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2025.07.08

Permanent Edition: Why Does the Face Sag? A Plastic Surgeon Explains Thoroughly! Part 2

夏目 隆太郎
Supervising Physician
Ryutaro Natsume

A dual-specialty doctor with a background in plastic surgery, bridging cosmetic surgery and ophthalmology. At the university hospital, he performed numerous high-difficulty cases, primarily focusing on eye and facial bone surgeries, cultivating precise techniques grounded in anatomy. He prioritizes achieving both aesthetic beauty and functional safety, offering customized treatments around the eyes that incorporate ophthalmological expertise. He actively utilizes not only incisional surgery but also non-invasive procedures like hyaluronic acid injections. By carefully assessing each individual's condition and unique appeal, he provides bespoke treatments that guide patients toward naturally harmonious, well-defined eyes.

Hello,Plastic Surgeon Ryutaro Natsumeis

【Summary of the First Half】

If you haven't read it yet, click here!https://biancaclinic.jp/blog/43052/

The causes of sagging are classified as follows according to their depth:

Surface ”skin sagging”

”Internal sagging Changes in fat mass, bone atrophy, and ligament laxityFacial contours and sagging centered around Sector 2

 

This time, we'll explain what types of sagging treatments are available and who they're recommended for!

Table of Contents:

”Skin Sagging Treatment

 ・Mophius 8

 ・Potenza

”Internal Sagging Treatment

 ・HIFU

 ・Borneuma

 ・Jalpro Super Hydro/Profilio

 ・Thread Lift

 ・Embrace RF

 ・Facelift

◎Skin Sagging Treatment

・What is Mofius 8?  

(Right: Before → Left: After)

Insert 24 fine needles (microneedles) into the subcutaneous tissue, and from the needle tipsIrradiate with powerful RF (radio wave) thermal energyThis is the treatment.

By intentionally creating micro-injuries in the tissue responsible for producing collagen and elastin within the skin, we activate the skin's inherent ability to heal itself.

Improving skin firmness and elasticity associated with aging, improving acne scars and other scars, andPowerful firming effect against saggingThere is.

In my personal opinion, among mechanical treatments,It is most effective against skin sagging.I'll do it!!

Because it's effective, it's a treatment that involves a bit of pain,We recommend nerve block anesthesia or subcutaneous anesthesia.I will do so.

・Recommended for:

I was not satisfied with the results of treatments like Potenza or Dermapen for skin laxity.

I don't want to cut my skin, but I'm willing to endure some pain to see real results in improving skin laxity.

Treatment Details: https://biancaclinic.jp/treatment/skin-care/skin/morpheus8/

 

・POTENZA

(Right: Before → Left: After)

Similar to Morpheus 8, it inserts ultra-fine needles called microneedles and emits RF energy from the needle tips.

The difference from Mofius 8 is that it performs RF irradiation whileDrug delivery function that introduces medication into the skin There is.

In addition to the dedicated formulation Macum,Rejuran and JuvellookIt is possible to efficiently introduce skin-nurturing preparations!

By utilizing various specialized tips, we address a wide range of skin concerns, including melasma, acne scars and pits, sagging skin, and fine lines.

A needle-free type (diamond tip) is also available, and by continuously irradiating with RF using monopolar and bipolar electrodes with different configurations,

especiallySuperficial Tightening Treatmentis possible.

In any case, compared to Mofius 8, it places less burden on the skin,Characterized by minimal pain and downtimeis.

・Recommended for:

Minimal downtime and as little pain as possible is preferable.

I want to treat not only skin sagging but also melasma and acne.

Treatment Details: https://biancaclinic.jp/medical-spa/skincare/potenza/

◎Treatment for Internal Sagging

・HIFU (High-Intensity Focused Ultrasound) (Device used: UltraCell Zi)

 

 

 

 

HIFU is a lifting treatment device that utilizes high-intensity focused ultrasound energy.

Concentrated thermal energy is applied to the deep SMAS layer—the skin's foundational layer—to lift sagging skin from deep within.

In addition to lifting sagging cheeks and double chins, it can also be applied around the eyes, making it effective for fine lines around the eye area.

・Recommended for: 

I want to improve sagging without any downtime.

 

Treatment Details: https://biancaclinic.jp/treatment_category/aging-care/aging_02/hifuzi/

 

・Borneuma

Boruneuma is a pain-reducedNext-generation non-invasive radiofrequency (RF) therapy deviceis.

This treatment delivers heat deep within the skin while minimizing damage to the epidermis, achieving a lifting effect.

・Difference from Hyufu:

Hyuf: During treatment, a snapping sensation, lifting effect, targets the deep SMAS layer of the skin, prone to sagging if improperly applied

Volnuma: Feeling of heat during treatment,A tightening effect that makes the skin cling tightlyTargets the dermis to the middle layer of fat near the skin surface, tightening the fibrous septa of fat.Resistant to moss growth

→Because the target audience differsYou'll feel the effects more when used together.

・Differences from other RF equipment: 
Featuring unique cooling and vibration functions along with a specially designed rounded tip, it minimizes discomfort.

・Recommended for: 

I want to improve sagging without any downtime.

I'm especially bothered by the Ponyo around my mouth.

I don't want to fail

Treatment Details: https://biancaclinic.jp/treatment/faceline/faceline_2/volnewmer/

・Jalpro Super Hydro/Profilio

The foundation of the skin for treatmentsTargeting the dermis and ligamentsIt is a type of skin rejuvenation injection.

Reinforce the supporting ligaments,Improve ligament laxity and skin saggingand,Lift naturally from withinwill be done.

 

・ Jalpro Super Hydro,Profiling Usage Differentiation

Jalpro Super Hydro: When used in combination with mechanical treatments such as HIFU or Voluma, if Profhilo was ineffective (due to underlying nutrient deficiency)

Profil: Strong efficacy when used as monotherapy

・Recommended for people like this?

I want to increase the effectiveness of mechanical systems.

I have reservations about surgical procedures like thread lifts.

I've summarized the differences on my blog! If you're interested, check it out here:https://biancaclinic.jp/blog/43005/

 

・Thread Lift

First Half of the Blog https://biancaclinic.jp/blog/43052/

As explained, increased fat in Sector 2 and overall sagging are major contributors to skin laxity.

Fat loss in Sector 3 causes sunken temples and cheeks.

Therefore, by lifting the fat in Sector 2 toward Sector 3 using thread lifts, we reposition the fat while eliminating sagging.

 

(Left: Before surgery / Right: 3 months after surgery / BIANCA LIFT 6 units)

 

 

Fat distribution changes with age, increasing in some areas and decreasing in others, resulting in facial contours with unevenness. Therefore, liposuction may be combined with other procedures to adjust overall facial volume.

(Left: Before Surgery Right: 3 Months After Surgery Facial Contouring Liposuction + Buccal Fat Removal + Thread Lift + Chin Hyaluronic Acid)

 

・Embrace RF

 

”Non-Surgical Facelift”Embrace RF, also known as...

Without incisions, RF (radiofrequency) energy is applied from within the skin to powerfully tighten sagging skin on the face and body.

 

Insert the long, thin cannula attached to the handpiece subcutaneously into the fat layer and skin surface.Direct RF irradiationby doing so

Extremely strong tightening and lifting effectThere is.

As introduced in the ”Internal Sagging Treatment,” it also targets the dermis, making it effective as a ”skin sagging” treatment.

Heated excess fat melts away, and by combining it with liposuction at the end, it achieves a refined finish without any lumpy fat.

Heating also provides a hemostatic effect, resulting in less swelling compared to liposuction alone and a lower risk of bleeding or hematoma formation.

・Recommended for: 

I'm hesitant about facelifts that involve incisions, but I want significant change.

Mofius 8, I also want to have liposuction and thread lift done at the same time.

 

Treatment Details:https://biancaclinic.jp/treatment/face/embrace/

”Treatment for ”Skin Sagging” + ”Internal Sagging"

・Facelift

(Left: Pre-operative Right: 1 month post-operative Deep Plane Facelift)

This procedure involves making incisions along the hairline and at the base of the ears, lifting the fascia while simultaneously tightening sagging facial contours.
It can improve localized sagging in areas such as the outer corners of the eyes, cheeks, nasolabial folds, and jawline.

Recommended for people like this:

can take time off

Even with an incision, I want the maximum lifting effect.

Treatment Details: https://biancaclinic.jp/treatment_category/aging-care/aging_01/facelift/

 

■ The Choice of Well-Aging

I don't think the feeling of "not wanting to look old" is inherently bad. However, becoming overly fixated solely on "wanting to look young" can lead to denying your own strengths and the accumulation of your life experiences.

Here, I'd like to share another quote from Audrey Hepburn.

Growing older means carving life into your face.

A woman's beauty only grows with the passing years.

Audrey's lifelong beauty never stemmed from the absence of wrinkles. It was the kindness and intelligence radiating from within her, along with her pride in aging gracefully, that captivated people.

■ What Cosmetic Surgery Can Do

Aesthetic medicine is one option for enhancing your life.

Many people are concerned about sagging skin but hesitate, thinking, "Surgery is scary" or "I don't know what's right for me."

For those individuals, I would like to carefully listen to your story and work together to find your own path to "well-aging."

Growing old gracefully means not fighting against age, but cherishing yourself while making the best choices for each stage of life.

It is also a journey toward the kind of beauty that radiates from within, embodied by Audrey Hepburn.

 

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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.

【Profile】

Plastic Surgeon Dr. Ryutaro Natsume

Ryutaro Natsume

Performed numerous facial surgeries, particularly focusing on the eye area and facial bones, in the field of plastic surgery.

Regarding treatments for the eye area, I believe that not only aesthetic appearance but also ophthalmic functionality is extremely important. To provide safer and more reliable treatments, I am currently deepening my expertise as an ophthalmologist.

We actively incorporate non-surgical procedures such as hyaluronic acid injections, in addition to treatments requiring surgical instruments.

From a multifaceted professional perspective encompassing cosmetic surgery, cosmetic dermatology, reconstructive surgery, and ophthalmology

BIANCA CLINIC, a leading Japanese clinic specializing in beauty and regenerative medicine, provides the latest aesthetic treatments.

【Career】

2020: Graduated from Tokyo Medical University Tokyo Metropolitan Saiseikai Central Hospital

2022 Jikei University Hospital Department of Plastic Surgery

2023 Department of Plastic Surgery Jikei University School of Medicine Kashiwa Hospital

2024 BIANCA CLINIC

【Professional Affiliations/Qualifications】

Japanese Society of Aesthetic Surgery (JSAS)

Full Member of the Japan Society of Plastic and Reconstructive Surgery

Full Member of the Japanese Society of Craniofacial Surgery

Full Member of the Japanese Ophthalmological Society

【SNS】

Instagram account 

 https://www.instagram.com/dr.natsume?igsh=OHBvd3VtajV1bmY1&utm_source=qr

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