Loose change: How to treat sagging skin

New ways to prevent your skin from losing firmness, volume and elasticity.

LOOSE CHANGE
Skin tends to get thinner as we age, losing volume, firmness and elasticity. It usually starts to bother us in our 40s, says Dr. Nick Carr, head of the division of plastic surgery at the University of British Columbia. Sun damage and smoking are at fault, as is a slowdown in collagen production and the hormonal changes associated with perimenopause.

AT HOME
There is no harm in using topical products that promise to lift sagging skin—as long as you’ve got realistic expectations. “They can thicken the dermis a bit, and maybe when you pinch your skin it will feel firmer, but the results won’t be dramatic,” says Dr. Nowell Solish, an assistant professor of dermatology at the University of Toronto.. Products like Dermalogica Age Smart Overnight Repair Serum and Chanel Ultra Correction Lift-Intensive Lifting Concentrate can have a modest impact, thanks to peptides that increase production of skin-plumping collagen, hyaluronic acid and elastin.

ON YOUR LUNCH HOUR
The newest facelift alternative for lax skin around the eyelids and jaw is Ulthera, a 30-minute treatment that uses ultrasound therapy to lift and tighten. Aside from mild flushing and sensitivity, there’s no downtime—but not everyone’s skin responds, says Solish. A surer bet may be hyaluronic-acid fillers, such as Juvederm or Restylane.

ON YOUR WEEK OFF
If derm’s-office procedures can no longer firm loose skin, “surgery is the best treatment,” says Carr. “The biggest new thing is fat transfer, which involves taking a fat graft from the tummy or thighs [via liposuction] and then re-injecting it around the brows, eyelids, cheek-bones or lips.” Downtime is about one week, but expect to have two or three procedures, since less than one-half of what is injected survives the transfer. The other development is in facelifts and brow lifts, which have become both less invasive and more natural-looking. “Surgeons now know how to avoid that windblown look,” says Carr. “They use the deep plane facelift, which places tension in the deeper fat and fascia layers instead of just the skin on top.” Plan on several weeks of recovery time, or consider a short scar facelift or endoscopic brow lift: Both involve fewer incisions and less downtime (about two weeks) and produce a subtler effect.