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2025.07.07
Permanent Edition: Why Does the Face Sag? A Plastic Surgeon Explains Thoroughly! Part 1
“Confident women are beautiful” is the core belief driving our pursuit of aesthetic medicine that positively transforms lives. Our specialty treatments include custom-designed hyaluronic acid injections and thread lift procedures that deliver natural-looking lifting results. We are also highly skilled in breast augmentation surgery that achieves a natural and beautiful bust line. As a KOL for Purreal Tri-Fill Pro, I actively promote advanced technologies, characterized by a meticulous approach to identifying only the necessary treatments. I strive to support each individual in rediscovering confidence in their inherent beauty and taking steps toward a life filled with happiness.
Hello,My name is Yuyu Okubo from BIANCACLINIC!
To have beautiful lips, use beautiful words.
To have beautiful eyes, look for the good in people.
――Audrey Hepburn
Growing olderIt is not about losing beauty. Rather, it is about the person's life and values shining through.The process of cultivating a unique and unparalleled "impression beauty"That's what I think.
This time, through sagging treatment, we will work alongside our patients.“The Ideal Way to Age”To walk that path, firstMedical Explanation of the Causes of SaggingWhile doing so, I would like to discuss the importance of well-aging.
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Causes of Facial Sagging
The face has multiple supporting ligaments at the yellow positions shown in Figure 1.
To prevent skin and fat from sagging due to gravity,As shown in Figure 2, ligaments are firmly attached to deep tissues such as bones and fascia.
As one agesThe ligament itself has weakened.When you can no longer be supported,The skin, fat, and fascia sag and become loose.。
Figure 1
Left side: Superficial fat layer
Right side: Deep fat layer
Yellow line: Suspensory ligament
Blue: Areas where fat increases with age
Red: Areas prone to sagging due to age-related fat loss
Figure 2(Source: https://www.allerganbeauty.jp/column/sagging)
As shown in Figure 3, the face is divided into Sectors 1, 2, and 3, with supporting ligaments between each Sector (I'm simplifying slightly for clarity).
In other words, the space betweenSkin and fat form a hammock structureThat is the case.
Facial fat tends to decrease in some areas and increase in others as we age. Particularly...Fat in Sector 2 increasesPart.
ThereforeSagging cheeks, especially around Sector 2That's why.
Figure 3(Source: Besins et al.'s Sector diagram, 2004)
As shown in Figure 4, with agingBones also atrophyI will do so.
Figure 4(Quoted from: "Facial Filler Injection Secrets and Area-Specific Techniques" by Kazumi Iwaki, 2017, Kakuseido Publishing)
Temporal bone atrophy→Moss on the temple
The bones around the eyes atrophy → The space where the eyes are housed, called the eye socket, expands →sunken eyes
Atrophy of the jawbone →Irregularities in the facial contour
Since some supporting ligaments are continuous with the skin and bone,When bones atrophy,The skin was pulled taut and indented,Unevenness appears on the face.
Sagging centered around Sector 2, and unevenness appearing on the face and jawline。
This isChanges in the deep layers of the faceis.
Changes in the superficial layers of the faceAs for,Skin sagging due to a decrease in elastin and collagen in the dermiswill appear.
Skin laxity in the superficial layer + laxity in the deep layer = ”the laxity that concerns our patients” will be.
Therefore, when we receive consultations regarding ”sagging,” we assess which layers are involved.
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■ Not "resisting" but "adjusting"
There are various methods for treating sagging skin, but I prioritize "rejuvenating" rather than "fighting" it.
We believe the essence of sagging skin treatment lies in drawing out a “natural youthful appearance” by combining HIFU, Voluma, thread lifts, injectable treatments, liposuction/fat grafting, Embrace RF, and facelifts—all while carefully considering each patient's unique bone structure, facial features, and values.
Next time, we'll reveal everything about sagging treatments with actual cases! We'll explain it all.
Through treatment, let's work together to cultivate the beauty that is uniquely yours right now.
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※There are various approaches to aesthetic medicine, and opinions and practices may differ among physicians. Please consider the information provided here as one reference only, and we hope you will choose medical care that suits you and meets your expectations.
We apologize if any unintended inaccuracies or misleading expressions were included. In such cases, we will make appropriate corrections or additions.
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