Overall facial sagging is common after age 45, or if there has been a lot of sun damage.

The skin envelope gets thinner, losing collagen, elastin, and fat and starts to be pulled down by gravity.  It is important to maintain collagen and elastin with protection (sunscreen and cofactors for collagen synthesis like Vitamin C).

Once the laxity has taken hold, there are several options that could be considered including Pellevé™, Thermage, Titan or ProfoundPellevé is a great overall skin tightening, brightener, and firming that is virtually pain-free.  Thermage is a one time treatment that is excellent for thicker or more oily skin and men.  Titan is great for very thin skin, especially the neck or for someone with implanted metal (those with metal cannot have Pellevé or Thermage).  Profound is not only tightens but also lifts and volumizes, improving the entire structure of the lower face after one treatment. Another option to tighten the skin under the chin and neck is Ultherapy®.