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As you age, elastinfibers stretch and the skin droops. it’s a breakdown of collagen and elastin, two substances that help hold your skin together and keep it taut, plump, and elastic.

Your genes and the level of sun exposure you’ve had during your lifetime determine how much you sag. Smoking contributes to skin sagging, too.


  • For major sagging (more common if you’re over age 50), a face-lift is the traditional choice. Younger women just starting to show the signs of gravity who are willing to settle for a much more subtle change can try Thermage (aka ThermaCool).
  • How they work: Plastic surgery is clearly the radical route. The surgeon can tighten skin and underlying muscle by slicing through both with a scalpel and lifting and tightening the tissue. Thermage uses radio frequency, a form of heat energy, to penetrate the epidermis (the most superficial layer of skin) and prompt the collagen-producing fibroblasts in the dermis (the lower layer of the skin) to produce new collagen. Thermage, which is considered noninvasive, gives your skin a gradual, subtle tightening effect.
  • Pros: ‘A face-lift can take 10 years off your face and last that long, too,’ says San Francisco-based plastic surgeon Kimberly Henry, MD, author of The Face-Lift Sourcebook. ‘Thermage often creates a subtle lift in the brow area immediately, and your skin will usually tighten 15 to 20 percent more over the next 4 to 6 months,’ says Weiss.
  • Cons: Clearly, a face-lift means a younger-looking you–but also a big bill, the risks of general anesthesia, downtime (10 to 14 days out of work, no strenuous activity for 4 weeks or more). All in all, it’s a 3- to 6-week healing process that includes moderate to extreme swelling, bruising, and discomfort. With Thermage, swelling is mild, but changes may be too subtle for you.

Laser resurfacing: Fraxel

  • Topically applied products that tighten skin temporarily or even the hemorrhoid treatment Preparation H–work in minutes. Obviously, these creams can’t hold a candle to the high-tech possibilities of surgery or Thermage. But if you need a quick fix before a big party, dermatologists think they’re a good bet.
  • How they work: Albumen, the protein that makes up the white of an egg, shrinks as it dries, causing your skin to contract and remain tightened for roughly the course of an evening. The key ingredient in Preparation H–phenylephrine HCL–is designed to shrink swollen tissue. Applied to the face, it can leave your skin feeling a touch more taut; just be sure to wipe it off before applying makeup because it doesn’t fully absorb (though it still tightens your skin).
  • Pros: They’re cheap and easy, and they go to work in minutes. Egg straight out of the shell can be drying, not to mention a bit messy. Preparation H is an underground trick of the beauty trade, where it’s used as an under-eye ‘depuffer.’
  • Cons: The Cinderella effect: It only lasts a few hours. Preparation H on the face isn’t particularly pretty; avoid the oil-based ointment and use the gel. And be sure not to get it too close to your eyes.
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