The sagging skin is one of the most aesthetic dysfunctions difficult to treat and one of the most common, especially when the patient wishes not to undergo plastic surgery to remove excess skin. We cannot see sagging as a pathology, but as a sequel, where the lack of tonicity of the skin and muscles is the result of intrinsic causes, such as genetic factors or aging; and extrinsic, such as obesity, pregnancy, high sun exposure, drastic weight loss, smoking or sedentary lifestyle.
Flaccidity is a slow and progressive process that occurs as skin laxity and muscle weakness due to the loss of collagen fibers, a protein responsible for the support of the skin, and also the lack of elastin.
Initially there is a decrease in cellular metabolism, as a result of the decrease in collagen fibers and elastin biosynthesis. Over the years, these fibers are degraded at a faster rate than they are produced. From the age of 25, it is already possible to notice the decrease in fibroblastic activity, with the consequent decrease not only in relation to the quantity, but also the quality of the collagen.
The most visible metabolic manifestation of aging seems, however, to be the delay in protein synthesis, because of which an imbalance between formation and degradation is established. The skin, with all that biological process, compromises its structure and tends to become thin at some points, wrinkled, dry and occasionally flaky. The collagen fibers of the dermis become thicker, Elastic fibers lose part of their elastic property and there is a gradual decrease in stored fat in the subcutaneous tissue. All these transformations favor the emergence of sagging, skin and muscle hypotonia.
Evolution of facial sagging over the years
As for the aging of the face, generalized skin sagging occurs with the loss of the superficial musculoskeletal system (SMAS). The SMAS is an anatomical structure located under the skin of the face, consisting of a fibromuscular network that covers and joins the muscles of the face and connects them to the dermis through fibrous septa. With the sagging of the skin and modification of the SMAS, associated with the movements of the mimic and action of the intrinsic and extrinsic factors of each individual, the signs of aging of the face that leave the flaccidity of the soft tissues and the visible asymmetries, due to the loss of elasticity.
Types of sagging:
Tissue and muscle
The tissue flaccidity refers to the state soft, loose tissue and emerges at about 25 to 30 years by a disorganization of collagen fibers that make with the skin to lose its elasticity. It is a true nightmare that is accentuated in thighs, abdomen, buttocks, arms and face.
The muscle flaccidity , may or may not be associated with the former giving an even worse aspect to parts of the body affected by the problem. It is mainly due to the wear of the muscle support fibers caused by the lack of physical activity, in addition to the passage of time.
