Hatate, Ariko
2026.02.04
Sagging face, what is the right choice? A true explanation of all treatments with and without cutting.
As a plastic surgeon, he has experienced many cases and has developed precise techniques and a deep anatomical understanding. Currently, combining his knowledge of plastic surgery with the latest technology, he provides a wide range of cosmetic treatments for skin, contouring, sagging, and other concerns of aging. He has also shared the responsibility of writing Japan's first textbook on gynecological cosmetic surgery, "Basic Techniques of Gynecological Cosmetic and Plastic Surgery. From her experience as an idol during medical school, she realized that "natural beauty" goes beyond the will to choose how you want to be, and she focuses on supporting her patients to "love yourself more every day". We are English-speaking and value counseling that is easy to talk to.
Hello, everyone!
Natural and elegant rejuvenationpropose,plastic surgeonのMs. Aliceis.
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'Over the years, my facial lines have become blurred and saggy.'
I'm curious about thread lifts and hyphae, but I'm not sure if they are right for me..."

This is a patient for combined treatment with ↑Embrace RF, liposuction, and thread lift.
When people begin to suffer from facial sagging, many first look up the name of the treatment.
But actually,The first and most important thing in sagging treatment is to know “what is the true nature of your sagging.is.
Sagging of the face is not caused by a single cause.
Skin, fat, muscle, supportive tissue, and skeleton--each change appears in combination.
First,Types of sagging by structureLet's sort out the
Facial sagging is considered "by structure
(1) Sagging skin (loss of firmness and elasticity)
When collagen and elastin decrease due to aging and UV rays,
The skin itself stretches and loses its elasticity.
Features
- Skin feels thin and pinched
- Fine wrinkles are increasing.
- Pulling back up "doesn't bring back the return."
Treatments that can be approached
- RF (volnuma, quantum, etc.)
- HIFU (High-Intensity Focused Ultrasound)
- Skin Rejuvenation System Treatment
- Thread Lift
- Facelift (with skin excision)
Non-surgical treatment is good at “tightening”, while surgical treatment is good at “removing excess skin”.is.
(ii) Sagging fat (change in quantity and position)
With age, fat is not only a matter of "losing" fat, but also of "dropping" fat.
Especially in the cheeks and under the chin, fat droops due to gravity and is noticeable as sagging.
Features
- Ponyo beside the mouth
- Facial line leaning
- double chin
Treatments that can be approached
- Liposuction of the face and under the chin
- RF therapy (Quantum/Facial Tight)
- Fat dissolving injection (for mild cases)
When fat is the cause,Pulling up is not enoughand there is,
A "reduce + tighten" treatment is effective.
(iii) Loosening of supporting tissues (SMAS and fascia)
The SMAS (superficial fascia) under the skin is an important structure that supports the face.
When this area loosens, the entire face appears to drop.
Features
- Cheeks have dropped.
- Lines have deepened.
- Your face looks more square than it used to.
Treatments that can be approached
- HIFU (SMAS irradiation)
- Facelift surgery (SMAS operation)
- Non-surgical treatment is positioned as “supportive” and surgery is positioned as “radical treatment.
4) "Drooping" sagging due to volume loss
When the face is less supported by fat and bone atrophy,
Even if there is no excess skin, it may appear sagging.
Features
- hollow-cheeked
- The temples have lost weight.
- look tired
Treatments that can be approached
- hyaluronic acid injection
- Fat injection
By supplementing support,Natural lifting effectcan be obtained.
(5) Severe and complex type of sagging
In many cases, multiple structures are changing simultaneously,
in this caseDifficult to achieve satisfactory results with single treatmentThat is the reality.
Approach
- Surgery + Device
- Liposuction + RF
- Thread and RF as maintenance after surgery
Combination treatment is the most complete.
Cutting vs. no cutting treatment, in the truest sense of the word.
Treatment without cutting is
✔ Less downtime
✔ Easy to receive
✔ Suitable for regular maintenance
On the other hand,
✔ Effectiveness is limited.
Cutting treatment is
✔ Dramatic and long-term
✔ Radical improvement of sagging
On the other hand,
✔ Large downtime
Neither is better or worse than the other, but it is important to know which is right for your current sagging and your situation.is.
You don't have to suffer alone.
The many causes of regret in sagging treatment,
The result is that the desired results are not achieved because the patient has received a trendy treatment or a treatment that he or she has heard of.
Even if it is the same “sagging”,
Treatment methods vary in combination and order from person to person.
The correct answer lies beyond a professional diagnosis.
Understand the structure of the face,
Diagnosis by a physician with all options of surgery, injections, and devices is the way to go,
It is a shortcut to sagging treatment without detouring.
Not "to cut or not to cut."
"What do I need and what is right for me right now?"。
It is important to calculate and schedule your budget and downtime, and undergo surgery under circumstances that you can properly tolerate.
Why don't we start by finding out what your sagging is?
Choose a doctor or clinic that you are comfortable with!

Author: Arisu Hatade
Board-Certified Plastic Surgeon / Cosmetic Surgeon
After graduating from Kyushu University School of Medicine, he worked in plastic and reconstructive surgery and cosmetic surgery at university hospitals and affiliated facilities, obtaining board certification in plastic surgery.
With extensive experience in a wide range of cases, from facial and trunk reconstructive surgery to cosmetic surgery, I prioritize achieving natural and beautiful results based on anatomical knowledge.
Having worked as an idol during my student days, I possess a unique perspective that understands both “beauty for being seen” and “beauty as medicine.” This allows me to offer customized aesthetic medical treatments tailored to each individual patient.
In my personal life, I love traveling and gourmet food, and I share information about beauty and lifestyle on Instagram.
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career
Graduated from the School of Medicine, Kyushu University
New Tokyo Hospital Initial Training
Jichi Medical University Hospital, Department of Plastic Surgery
Luce Clinic Employment
Shin-Koyama Municipal Hospital Plastic Surgery Department Employee
Teikyo University Hospital Department of Plastic Surgery
JR Tokyo General Hospital Plastic Surgery and Reconstructive Surgery Department Employee
Ariake Hifuka Clinic Employee
Professional Affiliations and Qualifications
Board-Certified Specialist, Japanese Society of Plastic and Reconstructive Surgery
Field of expertise
Cosmetic surgery (eyes, jawline, gynecological procedures, etc.)
Injection Therapy (Hyaluronic Acid, Botox, Fat Grafting)
Laser Skin Treatment
Regenerative Medicine and Anti-Aging Care