At a certain point, you notice it: the skin feels different. Less firm, less elastic. In the mirror, you see that the contours are getting softer. This is normal — and no reason to panic. But it is not inevitable either. The question is simply: what actually helps?
Why the skin loses its elasticity
To understand what helps, you first need to understand what is happening. Skin ageing starts earlier than most people think — collagen breakdown begins as early as the mid-twenties. From the age of 25, the skin loses roughly 1–1.5% of its collagen per year. That sounds like very little, but it adds up significantly over the years.
Three factors work together:
- Collagen loss: Collagen gives the skin its structure and firmness. Less collagen means less support
- Elastin breakdown: Elastin is responsible for the skin's ability to snap back after being stretched. Once broken down, the body barely produces new elastin
- External factors: UV exposure (photoageing), smoking, diet, hormones (especially during menopause), and lack of sleep all accelerate the process considerably
Hormonal changes play a particularly significant role: in the first five years after menopause, the skin can lose up to 30% of its collagen. This explains why many women notice a sudden change during this phase.
Where it shows the most
Not all areas of the face age at the same rate. The areas where loss of elasticity becomes most visible:
- Cheeks and jawline: The contours become softer, the cheeks sag slightly. Drooping jowls change the profile noticeably
- Neck: The skin on the neck is particularly thin and has fewer sebaceous glands. Horizontal lines and a "turkey neck" appear here first
- Decolletage: Like the neck, the decolletage is often exposed to UV radiation but rarely adequately protected
- Hands: Often overlooked, but the hands reveal age faster than the face — thin skin, visible tendons, volume loss
What does NOT help
I want to be honest, even if this is not what everyone wants to hear:
- Creams with "lifting effects": No cream can tighten sagging tissue. Film-forming agents create a brief sensation of tightness, but no structural change. Good skincare matters — but as prevention, not therapy
- Face yoga and facial exercises: A popular trend, but the evidence is thin. Repeated muscle movements can actually deepen wrinkles — the exact principle that causes expression lines
- Home remedies like egg-white masks or cucumber slices: Briefly cooling and moisturising, but with no effect on the skin's structure
- Supplements alone: Collagen drinks and capsules can be supportive, but they cannot reverse skin that has already become lax. They are a complement, not a solution
What actually helps
The good news: effective treatments exist — and they do not have to be invasive. I categorise them by intensity:
Mild: Prevention and first steps
For patients in their late twenties to mid-thirties who are noticing the first signs or want to prevent them:
- Skinboosters: Micro-injections of hyaluronic acid directly into the upper skin layer. They improve hydration and skin elasticity. Ideal as an entry point and for prevention
- Mesotherapy: Cocktails of vitamins, amino acids, and hyaluronic acid that nourish the skin and stimulate collagen production. Particularly good for a fresh complexion
Moderate: Active skin improvement
For visible elasticity loss that goes beyond the first signs:
- Profhilo: Bio-remodelling with highly concentrated hyaluronic acid. Tightens and hydrates the skin while stimulating collagen and elastin. One of my favourites for face and neck — the results after 2 sessions are often impressive
- Polynucleotides (PDRN): DNA fragments that activate cellular repair. Particularly effective for dull, lacklustre skin and the delicate under-eye area. They work at the cellular level — the skin regenerates from within
Advanced: Intensive stimulation
For pronounced sagging that requires targeted intervention:
- Radiesse: Calcium hydroxylapatite microspheres that have a powerful collagen-stimulating effect. It acts as a biostimulator — the skin builds new collagen over months. Particularly effective along the jawline and cheeks
- Combination therapies: The best results are often achieved with a step-by-step concept that combines different treatments — for example, polynucleotides for the cellular foundation, Profhilo for hydration, and Radiesse for collagen stimulation
Neck and decolletage: Why this area is special
The neck and decolletage are the areas most frequently neglected — and the most difficult to treat. Why?
- The skin is significantly thinner than on the face
- Fewer sebaceous glands mean less natural moisture
- Years of UV exposure without adequate sun protection
- Traditional fillers are often not ideal here — the thin skin shows irregularities immediately
What works best here: Profhilo (specifically approved for the neck and backed by studies), polynucleotides for skin renewal, and skinboosters for baseline hydration. I avoid volumising fillers on the neck in most cases.
My treatment approach
In my practice, I always address elasticity loss systematically:
- Analysis: Where exactly is the elasticity loss most pronounced? What is the overall skin quality like? Which factors are accelerating the process (UV, smoking, hormones)?
- Skin quality first: Before I even think about volume or contour, I improve the skin quality. Polynucleotides, Profhilo, or skinboosters as a foundation. This takes 4–8 weeks, but it is always worth it
- Volume and contour only if needed: Not every case of sagging skin requires filler. When skin quality improves, many cases already look significantly better. Only once the foundation is right do I correct selectively — for example, with Radiesse along the jawline
- Maintenance: Skin quality is not a one-off project. Touch-ups every 6–12 months maintain the result. This also includes good sun protection and the right skincare routine
My conclusion
A few years ago, I would have reached for fillers almost automatically when treating sagging skin. Today, I start most cases with biostimulation — and I am consistently surprised by how much changes simply from improving the skin quality. Some patients end up not needing any filler at all, because the skin tightens from within.
Sagging skin is not a foregone conclusion. But the order in which you treat matters. Getting that sequence right is the difference between "looking great" and "looking overdone." If you are wondering where you stand and what makes sense for your skin, let us discuss it in a personal consultation.
