Skin Laxity: Why It Happens and What Can Realistically Be Done

Skin laxity is one of the most common concerns patients bring to The London Road Clinic, and one of the most important to approach with honesty. The treatments available for it genuinely work for the right patient in the right situation. They also have real limits, and presenting non-surgical treatment as an equivalent to surgical correction does a disservice to the people considering it.

This article explains what actually drives skin laxity, which treatments address which parts of the problem, and how to think about what is realistic for your situation.

What actually causes laxity

The visible softening and descent of facial tissue is not driven by a single factor. It is the cumulative result of changes happening simultaneously at multiple levels beneath the skin.

Collagen and elastin decline. The skin’s structural proteins, explained in more detail in our guide to collagen, elastin and hyaluronic acid, reduce in quantity and quality with age. The dermis becomes thinner and less supported.

Fat pad atrophy and descent. The face contains multiple discrete compartments of deep fat that provide volume and structural support from below. With age, these fat pads both shrink and descend.

Bone resorption. The facial skeleton slowly reduces in volume with age. The orbital rim, the mid-face and the mandible all resorb, reducing the structural foundation on which overlying tissue rests.

Skin thinning. The dermis gradually thins with age and UV exposure, becoming less able to provide structural support to the tissue above it.

Where laxity tends to present

Lower face and jowls. The most common concern. As the deep fat descends and the mandible resorbs, the overlying tissue follows gravity, creating fullness at the jowl and loss of definition along the jawline.

Neck. Skin laxity at the neck is compounded by the platysma muscle, which forms bands as it slackens with age.

Midface. Volume loss and fat pad descent create a flattened, tired mid-face.

Non-surgical treatments: what they address

Forma radiofrequency uses controlled heat to stimulate collagen production in the dermis and provide gentle tightening. It is well suited to mild laxity at the lower face, jawline and neck. Forma is a maintenance treatment as much as a corrective one.

Fractora fractional radiofrequency microneedling delivers more significant dermal remodelling than surface radiofrequency by combining needle penetration with deep energy delivery. For patients where skin quality and moderate surface laxity are the primary concern, it produces stronger collagen remodelling than Forma.

Profhilo addresses the skin quality component of laxity, improving hydration and stimulating the body’s own collagen, elastin and hyaluronic acid production. Where the skin looks and feels thin, crepey or poorly supported, Profhilo is often one of the most noticeable improvements a patient can make.

Dermal filler for structural support is one of the most overlooked elements of laxity management. When volume is restored to the cheeks, temples and along the jawline, the overlying tissue is structurally supported. This approach works well for mild to moderate laxity. It is genuinely and significantly oversold in cases of substantial descent.

Polynucleotides contribute to the skin quality component, improving firmness, texture and hydration at the dermal level.

Where non-surgical treatment reaches its limit

For mild laxity, non-surgical treatment works well. A combination of radiofrequency, collagen-stimulating treatment and appropriate structural filler can produce results that are genuinely visible and that last with maintenance.

For significant jowling, marked neck laxity or substantial tissue descent, non-surgical treatment cannot replicate what a surgical approach achieves. At The London Road Clinic, we say this at consultation rather than suggesting it can be managed non-surgically when it cannot. Dr Shahe Boghossian’s background includes surgical assessment, and where a surgical discussion is appropriate, we will have it honestly.

Frequently asked questions