provides both the mechanical stimulation of microneedling and controlled thermal stimulation to encourage more significant collagen remodelling.

For more advanced laxity, microneedling alone may not provide enough tightening, and another treatment or combination approach may be more appropriate.

Downtime depends on the skin tightening treatment.

• Gentler treatments such as Laser Genesis usually involve very little interruption to normal activities.
• HIFU generally has minimal visible downtime, although tenderness or swelling can occur.
• Following radiofrequency microneedling with Secret RF, there may be redness, swelling and small visible treatment marks for a short period.
• Secret PRO and more intensive laser resurfacing treatments can involve greater recovery because the surface of the skin is also being treated.
• Fotona treatments vary considerably depending on which laser mode and intensity we use.

We discuss expected recovery as part of your treatment plan so that the treatment can be matched to both your skin and the amount of downtime you are comfortable with.

Yes. Significant or rapid weight loss can make loose or sagging skin more noticeable because the skin may not contract at the same rate as the underlying volume is lost.

When body or facial volume reduces, the overlying skin has less tissue underneath it providing support. If the skin has good elasticity, it may gradually contract. However, following significant or rapid weight loss, particularly when collagen and elastin have already reduced with age, loose skin can become more noticeable.

Facial weight loss can also reduce the volume of the fat compartments that support the cheeks, temples and lower face, making both hollowness and sagging more apparent.

Treatment therefore needs to establish whether the problem is primarily loose skin, loss of volume or both.

The number and spacing of skin-tightening treatments varies according to the technology, treatment area, degree of laxity and the response of your tissues.

Many collagen-stimulating treatments work best as a course rather than as a single treatment. Each treatment stimulates a biological repair process, and collagen then develops and remodels over the following weeks and months. We may also use different treatments sequentially if different layers of the tissue need addressing.

This is one of the most important questions in facial rejuvenation because loose skin and facial volume loss are different problems but frequently occur together.

If support has been lost from the facial fat compartments or underlying structure, tightening the skin alone may not restore natural facial proportions.

If facial structure and volume remain good but the skin has become lax, adding filler may create unnecessary fullness rather than treating the cause.

Many patients have several changes occurring together including reduced collagen, volume loss, tissue descent and skin laxity. At Thames Skin Clinic, our THAMES assessment looks at the face as a whole and assesses the different tissue layers before treatment is recommended.

Your plan may therefore involve skin tightening, volume restoration, collagen stimulation or a combination of treatments. The aim is not simply to make the face fuller or tighter but to restore support, improve skin quality and achieve a natural result.