How to Tighten Sagging Skin on Face: Volume Loss vs. Skin Laxity Treatment
Sagging skin on your face—whether it’s jowls, nasolabial folds, hollow cheeks, or drooping eyelids—makes you look older and tired. While aging naturally causes skin to lose elasticity, most facial sagging after age 40-50 is actually caused by volume loss, not just loose skin.
This is why many people are disappointed when skin-tightening treatments (lasers, RF, creams) don’t deliver the lift they expected. If you don’t address the underlying volume depletion, tightening alone won’t restore a youthful appearance.
Key Insight: After age 40, your face loses ~5-10cc of fat volume per decade. This causes cheeks to hollow, temples to sink, and skin to sag downward. FAMI fat transfer (facial fat grafting) restores lost volume for a natural “lift” without surgery, while Legend RF skin tightening addresses any remaining skin laxity.
Dr. Bill Johnson, board certified cosmetic physician with 1,000+ facial rejuvenation procedures, explains which treatments actually work for sagging face skin—and when FAMI fat transfer is more effective than a traditional facelift.
Why Does Face Skin Sag? Volume Loss vs. Skin Laxity
Understanding the cause of your sagging helps you choose the right treatment:
Primary Cause: Facial Volume Loss (Fat Atrophy)
As you age, your face loses fat in key areas:
- Cheeks: Hollowing causes mid-face to flatten and skin to droop
- Temples: Sunken temples create aged appearance
- Under-eyes: Fat pad descent creates tear troughs and bags
- Jawline: Loss of fat support causes jowls to form
Result: Skin hangs downward because there’s nothing supporting it from underneath. This looks like “sagging” but it’s actually volume depletion.
Secondary Cause: Collagen & Elastin Breakdown (Skin Laxity)
Your skin also loses structural proteins:
- Collagen production decreases ~1% per year after age 20
- Elastin fibers degrade (skin can’t “snap back”)
- UV damage accelerates breakdown
- Weight loss, pregnancy, illness worsen laxity
Result: Even if volume is restored, loose skin may need tightening.
Which Problem Do You Have?
If your face looks hollow, sunken, or gaunt: Volume loss is primary → FAMI fat transfer best solution
If your face looks droopy with visible jowls but not hollow: Mixed (volume + laxity) → FAMI + Legend RF tightening
If you have very loose, crepey skin without much hollowing: Primarily laxity → Surgical facelift or Legend RF
6 Ways to Tighten Sagging Face Skin (Ranked by Effectiveness)
1. FAMI Fat Transfer (Most Effective Non-Surgical Solution)
For most people over 40-50 with sagging face skin, FAMI (Facial Autologous Muscular Injection) provides the most natural, long-lasting results without a surgical facelift.
How FAMI works:
- Your own fat harvested from abdomen/thighs
- Purified and injected into facial areas that lost volume
- Fat placed near muscle and bone (high survival rate)
- Restores cheek volume, temples, under-eyes, jawline
- Creates natural “lift” by re-supporting sagging skin
Why FAMI beats skin tightening alone:
- ✓ Addresses root cause (volume loss) not just symptom (sagging)
- ✓ Permanent results (fat integrates, lasts for life)
- ✓ Natural appearance (uses your own fat, not foreign material)
- ✓ Awake procedure (local anesthesia, no general)
- ✓ 1 week recovery vs. 2-4 weeks for facelift
Best candidates for FAMI:
- Age 40-70 with hollow cheeks, temples, or under-eyes
- Mild to moderate sagging (not severe jowls)
- Want natural-looking rejuvenation (not “done” look)
- Prefer non-surgical option to facelift
- Good overall health with realistic expectations
Results: Visible improvement in 2-3 months as swelling resolves. Permanent fat survival (some patients add touch-ups after 10+ years as rest of face ages).
Cost: $2500 – $7500 (one-time procedure, lasts for life)
Learn more about FAMI fat transfer for face rejuvenation →
2. Legend RF Skin Tightening (For Skin Laxity Without Volume Loss)
If your face sagging is primarily loose, crepey skin (not hollowing), Legend Progressive Skin Tightening uses radiofrequency to stimulate collagen production and tighten skin.
How Legend works:
- Monopolar RF heats deep skin layers to 40-42°C
- Triggers collagen contraction + new collagen production
- Gradually tightens skin over 3-6 months
Best for: Mild to moderate skin laxity, crepey texture, fine lines
Not effective for: Volume loss, deep hollowing, severe jowls
Treatment: 6 sessions, no downtime, results last 1-2 years
Learn more about Legend RF skin tightening →
3. Surgical Facelift (For Severe Sagging)
Traditional facelift remains the gold standard for severe face/neck sagging with significant jowls and loose skin.
Best for: Severe sagging, excess skin, patients 60+
Drawbacks: General anesthesia, 2-4 week recovery, higher cost ($15K-$25K+), surgical risks
Why many choose FAMI instead: FAMI provides 60-70% of facelift results with 1/4 the downtime and no surgery
4. Dermal Fillers (Temporary Volume Restoration)
Another non-invasive option includes dermal fillers and injections to help plump up your skin and improve collagen production. BOTOX is the most popular solution for minor and moderate sagging, but other options, such as Restylane and Radiesse, can help with minor wrinkles and sagging. Injectables are not a permanent solution however, as they only last three months to a year — depending on which injection you receive.
5. Topical Creams & Lotions
There are many topical creams and lotions available that claim to firm and tighten the skin, but to see real results, you must use these products for extended periods. The majority of these products also only work for very mild cases of sagging skin, so if your situation is more serious, you may be out of luck and out of money spent on products not suited for you.
6. Facial Exercises
A study from Northwestern University revealed that performing specific facial exercises increases the size of the facial muscles, which in turn helps to reduce the appearance of sagging skin. Unfortunately, to see results, individuals must perform the exercises several times a day for several weeks. Another negative about this type of treatment is that making the same facial expressions repeatedly can lead to the development of wrinkles.
Face Rejuvenation Treatment Comparison
| Treatment | Best For | Downtime | Results Last | Cost |
|---|---|---|---|---|
| FAMI Fat Transfer | Volume loss, hollow cheeks/temples | 7-10 days swelling | Permanent | $2.5K-$7.5K |
| Legend RF | Mild skin laxity, crepey texture | None | 1-2 years | $400 per session × 6 |
| Dermal Fillers | Quick results, testing before FAMI | Minimal | 12-18 months | $600-$1,200/syringe |
| Surgical Facelift | Severe sagging, excess skin | 2-4 weeks | 10+ years | $15K-$25K+ |
| Retinol Creams | Very mild sagging, prevention | None | Ongoing use required | $30-$150/month |
Tighten Sagging Face Skin – Dallas FAMI & Legend RF Treatment
For most people experiencing facial sagging after age 40-50, the issue isn’t just loose skin—it’s volume loss. FAMI fat transfer addresses the root cause by restoring facial volume, naturally lifting sagging skin and creating a more youthful contour without surgery.
For those with primarily skin laxity (without significant volume loss), Legend RF skin tightening provides non-invasive collagen remodeling.
Dr. Bill Johnson, board certified cosmetic physician with 1,000+ facial rejuvenation procedures, will assess whether you need volume restoration (FAMI), skin tightening (Legend), or both.
Schedule Your Free Face Rejuvenation Consultation
Dr. Johnson will evaluate your facial volume loss and skin laxity to recommend the most effective treatment approach.
📞 Call or Text:
FAMI Fat Transfer →
Legend RF Tightening →
Innovations Medical – Dallas, TX
12660 Coit Rd, Suite 100, Dallas, TX 75251
