Facial laxity rarely sits in a single layer. For some it is the superficial dermis; for others, accumulated submental fat; for others again, laxity in the SMAS — and a good number present with all three at once. Choosing a technology therefore begins with identifying which layer is responsible, not with a device name.
Common presentations in this group
- A jawline that has lost definition, with early jowling
- Deepening nasolabial folds and downturned mouth corners
- Skin that no longer feels firm, with pores appearing larger under gravity
- Upper eyelid heaviness and fine lines around the eyes
- A generally tired appearance without pronounced wrinkles
Where facial laxity can originate
Two people can present with what looks like the same concern and have entirely different layers responsible — which is why assessment comes before any choice of device.
Skin and collagen
As collagen and elastin in the dermis decline, skin loses elasticity: it feels loose, pores appear larger, and fine lines become more visible. This is usually the earliest form of laxity to appear and often precedes everything else.
Treatment at this layer delivers energy that prompts the skin to build new collagen — Thermage FLX and Volnewmer using radiofrequency, Sofwave working in the mid-dermis, Titanium Lifting using several laser wavelengths simultaneously, and EXION where hydration and overall skin quality matter alongside firmness.
The fat layer
Fat across the cheeks and under the chin that has accumulated or descended blurs the jawline and creates a double chin. Tightening the surface alone will not address this, because the cause is volume rather than loose skin.
The technologies that act on this layer are ONDA Pro Face, which uses microwave energy targeted at fat cells, and HIFU Sygmalift 3D, which reduces cheek and submental volume to slim the facial contour.
Facial muscle
When facial muscles lose tone, the face reads as flatter and lower even where the skin itself is not especially loose. This group includes patients who want definition restored without their face looking smaller.
EMFACE works at this layer, stimulating muscle alongside treating the skin.
The SMAS
The SMAS is the fibrous layer beneath the skin and fat that supports facial structure. When it becomes lax, sagging is at its most pronounced — and surface tightening cannot correct it.
Ultherapy Prime reaches this layer, and it lets the physician see the tissue planes during treatment so energy is placed exactly where intended.
Combining technologies
In practice, a consultation about a sagging face seldom turns out to involve one layer alone. Submental fat together with SMAS laxity is a common finding — and adding more sessions of a single device will not match what two technologies working at different depths can do, spaced and sequenced as the physician plans.
For a technical comparison of the individual devices — the depth each works at, how long results take to appear, and aftercare — see the Lifting & Tightening devices page.
Frequently asked questions about lifting
At what age should treatment begin?
There is no fixed age. Collagen begins to decline from around 25, but the decision rests on what the assessment actually shows rather than on a number. Anyone noticing a change in the jawline is welcome to come in for an evaluation.
How long do results last?
Generally 6-12 months, depending on the programme, age and self-care. Since ageing continues regardless, these treatments slow and improve the process rather than stop it.
How does this differ from fillers and botulinum toxin?
Programmes in this group stimulate the skin to build its own collagen. Fillers restore volume; botulinum toxin relaxes muscle. The three address different mechanisms and are often used together where the physician judges it appropriate.
Will the result look unnatural?
These technologies work through the skin's own collagen response, so change appears gradually over several weeks rather than altering facial structure immediately.
Is it painful?
Sensation varies by technology and by individual tolerance — some programmes feel warm or produce brief pulses, others are barely felt. What to expect is explained before each session, with pain management provided as appropriate.
Book an assessment
If you are unsure which layer your laxity sits in, an assessment will point you more accurately than choosing by device name. See the other groups on the Treatments page, or the full equipment list under Technology & Devices.
Dr. Supranee consults every Monday, Wednesday, Friday and Saturday, 13.00-18.00.
Individual results vary depending on skin condition, facial structure, and post-treatment care. A physician assessment is recommended before deciding on any treatment.
For enquiries, call 098-829-0922 or 02-118-2828