How do I treat sagging skin around mouth non surgically? (Photos)

Question

I’m 44 years old. I do not smoke, drink minimally, eat relatively healthy, drink a lot of water (up to a gallon a day), and exercise regularly. I wear cerave day cream with SPF 30 daily and avoid long exposure in the sun. I wear Cerave night moisturizer as well and wear makeup sparingly. The lines around my mouth have gotten worse over the years and I’m not sure what to do to make them less saggy. I do not want surgical options at this point, but possibly in the future. Is there anything I can do now to reduce the appearance and sagging ?

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. Helps reduce appearance of Cellulite by helping aid the production of collagen and tightening the skin. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

First, let me congratulate you on practicing several excellent health habits, 
The troubling sagging and wrinkling that are seen in the photos typically results from a loss of volume in the cheeks that occurs with the passage of time Since much of the volume loss that contributes to the aging appearance occurs in the deeper layers of fat, as well as in muscle, bone, etc., this relentless aging process typically shows up more in thinner individuals who do not have a lot of more superficial fat to act as a mask. (This is why heavier people who lose a lot of weight rapidly appear to age overnight). 
Happily, the use of a robust HA volumizing filler for a nonsurgical cheek augmentation can provide the necessary volume and lift to diminish the folds and wrinkles below. And, if still necessary, a medium viscosity HA filler can additionally be used to directly elevate and smooth the indentations. In the hands of an experienced injector, treatment should typically take about fifteen minutes with immediate results and with little to no significant post-procedure downtime. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injection expert. Best of luck.

Jeffrey H. Spiegel, MD · Answer

You are very thin. Your face is lacking fat / volume. This can be addressed by adding fat, adding filler, tightening the skin (a "mini" facelift)...

Anna Chacon, MD, FAAD · Answer

At 44, what you’re noticing around the mouth is a mix of volume loss, skin laxity, and repetitive muscle movement—and you’re already doing the right things lifestyle‑wise.

Nonsurgical options that can help now:

- Hyaluronic acid filler placed conservatively to support marionette lines and soften the corners of the mouth (this often makes the biggest visible difference).
- Energy‑based skin tightening (radiofrequency or ultrasound) to stimulate collagen and improve laxity over time.
- Small amounts of neuromodulator around the mouth to reduce muscle pull that deepens lines.
- Microneedling (with or without RF) to improve skin quality and firmness gradually.
- Nightly retinoid if tolerated, plus continued daily sunscreen.

These treatments won’t replace surgery, but they can noticeably soften sagging and lines and help you maintain your appearance for years. Results are subtle, natural, and require maintenance. When laxity progresses further, surgical options can still be considered later.

A personalized, combination approach typically gives the best outcome.

Samet Bozcan, MD · Answer

The lifestyle and skincare habits you’ve shared show that you’re already taking very good steps to protect your skin. Lines and sagging around the mouth are common concerns caused by age-related collagen and elastin loss, gravity, and repetitive facial movements. Before considering surgery, there are effective medical aesthetic options that can provide noticeable tightening and lifting in this area.At our clinic, we offer two different non-surgical alternatives for this purpose:1. Our patented Ghost Face Lift treatment:This specialized protocol targets the underlying support tissues of the skin to create a lifting effect around the mouth and throughout the face. By stimulating collagen production, it helps achieve a firmer, more lifted, and more youthful appearance over time. It is suitable for patients seeking natural-looking results without surgery. The treatment contains polycaprolactone.2. FDA-approved Thermage FLX treatment:Thermage FLX uses radiofrequency energy to stimulate collagen renewal in the deeper layers of the skin. It is particularly effective in reducing sagging around the mouth, jawline, and lower face. It is a single-session treatment that provides progressive tightening over time.To determine which method is most suitable for you, a one-on-one evaluation based on your facial structure, skin quality, and expectations would be the most accurate approach.

How do I treat sagging skin around mouth non surgically? (Photos)

Answers (5)

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