What Exactly Is Skin Laxity?
In simple terms, skin laxity describes the condition of having loose skin. According to Dr. Amy Lewis, a dermatologist in New York City, this condition arises from the reduction in collagen and elastin levels. “Collagen is the primary structural and most plentiful protein in our bodies, serving as the cornerstone of skin health,” she explains. Unfortunately, collagen production begins to decrease by 1% annually starting in our 20s. Alongside this, elastin, a protein responsible for the skin's elastic properties, also diminishes. “Elastin acts like a spring within the skin's fibers, enabling it to snap back into place after stretching,” Dr. Lewis notes. To illustrate, she compares these proteins to a Slinky toy, where the metal coils symbolize collagen and the spring's ability to return to its original shape represents elastin. As we age, coupled with poor lifestyle choices and genetic factors, the loss of these proteins leads to sagging skin. However, advancements in dermal fillers and skin-tightening lasers offer non-invasive solutions to help rejuvenate the skin.
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What Causes Skin Laxity?
As individuals grow older, significant changes in skin texture are common. While wrinkles and fine lines are noticeable, sagging skin is another concern. Although aging is a major factor, several other elements contribute to skin laxity. “Genetics, sun exposure, diet, lifestyle, stress, and smoking are the primary culprits,” Dr. Lewis observes. She also emphasizes that skin aging can be influenced by various factors beyond genetics, including lifestyle habits, diet choices, hydration levels, and exposure to sunlight or harmful chemicals. “Additional causes include significant weight loss, repetitive facial movements, chronic stress, and gravity's effects,” she adds. Patients who have faced serious illnesses, whether metabolic, cancer-related, or stress-induced, are also more susceptible to increased skin laxity.
Dr. Jason Emer, a board-certified dermatologic surgeon in West Hollywood, California, believes that skin laxity is largely determined by genetic factors. “Some people naturally sag more with age, while others experience early sagging due to hormonal shifts, like after childbirth, or weight fluctuations from yo-yo dieting or marathon running,” he explains. While genetic predispositions are largely uncontrollable, lifestyle changes such as avoiding smoking, limiting sun exposure, and consuming an antioxidant-rich diet can help mitigate free radical damage. “By taking steps to reduce collagen and elastin degradation and enhance their production, skin laxity can be slowed or even partially reversed,” Dr. Lewis advises.
The Different Types of Skin Laxity
Skin laxity can be categorized into mild, moderate, and severe degrees. “Mild laxity is noticeable in the jowls and midface but not significantly in the neck,” Dr. Emer describes. As the condition progresses to moderate and severe stages, the neck becomes more visibly saggy with wrinkles, jowls form around the mouth, and neck muscles become more prominent. Individuals with significant neck structure loss or extensive loose skin often require surgical intervention, according to Dr. Emer.
Historically, many patients sought fillers to address skin laxity, but the results were often unsatisfactory due to limited non-surgical lifting options. Radiofrequency treatments emerged as an alternative, though their effects were short-lived, lasting only a few weeks. “These treatments are akin to skin workouts; without consistent use, the results diminish, and sagging resumes,” Dr. Emer notes. Today, more effective non-invasive treatments like ultrasound and microneedling radiofrequency procedures are available.
Treatments for Mild Laxity
For those with mild laxity and minor neck jowling, Thermage or Ultherapy are recommended as reliable skin tightening methods. Thermage, a high-energy radiofrequency treatment, can be performed once or twice a year. Its newer version, Thermage FLX, is versatile, treating laxity in various body areas, including the arms, thighs, abdomen, and buttocks. Ultherapy uses ultrasound to generate heat beneath the skin's surface, promoting tightening. Microneedling radiofrequency treatments like Fractora and Morpheus are also effective in stimulating new collagen production. Fraxel and eMatrix lasers, utilizing fractionated technology and radiofrequency heat, are excellent for collagen regeneration.
Dr. Emer often recommends Fractora or Morpheus for their minimal pain and noticeable results. These treatments can be applied to wrinkly areas like the knees, elbows, and chest, and even for vaginal tightening. They can be performed every two to three months and combined with annual Thermage or Ultherapy sessions. “Combining treatments addresses underlying tissue, muscles, and texture,” Dr. Emer explains, noting that while non-invasive treatments can be costly over time, they offer a good alternative to surgery for those averse to lengthy recoveries. For some, a mini facelift remains an option for mild neck and jowl laxity.
Another non-invasive option is threading, which involves inserting internal sutures through small punctures to lift and tighten the skin. Immediate results are visible, and over time, the dissolvable stitches boost collagen production. Silhouette InstaLift and PDO NovaThreads are examples of such treatments, lasting up to a year and 6 to 12 months, respectively.
Related: The Lesser-Known Eye Lift Procedure Gaining Popularity in Hollywood
Treatments for Moderate Laxity
For patients with moderate laxity who prefer non-surgical options, treatments like ThermiRF, FaceTite, or Renuvion can be beneficial. ThermiRF involves heating the tissue beneath the skin through a small puncture, often resulting in a “pseudo neck lift.” FaceTite delivers electrical energy via a probe, and Renuvion uses helium-derived plasma and radiofrequency energy. These treatments, requiring expertise to avoid skin burns, offer results lasting two to three years with minimal recovery time compared to surgery. “While they don't replace a neck lift, they provide about 20% to 30% of its effects in one session,” Dr. Emer notes. These treatments are sometimes combined with liposuction.
Treatments for Severe Laxity
Non-surgical devices may not effectively address severe laxity resulting from childbirth or significant weight loss. In such cases, surgical options like a tummy tuck or body lifts (arms, breasts, thighs) are recommended. The same applies to facial laxity; maintaining a facelift's results requires ongoing treatments like Morpheus every three months and Thermage or Ultherapy annually. “Even with a $30,000 facelift, regular maintenance is crucial to prevent reverting to the natural aging process,” Dr. Emer emphasizes.
