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Facial Sagging: What a Non-Surgical Facelift Can Do

In a profile photo, you find your jawline less defined. From the front, your cheeks seem less full than before. Facial sagging can be related to volume loss beneath the skin; this is not the same issue as skin that needs tightening. What is known as a non-surgical facelift covers treatments with different goals. They can improve the appearance of the face, but they do not give the results of a surgical facelift. CARE MD, in Sainte-Thérèse, offers focused ultrasound for skin tightening.

Woman with short dark hair, head slightly lowered, jawline slightly sagging, on a brick-lined street.

In Brief

Five things to know before deciding
  • What changes: aging and sun exposure can be accompanied by sagging and volume loss beneath the skin. A less defined contour and a hollow do not necessarily call for the same treatment.
  • What a non-surgical treatment can do: tightening the skin or restoring volume can improve the appearance of the face, without the results of a surgical facelift. No cream lifts sagging skin.
  • At CARE MD: focused ultrasound, a skin tightening treatment; fractional CO2 laser and volume-restoring injections should be discussed during the assessment, depending on what has changed.
  • Choosing a treatment: start with the change that bothers you; the assessment can also lead to another treatment, to waiting or to doing nothing.
  • Emergency: a face that droops suddenly, especially on one side, can be a sign of a stroke; call 9-1-1.

If Skin Firmness Is What Has Changed

When skin firmness, rather than volume, is what has changed, CARE MD offers a tightening treatment: focused ultrasound (HIFU) for the face. Its heat, delivered below the surface, can prompt the skin to produce collagen; the effect remains modest and builds up over several months.

Why the Face Sags Over the Years

Over the years and with sun exposure, wrinkles, dryness and sagging related to volume loss beneath the skin can appear. What bothers you may therefore be a hollow as much as less firm skin.

In the mirror, these changes do not all look the same.

During the assessment, describe what you see without having to decide for yourself between skin and volume. The distinction matters: tightening the skin and restoring volume are two different goals. A treatment designed for one does not necessarily address the other.

At 40, if your face seems to be sagging, your age is not enough to determine the choice of treatment. The passing years and sun exposure can contribute to this. To choose, start with what has changed for you and what you would like to improve.

Loose skin

This is skin laxity: skin that looks less taut over the cheeks and along the jaw.

Reduced volume

Cheeks that look more hollow to you, more pronounced temples or less full cheekbones are changes to point out during the assessment, without working out the cause on your own.

Jowls

The lower cheeks become heavier on each side of the chin, and the jawline loses its definition.

Creams and Exercises: What They Can Do, and What They Don't

A good moisturizer plumps up the surface of the skin and makes fine lines less visible for a time. It does not lift sagging skin: no cream or lotion penetrates deeply enough to lift the tissues. A lifting claim on a jar does not change this limitation. Hydration can make fine lines less noticeable, without lifting the skin. Daily sun protection complements it, since sun exposure contributes to sagging.

Facial exercises and massage are appealing because you do them at home. Improvements in the appearance of certain areas are possible, but the effectiveness of exercises and massage remains uncertain. Do not expect them to give you a facelift.

A few habits matter if you are considering a treatment: protecting yourself from the sun and never using tanning beds, not smoking, drinking little alcohol, eating a healthy diet and maintaining a stable weight. They are among the conditions in which tightening produces its best results.

If your concern is instead fine lines, skin texture or radiance, it relates to the skin's surface rather than sagging: it concerns facial rejuvenation.

Which Non-Surgical Facelift Method Should You Choose?

Hollowing in a cheek and sagging skin are not the same concern. To choose a non-surgical facelift method, start with what you want to change rather than with the name of the treatment.

Skin that has lost its firmness. Focused ultrasound delivers heat below the surface of the skin. This heat can stimulate collagen production. The tightening remains modest and generally appears within two to six months after a treatment. Additional treatments may provide a benefit; this general timeframe does not tell you what result to expect or how many sessions will be right for you. This treatment is mainly appropriate for mildly sagging skin; if the skin is very loose, it may not help. At CARE MD, it is performed by an esthetician or a nurse, and the assessment includes checking whether the area that bothers you is suited to it. Focused ultrasound for the face targets skin firmness: it does not make up for lost volume.

Skin affected by sun exposure that has also lost its firmness. The fractional CO2 laser acts on small sections of skin. The healing that follows is accompanied by collagen production. The changes can involve wrinkles, spots, texture and skin laxity, not a proven correction of sagging as a whole. You need to plan for a period of convalescence. If you are considering this laser to tighten the skin, discuss this use during the Global Aesthetic consultation.

Ultrasound and laser are needle-free approaches, but their after-effects differ: laser resurfacing requires a period of convalescence and carries, among other things, a risk of scarring. External radiofrequency, for its part, uses a device placed on the skin to heat the tissues beneath it. If you are torn between these approaches or are considering thread lifts, bring this question to the Global Aesthetic consultation, without assuming that all of these procedures meet your needs.

A hollow, reduced volume. In this case, volume-restoring injections should be discussed. They can restore a fuller appearance where volume is lacking, without doing the same job as skin tightening.

Very loose skin. Here, tightening may not be enough.

With ultrasound, the expected improvement is modest and gradual, over several months. Laser works through skin healing and requires a recovery period. Volume-restoring injections aim for a fuller appearance; both their effect and how long it lasts depend on the material, the area and your tissues. Some products are absorbed over time. These are differences in goal, timeframe and what to expect afterwards, not a ranking from best to worst. The number of sessions, maintenance and the time to set aside after the treatment are clarified for the procedure being considered during the Global Aesthetic consultation. The choice may also be to wait or to do nothing.

Jowls and Facial Outline: What Can Be Considered Without Surgery?

Jowls mainly change the contour: from the front, the outline of the face looks less defined, as does the jawline. To understand this contour, a distinction must be made during the assessment between what needs tightening and what lacks volume. The appearance of the jowls is not enough to choose an injection or a skin treatment.

A non-surgical treatment does not guarantee that jowls will disappear. If the skin is mildly sagging, tightening with focused ultrasound can bring a modest lifting effect that builds up over months. If volume is missing, an injection can restore a fuller appearance; its result varies with the structure of your tissues, the amount injected and the product. Restoring volume and tightening sagging skin remain two distinct goals. When sagging is significant, these treatments may not be enough to reshape the outline of the face.

If it is volume under the chin that blurs the line between the face and the neck, the question is a different one: it is about a double chin.

Facial Volume Loss: Hollow Cheeks, Temples and Cheekbones

You find your cheeks more hollow, your temples more pronounced or your cheekbones less full. These observations deserve to be examined, but on their own they are not enough to establish the cause. Aging and sun exposure can be accompanied by sagging related to volume loss beneath the skin. During the consultation, say when you noticed the change and also mention any change in weight. This does not predetermine which area to inject.

If your cheeks are becoming hollow quickly, for no apparent reason, or along with weight loss you cannot explain, talk to your family doctor first, before pursuing any aesthetic treatment.

Restoring volume, stimulating collagen and hydrating the skin are not three ways of promising the same result. The goal of the injection matters as much as its name.

A dermal filler

A hyaluronic acid injection aims for a fuller appearance. It is a way of adding volume, not a promise to tighten all of the skin. The result depends on your tissues, the amount and the type of product; the body absorbs some gels over time, and how long the effect lasts depends on the product and the area.

A biostimulator

A collagen biostimulator aims to stimulate collagen production. Several materials have this effect, so biostimulation is not always separate from adding volume. These products cannot be ranked by how much collagen they will stimulate, nor can they be expected to provide a guaranteed lift.

A skin booster

The goal of this injectable skin hydration is hydration, not filling a hollow. CARE MD distinguishes it from dermal fillers; it must not be chosen as if it restored the same volume.

At CARE MD, the treatment is carried out by our professionals: a doctor, or a nurse injector supervised by a doctor. During the assessment, ask which product and which area are being considered, as well as whether the effect is temporary and what could be done if the result is unsatisfactory. The fact that some products are absorbed does not mean that all injections can be removed in the same way.

The fold that runs from the side of the nose to the corner of the mouth is assessed separately: filler for nasolabial folds targets that specific fold, not the face as a whole.

Surgical or Non-Surgical Facelift: What Each Approach Can Do

A facelift, or rhytidectomy, is a surgical procedure that aims to make visible signs of aging in the face and neck less noticeable. Non-surgical treatments can improve the appearance of the face, but they do not give the results of a surgical facelift. Choosing a non-surgical facelift therefore means aiming for an improvement, not an equivalent result.

When the skin is very loose, tightening may not help. A plastic surgeon can then tell you whether a facelift makes sense in your situation. The decision is about what can realistically be improved, not about a promise to restore the same facial appearance with or without surgery.

Risks and What to Expect Afterwards, Depending on the Method

Each method has its own after-effects and its own risks; knowing them is part of the choice.

Focused ultrasound. The intended effect comes from heat delivered below the surface. Before deciding, the side effects and contraindications of the planned device, as well as the areas that can be treated, must be clarified during the assessment. A modest effect does not mean that the risks are negligible.

Fractional CO2 laser. It requires days of recovery and can leave scars. An active skin infection is one of the contraindications, as are certain diseases that interfere with healing, such as scleroderma, or a history of skin disease that can reappear where the skin is injured, such as vitiligo or psoriasis.

Volume-restoring injections. Pain, bruising, redness, swelling, nodules (small lumps under the skin), abscesses or infection are possible. More rarely, the product is accidentally injected into a blood vessel; it can then cause necrosis, meaning the death of part of the tissue, vision problems severe enough to cause blindness, or a stroke.

Seek care right away

During or shortly after a volume-restoring injection, unusual pain, a change in vision, skin that turns white, grey or blue near the injection site, or any sign of a stroke requires immediate medical care.

A Face That Droops Suddenly: Call 9-1-1

Sagging that develops over the years calls for an aesthetic assessment. A face that droops suddenly, especially on one side, does not: it can be a sign of a stroke. The other warning signs are weakness on one side of the body, numbness or tingling in the face, arm or leg, difficulty speaking or understanding what is said to you, and vision problems, such as double vision or loss of sight in one eye. If you or someone close to you shows any of these signs, call 9-1-1 immediately: do not fill out a form and do not wait for an appointment.

If you are wondering whether facial sagging can be caused by an illness, its sudden onset is the first thing that should alert you; only a doctor can establish the cause.

Preparing for Your Global Aesthetic Consultation

At CARE MD, in Sainte-Thérèse, the Global Aesthetic consultation is an opportunity to discuss what bothers you: skin firmness, a hollow or the contour of the lower face. If you notice bands in your neck, describe this change during the assessment too, without assuming straight away that it is skin that needs tightening. Mention your health problems, your allergies, your medications and supplements, and any cosmetic treatments you have already had; do not change how you take any medication on your own. Also say what you are hoping for, and how many days of recovery you can allow yourself.

The assessment may show that another treatment suits you better than the one you had in mind, that it is better to wait, for example if the skin is infected before a laser treatment, or that it is better to do nothing. Filling out the form or coming in for a consultation does not guarantee a treatment or a result. For the treatment being considered, ask what it can change in your case, when you can judge the result, how many sessions to plan for, what risks it carries and its total cost.

Ask Us About Your Facial Sagging

Describe what has changed in your face and the questions you have. If your face droops suddenly, do not send a message: call 9-1-1.

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Frequently Asked Questions

Can you lift a drooping face or tighten the skin without surgery?

Partly, and it all depends on what has changed. If the skin is mildly sagging, focused ultrasound, which CARE MD offers, delivers heat below the surface and can produce a modest lifting and tightening effect, which generally appears within two to six months. If volume is missing, an injection can restore a fuller appearance; restoring volume and tightening the skin remain two distinct goals. To correct significant sagging, these treatments may not be enough, and none of them gives the results of a surgical facelift.

Sources2 references
References for this answer
Is a non-surgical facelift worth it?

It depends on what you expect from it. For mildly sagging skin, tightening can bring a modest improvement that builds up over months. If you are hoping for the change a surgical facelift brings, non-surgical treatments will not provide it, and significant sagging may be beyond what they can do. Weigh the realistic change, how long it takes before you can judge it, recovery, the risks, the number of sessions and the total cost. During the Global Aesthetic consultation, the conclusion may also be to wait or to do nothing.

Sources2 references
Can a cream tighten the skin on your face, and which one should you choose?

No cream or lotion lifts sagging skin: it does not penetrate deeply enough to do so. A good moisturizer plumps up the surface and makes fine lines less noticeable, but this effect is temporary. The product to choose is therefore not one that promises to tighten the skin, but one that hydrates it, along with sun protection, since sun exposure contributes to sagging. When the skin really is sagging, treatments such as focused ultrasound or volume-restoring injections should be discussed, depending on what has changed.

Sources2 references
References for this answer
Can facial exercises tighten a sagging face?

They sometimes improve the appearance of a specific area, but their effectiveness has not been established with enough confidence to expect them to give you a facelift. If you do them, keep your expectations modest: they do not replace either skin tightening or added volume when that is what has changed. Other habits matter if you are considering a treatment: protecting yourself from the sun, not smoking, drinking little alcohol and maintaining a stable weight are among the conditions in which tightening produces its best results.

Sources2 references
Your face is sagging at 40: is it time to act?

Your age alone does not determine the choice of treatment. Aging and sun exposure can be accompanied by sagging and volume loss beneath the skin. What matters is what you see and what you would like to change: mildly sagging skin is better suited to tightening than very loose skin, and a hollow calls for a different approach than less firm skin. During the Global Aesthetic consultation, the answer may be a treatment, another approach or the choice to wait.

Sources3 references
What side effects do you need to know about before a treatment?

They depend on the method. Fractional CO2 laser requires a period of convalescence and can leave scars; a skin infection means the treatment is postponed. Volume-restoring injections can cause pain, bruising, redness, swelling, nodules or infection; more rarely, an injection into a blood vessel can lead to necrosis, damage to vision or a stroke. During or shortly after an injection, unusual pain, a change in vision, or skin that turns white, grey or blue near the injection site requires immediate medical care. For focused ultrasound, the decision must take into account the device used, its side effects and its contraindications; these must be clarified during the assessment, before the treatment.

Sources4 references
Is it serious if one side of the face droops?

If it droops suddenly, yes: a face that sags all at once, especially on one side, can be a sign of a stroke. Call 9-1-1 immediately, whether this sign occurs alone or with weakness on one side of the body, numbness in the face, arm or leg, difficulty speaking or understanding, or a vision problem. Do not fill out a form and do not wait for an appointment. By contrast, sagging that develops slowly, over the years, calls for an aesthetic assessment.

Sources1 reference
References for this answer
Sources10 references
  1. Many ways to firm sagging skin, American Academy of Dermatology (opens in a new tab) (American Academy of Dermatology)
  2. Cosmetic injections, Health Canada (opens in a new tab) (Health Canada)
  3. Dermal Fillers (Soft Tissue Fillers), U.S. Food and Drug Administration (opens in a new tab) (U.S. Food and Drug Administration)
  4. Fractional Carbon Dioxide Laser Resurfacing, PubMed Central (2012) (opens in a new tab) (PubMed Central)
  5. Fractional deep dermal ablation induces tissue tightening, PubMed (2009) (opens in a new tab) (PubMed)
  6. Evaluation of the biostimulatory effects and the level of neocollagenesis of dermal fillers: a review, Europe PMC (2022) (opens in a new tab) (Europe PMC)
  7. Efficacy of Conservative Techniques for Mechanical Facial Rejuvenation: A Systematic Review, PubMed (2025) (opens in a new tab) (PubMed)
  8. Facelift Surgery, American Society of Plastic Surgeons (opens in a new tab) (American Society of Plastic Surgeons)
  9. Stroke, Public Health Agency of Canada (opens in a new tab) (Public Health Agency of Canada)
  10. Fillers: Preparation, American Academy of Dermatology (opens in a new tab) (American Academy of Dermatology)

When to Seek Care for a Sagging Face

Features that sag slowly should be examined during a consultation; a face that droops abruptly requires emergency help.

Limitations and precautions

One side of the face drooping, a weak arm, slurred speech or blurred vision: call 9-1-1 at once.

Seek care right away: get immediate medical care for any warning sign during or shortly after a volume-restoring injection. The warning signs relate to vision (a change in vision), the skin (white, grey or blue skin near the injection) or pain (unusual pain).

Infected skin means fractional CO2 laser treatment is postponed; certain skin or healing disorders rule it out.

Tell the person assessing you about any illnesses, allergies, treatments, supplements and past skin care and treatments, without stopping any treatment on your own.

A face that becomes hollow for no known reason, along with weight loss, needs to be seen by your doctor first.

Without surgery, the appearance of a sagging face can be improved, but the results of surgery cannot be obtained.

Skin that sags a great deal may not respond to tightening.

Tightening with ultrasound remains modest and takes months to become visible; neither its extent nor its duration is guaranteed.

A cream does not lift sagging tissues, and the effect of facial exercises has not been established.

Let's Talk About What Has Changed in Your Face

A Global Aesthetic consultation at CARE MD, in Sainte-Thérèse, is an opportunity to distinguish between skin, volume and contour before choosing a treatment, or choosing none at all.

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