Facial flaccidity (Sagging Skin)
At our centres in Madrid: Serrano 143, Serrano 166 and La Moraleja
Specialists in
Treatment of facial flaccidity
At the Grupo Pedro Jaén Facial Aesthetics Unit, we offer medical-aesthetic treatments and minimally invasive surgical procedures aimed at alleviating flaccidity and sagging skin from its earliest stages and in various areas of the face, to slow down what many patients and specialists consider to be the main indicators of ageing.
Recognised reference clinics in Spain
Home > Aesthetic Medicine > Facial Aesthetic Medicine > Facial Flaccidity
What sets us apart
Holistic approach with access to the latest treatments
At the Grupo Pedro Jaén Facial Aesthetics Unit, we offer medical-aesthetic treatments and minimally invasive surgical procedures aimed at alleviating flaccidity and sagging skin from its earliest stages and in various areas of the face, to slow down what many patients and specialists consider to be the main indicators of ageing.
Focused ultrasound (Ultherapy)
Radiofrequency microneedling
Biostimulators
Skin tightening systems
Needle-free radiofrequency
Fractional CO₂ laser
Focused ultrasound
Focused ultrasound (Ultherapy) is an innovative solution to combat facial sagging without surgery. The treatment stimulates collagen regeneration by reaching the deepest level of the skin, the SMAS, the fascia that supports the muscles of the neck and face. It is an ideal option for those who wish to tighten the face without long recovery times.
Safe and non-invasive
The focused ultrasound equipment we use at Grupo Pedro Jaén offers real-time ultrasound imaging. This means our specialists can visualise the layers of tissue that are receiving the energy and precisely target those areas that need it most. This also provides extra safety and prevents the patient experiencing discomfort or pain.
Lifting effect without surgery
This treatment is suitable in cases of mild to moderate sagging, especially to lift the eyebrows and drooping eyelids. It is also highly recommended for redefining the jawline, thanks to the tightening effect it has on the skin of the lower third of the face and the area under the chin. This mechanism also visibly reduces wrinkles on the neck and décolletage.
Radiofrequency microneedling
Radiofrequency microneedling combines two advanced technologies to improve skin firmness. By combining thermal energy with microperforations, a regenerative response is generated in the dermis which stimulates the production of collagen and elastin and creates a tightening effect from the deepest layers of the skin.
Visible results from the first session
The deep heat of the radiofrequency induces immediate tissue retraction, while the microneedles promote cellular repair. With each session, the skin’s appearance progressively improves, and it gains firmness and texture. The effectiveness of this treatment makes it especially useful for the neck, lower face and around the eyes.
Effectiveness endorsed by experts
Thanks to our experience in working with this technology, we are able to treat delicate areas with precision and safety. Moreover, as a minimally invasive procedure, it enables a quick and uncomplicated recovery, ideal for those seeking an effective solution without the need for surgery.
Biostimulators
Biostimulators are injectable treatments that act by stimulating fibroblasts – cells responsible for producing new collagen and elastin, substances linked to skin firmness and flexibility – thus slowing down the sagging process linked to ageing.
Natural result without adding volume
Unlike fillers, collagen stimulators don’t generate immediate volume but offer a progressive improvement in skin quality. They are especially suitable for cases of slight sagging or loss of density, and can be applied to the face, neck and décolletage. The result is firmer, more luminous and revitalised skin with a natural look.
Improved skin quality
These treatments don’t add volume, and they improve skin structure in the long term. Applying them to the jawline, lower cheeks, neck and around the mouth enables firmness to be recovered without altering the natural expression, offering a gradual and balanced rejuvenation. They can be combined with other treatments according to each patient’s needs.
Skin tightening systems
Skin tightening systems are a minimally invasive option to combat sagging and redefine facial or body contours without surgery. They are introduced into the skin by means of fine cannulas, reducing sagging in two ways: with immediate tensing by traction and by the progressive stimulation of collagen.
Immediate lifting effect
Once injected under the skin, our specialist exerts a mechanical traction movement that lifts and supports the tissues in the cheeks, neck and jawline. As they are reabsorbed, they induce collagen production, which prolongs the tightening effects and improves skin firmness over time.
Personalised and safe treatment
Skin tightening systems are biocompatible to eliminate the likelihood of rejection. The treatment is carried out in a consulting room, is rapid and requires only a very short recover time. Skin tightening systems are mainly used on the middle and lower third of the face, the neck and, in some cases, also on the body. This treatment is an effective option for those seeking natural rejuvenation without surgery.
Needle-free radiofrequency
Needle-free radiofrequency is an ideal alternative for those seeking to improve facial firmness without invasive procedures. Heat is induced into the deep layers of the skin, stimulating the regeneration of collagen and elastin, and resulting in firmer and more toned skin.
Firmness and elasticity
This treatment generates a gradual heating of the deep layers of the skin, encouraging the collagen fibres to contract. It is particularly effective on the neck, cheeks and under the chin, where sagging is often most visible. The results are gradual and natural, without altering the natural expression.
Innovation that puts patients first
In order to thoroughly address all our patients’ needs, our Facial Aesthetics Unit has the most advanced radiofrequency equipment (Thermage, Thermage FLX) and focused ultrasound equipment (Ultherapy), as well as technology that combines radiofrequency with ultrasound in the same equipment (Exilis, Accent Prime).
Fractional CO2 laser
Fractional CO2 laser is an effective tool to improve skin quality and combat sagging without surgery. The technology enables a deep regeneration of the dermis, achieving firmer skin and a more luminous, uniform and renewed skin surface.
Collagen and elastin stimulation
Using pulses of fractionated light, this laser generates controlled micro-injuries in the skin, promoting the production of collagen and elastin, two substances linked to skin firmness and suppleness. In addition to tightening the skin, this laser helps to reduce fine wrinkles, scars, enlarged pores… and improves the texture of the neck and décolletage.
Tailored to the patient’s needs
Each session is personalised according to the type of skin and the degree of sagging, allowing for a precise and effective treatment. Current equipment enables the parameters to be adjusted so that excellent results can be achieved with very mild peeling. It is an ideal treatment for those who wish to improve firmness without resorting to surgery or long recovery periods.
Plastic surgery for complex cases
In cases of severe sagging, plastic surgery offers a more durable solution to restore facial firmness. Procedures such as facelifts can correct sagging tissue and restore facial harmony with lasting results.
3D facelifts
This treatment repositions the tissues from deep within the SMAS and platysma for a more lasting and natural result. It follows a volumetric approach by assessing facial structure and skin quality to design a personalised surgical plan. Traction vectors are analysed to avoid artificial effects, such as hairline displacement or alterations in natural wrinkles and facial expression. This ensures a more balanced and less invasive facelift than traditional procedures.
Hybrid techniques
Other options are also available to achieve an elegant and natural rejuvenation, such as the mini facelift, which involves smaller and less invasive incisions than a conventional facelift, offering more targeted results and faster recovery. Another option is the brow lift, often combined with injected neuromodulators and fillers, as well as eyelid surgery, which can be enhanced with injected treatments.
What it is, how it develops and treatment options
A guide to understanding facial flaccidity
Skin deterioration associated with the ageing process begins much earlier than we often realise and does not manifest solely as pigmentation changes or wrinkles. Facial flaccidity is one of the ageing signs that causes the greatest concern among patients, mainly because until relatively recently it could only be addressed surgically in advanced stages through a full facial lift.
How facial flaccidity develops
From approximately the age of 25, and as part of the natural ageing process, the body begins to lose collagen. Collagen is a key protein of connective tissue, present in muscles, tendons and ligaments, and also in the skin, where it provides firmness and structural support. Initially, collagen degradation is progressive but slow. However, from around 35–40 years of age, collagen loss accelerates, leading to a more rapid inversion of what is known as the triangle of beauty.
The triangle of beauty is a concept often used by specialists to illustrate facial ageing in a clear and visual way. In a young face, this imaginary triangle has its widest points at the cheekbones and a narrow, well-defined jawline. The upper face appears wider, while the chin forms the narrowest point, giving the face a relaxed and balanced appearance. The apex of the triangle points upwards towards the glabella, while its base lies at the corners of the mouth. As ageing progresses, this triangle gradually inverts: the jawline becomes wider and less defined, the cheeks descend, and the nasolabial folds become more pronounced. Eventually, the corners of the mouth tend to droop, and the overall facial appearance becomes more aged, tired and, in some cases, sad.
Another contributing factor to this inversion is the progressive weakening of ligaments and tendons in the zygomatic (cheekbone), malar (cheek) and mandibular regions. The loss of tension in these supporting structures—which connect muscles to bone—combined with the effect of gravity, leads to tissue descent and the development of facial flaccidity. This process is further aggravated by the reduction in collagen and elastin. As a result, the tear trough becomes more pronounced, the cheeks descend, and lax tissue appears along the premandibular groove—the lower facial contour that defines what is commonly referred to as the facial contours.
“In most cases, the best results are achieved by combining different therapeutic options and acting at an early stage.”
Treatments for facial flaccidity
Understanding the mechanisms that lead to facial flaccidity and the inversion of the triangle of beauty allows us to apply different aesthetic medical treatments aimed at slowing down or minimising progressive tissue descent. These approaches focus on stimulating collagen production and applying skin-tightening procedures. Depending on the degree of facial flaccidity, different treatment options may be considered:
Fractional CO₂ laser
The energy delivered by fractional CO₂ laser induces selective deep tissue heating, improving dermal vascularisation, stimulating collagen production and tightening the fibrous structures that connect the skin to the underlying muscle layers. This contributes to progressive skin firming and an overall improvement in skin quality, without damaging the skin surface or surrounding tissues.
In addition, fractional CO₂ laser produces a controlled superficial skin injury that accelerates epidermal renewal. This allows treatment of the main signs of photoageing—such as pigmentation, dehydration and wrinkles—providing a short-term rejuvenating effect that continues to improve over time. Within a few days of treatment, the skin appears smoother and more even, with reduced pore size and softened wrinkles.
Grupo Pedro Jaén also has access to other laser technologies, such as picosecond lasers, which may be used as an alternative or complementary option depending on individual clinical needs.
Radiofrequency microneedling
Radiofrequency microneedling
Radiofrequency microneedling is an advanced technology available in only a limited number of centres. Its mechanism of action is based on delivering radiofrequency energy to much deeper skin layers through an array of fine needles.
In addition to acting as conduits for thermal energy, these microneedles trigger the body’s natural repair mechanisms in response to controlled micro-injuries.
This process stimulates collagen production, improves skin quality and generates a powerful tightening effect through the combined action of heat-induced tissue contraction and mechanical stimulation.
Conventional radiofrequency
Conventional radiofrequency also works by heating the deeper layers of the skin, without the need for ultrasound guidance or needles. It is applied at different energy levels and usually requires a variable number of sessions depending on the equipment used.
This technique is particularly suitable for mild to moderate flaccidity, for redefining the facial contours and improving the appearance of the double chin. The newly formed collagen is stronger and of higher quality, resulting in a visible reduction in skin laxity. Although improvements can be noticed early on, results become more evident over the following weeks and are maintained for a variable period. Treatments can be repeated and combined with other procedures for optimal outcomes.
At Grupo Pedro Jaén, we use medical-grade radiofrequency equipment to achieve more effective and consistent results. It is one of the most commonly used resources in our Facial Aesthetics Unit.
Focused ultrasound (Ultherapy)
Focused ultrasound treatments act against flaccidity by stimulating fibroblasts and increasing collagen production through selective heating of deep skin layers, without affecting the skin surface.
They are applied under ultrasound guidance, allowing precise identification of the treatment area. The procedure may cause some discomfort, which is why topical or local anaesthesia is often used. Focused ultrasound is indicated for moderate flaccidity and provides excellent results in the neck, in redefining the facial contours and jawline, lifting the eyebrows, reducing under-eye bags, and firming the skin of the décolletage.
Grupo Pedro Jaén has access to the most advanced focused ultrasound technology currently available (Ultherapy).
Skin tightening systems
Skin tightening systems involve the implantation of biocompatible, resorbable devices into the deep dermis using fine needles or cannulas. The placement follows a vector-based design previously marked on the patient’s face, which guides the trajectory of the system beneath the skin.
The device is inserted through a small entry point and positioned using a guiding needle. Once in place, it is anchored by small barbs and the guide is removed.
The specialist then applies gentle traction to reposition the tissues, achieving an immediate lifting effect that progressively improves over the following weeks as collagen and elastin are produced around the device.
These systems not only reduce flaccidity but also improve skin tone and soften wrinkles, providing a more pronounced anti-ageing effect. As they are made of biocompatible, resorbable materials, they do not require surgical incisions or sutures.
Patients can resume normal daily activities almost immediately. Any discomfort is minimal and easily managed with local cold application and standard anti-inflammatory medication. Specific recovery measures are generally limited to avoiding massage of the treated area, intense physical exercise and facial treatments during the first few days.
The effects typically last between 18 months and three years. Once this period has elapsed, the treatment can be safely repeated.
Skin tightening systems are particularly suitable for mild to moderate flaccidity and for patients who do not require or do not wish to undergo surgery. In cases of severe flaccidity or late intervention, surgical lifting remains the most appropriate option. At Grupo Pedro Jaén, these procedures are performed using minimally invasive techniques within our Plastic Surgery Unit.
More information
Below you will find the authorship and references for the information provided on this page:
Authorship and references
The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.
References on facial flaccidity:
1. Fabi SG. Noninvasive skin tightening: focus on new ultrasound techniques. Clin Cosmet Investig Dermatol. 2015 Feb 5;8:47-52. doi: 10.2147/CCID.S69118. PMID: 25709486; PMCID: PMC4327394.
2. Khan U, Khalid N. A Systematic Review of the Clinical Efficacy of Micro-Focused Ultrasound Treatment for Skin Rejuvenation and Tightening. Cureus. 2021 Dec 4;13(12):e20163. doi: 10.7759/cureus.20163. PMID: 35003992; PMCID: PMC8722640.
3. Sakata A, Abe K, Mizukoshi K, Gomi T, Okuda I. Relationship between the retinacula cutis and sagging facial skin. Skin Res Technol. 2018 Feb;24(1):93-98. doi: 10.1111/srt.12395. Epub 2017 Sep 4. PMID: 28868761.
4. Shome D, Vadera S, Ram MS, Khare S, Kapoor R. Use of Micro-focused Ultrasound for Skin Tightening of Mid and Lower Face. Plast Reconstr Surg Glob Open. 2019 Dec 31;7(12):e2498. doi: 10.1097/GOX.0000000000002498. PMID: 32537285; PMCID: PMC7288869.
5. Carniol PJ, Harirchian S, Kelly E. Fractional CO(2) laser resurfacing. Facial Plast Surg Clin North Am. 2011 May;19(2):247-51. doi: 10.1016/j.fsc.2011.05.004. PMID: 21763986.
6. Dadkhahfar S, Fadakar K, Robati RM. Efficacy and safety of long pulse Nd:YAG laser versus fractional erbium:YAG laser in the treatment of facial skin wrinkles. Lasers Med Sci. 2019 Apr;34(3):457-464. doi: 10.1007/s10103-018-2614-6. Epub 2018 Aug 16. PMID: 30117052.
7. Urdiales-Gálvez F, Martín-Sánchez S, Maíz-Jiménez M, Castellano-Miralla A, Lionetti-Leone L. Concomitant Use of Hyaluronic Acid and Laser in Facial Rejuvenation. Aesthetic Plast Surg. 2019 Aug;43(4):1061-1070. doi: 10.1007/s00266-019-01393-7. Epub 2019 May 9. Erratum in: Aesthetic Plast Surg. 2019 Sep 17;: PMID: 31073742; PMCID: PMC6742610.
8. Victor Ross E, Chodkiewicz H, Javvaji S, Zumwalt J, Kutscher TD, Tran C. Enhanced Pulsed Dye Laser for Facial Rejuvenation. Lasers Surg Med. 2021 Jan;53(1):109-114. doi: 10.1002/lsm.23309. Epub 2020 Aug 10. PMID: 32779273.
9. Ziai K, Wright HV. Carbon Dioxide Laser Rejuvenation of the Facial Skin. Facial Plast Surg Clin North Am. 2022 Aug;30(3):331-346. doi: 10.1016/j.fsc.2022.03.007. PMID: 35934435.
Where we see patients?
Clinics in Madrid
Grupo Pedro Jaén is a medical group founded more than three decades ago with the aim of providing medical, surgical and aesthetic solutions related to skin health and appearance. Led by Dr Pedro Jaén, the group has a highly specialised medical team that covers every area of care with top-level specialists, carries out extensive training activities, is a leader in medical research, and operates several clinics in Madrid, from which it offers the highest standards of care and clinical excellence to all patients.
Calle Serrano 143
This centre is the main headquarters of Grupo Pedro Jaén. It provides diagnostic and treatment services in skin cancer, clinical and aesthetic dermatology, laser treatments and other related specialties.
Mon - Fri: 09:00 - 21:00 / Sat: 09:00 - 14:00
Calle Serrano 143, El Viso neighbourhood, Chamartín district, 28006 Madrid, Spain
La Moraleja
Located in Plaza de La Moraleja, this exclusive centre allows Grupo Pedro Jaén to bring its medical and aesthetic services closer to patients across the entire northern area of Madrid.
Mon - Thu: 09:30 - 20:00 / Fri: 09:30 - 18:00
Calle de la Estafeta 8, ground floor, La Moraleja, 28109 Alcobendas, Madrid, Spain
Calle Serrano 166
This centre currently offers services in body aesthetic medicine, endocrinology, nutrition, complementary aesthetic medicine and post-surgical aesthetic treatments.
Mon - Fri: 09:00 - 21:00 / Sat: 09:00 - 14:00
Calle Serrano 166, El Viso neighbourhood, Chamartín district, 28002 Madrid
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