Tightening & Lifting
Skin laxity, loss of elasticity, noticeable sagging across face, neck and body.
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Why the face and neck loosen
People describe it in their own words: the jawline has lost its edge, jowls have appeared, the lower face looks heavier in photographs, or the neck looks older than the face. The clinical term for most of it is laxity, but it is rarely a single change. Several layers of the face alter with age, often at once, and which of them has changed most decides the treatment that will work.
i
Skin laxity and loss of elasticity
i
Skin laxity and loss of elasticity
With age, the skin makes less collagen and elastin, the proteins that give it strength and spring, and for many women the decline speeds up in the years after menopause. Skin with less of both stretches more easily and recoils less, so it starts to sit lower and to fold where it once held its line. Smoking and years of sun exposure age it faster.
What might work: Endolift®, XERF, Profhilo (biostimulators).
ii
Loosening support
ii
Loosening support
Fibrous bands called retaining ligaments anchor the skin, and the fat beneath it, to the deeper structures of the face. As they weaken, the tissue they hold sits lower. Along the jaw this is where jowling begins: the tissue just above the ligament there lengthens, and the jawline loses definition.
iii
Lost and shifting volume
iii
Lost and shifting volume
Facial fat sits in separate compartments. With age, some of them deflate and others slide lower, most noticeably in the cheeks. When the midface loses fullness, the skin beneath it has less to rest on, and the lower face can look heavier even where the skin itself has changed little. Putting that support back gives the tissue above it something to sit on again.
What might work: biostimulators (Sculptra, Juläine, HarmonyCa), dermal fillers.
iv
Changes in the bone
iv
Changes in the bone
The skeleton beneath the face changes too. The midface slowly recedes and the jaw loses height, leaving the soft tissue above it less framework to sit on, which is part of why the jawline and the angle beneath the chin lose definition. Heat and collagen work on soft tissue, so where lost structure is part of the picture, injectable treatment placed near the bone restores that support.
What might work: dermal fillers.
v
Fullness under the chin and at the jaw
v
Fullness under the chin and at the jaw
Small deposits of fat under the chin and at the jawline add weight to skin that is already loosening, and reduce the definition where the jaw meets the neck. Where fat and laxity sit together, the plan treats both, which is why the assessment looks at each of them.
What might work: Endolift®.
vi
Weight loss
vi
Weight loss
Losing a lot of weight, however it happens, can leave skin that stretched to accommodate it without the elasticity to follow. Some of what looks like loose skin afterwards is lost volume, which is why the two are assessed separately. Planning works best once your weight has settled, so that the treatment is made for the face you will keep.
What might work: Endolift®, XERF, biostimulators.
Treatments for laxity, and who each one suits
Two of these tighten with controlled heat but reach the loosened tissue by different routes: Endolift® from beneath the skin, XERF through it. The third rebuilds support rather than tightening. Your assessment decides which of them suits you, and some plans use two together.
Endolift®
For laxity along the jaw and neck
Endolift is a minimally invasive laser treatment, and at ART Clinic it is in the hands of Dr Priya Verma or a doctor she has personally trained. The area is numbed with local anaesthetic first; then a fine optical fibre is passed beneath the skin through tiny entry points, with no cuts or stitches, and delivers laser energy to the loosened tissue from within. The heat is designed to tighten the fibrous bands that hold the skin in place and to prompt new collagen over the following months, and the same treatment can be used to reduce small pockets of fat along the jaw and beneath the chin. It is usually a single treatment, and you can pick up your day afterwards, allowing for minor swelling where the local anaesthetic went in. Early to moderate laxity is where it does its best work, on the tissue you already have.
XERF
For earlier laxity, without needles
XERF is a non-invasive radiofrequency treatment. Each pulse passes energy through the skin at two frequencies, designed to heat at different depths, while a cooling spray protects the surface. Heat of this kind makes collagen contract, then prompts new collagen to form over the following months. There are no needles and no anaesthetic, and any redness or mild swelling tends to settle within a day or two, so there is no time off to plan for. It is given in one session, and the firming carries on for months after it. It suits earlier laxity and loss of firmness across the face, jawline and neck; for laxity that is more established, Endolift® reaches further.
Biostimulators
For laxity with thinning skin or lost fullness
Biostimulators are injectables that prompt your own tissue to rebuild support, and ART Clinic uses four. Profhilo suits thinned, loosening skin across the face and neck. HarmonyCa lifts a little on the day it goes in, and suits an early loss of contour in the lower face. Sculptra and Juläine, both poly-L-lactic acid (PLLA), restore firmness and a little of the fullness beneath, gradually. Rather than tightening the way heat does, they add support that builds over weeks and months, across one to three sessions depending on the product. Where laxity comes with thinning or lost fullness, a biostimulator can come first, or sit alongside Endolift or XERF.
Treatments that sometimes sit alongside tightening
Dermal fillers
Where lost volume or receding bone is part of what reads as sagging, fillers can restore some of that support, and they are sometimes planned alongside a tightening treatment. About dermal fillers
Endolift® Body
The same procedure, used below the neck for looser skin on areas such as the upper arms, abdomen and knees. About Endolift® Body
Polynucleotides
Where the skin has also thinned and become crepey, polynucleotides support skin quality and repair alongside the tightening. About polynucleotides
Endolift® and XERF, side by side
Endolift®
XERF
How it works
Laser energy, delivered beneath the skin through a fine fibre
Radiofrequency energy, delivered through the skin from the surface
Comfort
Local anaesthetic first, then warmth and gentle pressure
No needles; a cooling spray with every pulse
Appointment
60–90 min
90–120 minfor the full face and neck
Back to your day
Same day;minor swelling from the local anaesthetic
Same day;any redness fades in 1–2 days
When it shows
1–3 months,building for longer
1–3 months
Sessions
1
1
Suited to
Early to moderate laxity, especially along the jaw and neck, including where some fullness sits with it
Earlier laxity and loss of firmness, including for people who can't take time off
Questions about tightening and lifting
How do I know whether Endolift or XERF is right for me?
You don't need to know before you come in. It depends on how far the laxity has gone, whether fullness sits with it, which areas are involved and how much downtime you can take. Endolift works from inside the tissue and suits more established laxity along the jaw and neck; XERF works from the surface, suits earlier laxity and involves no needles. Your assessment shows which fits your face, and whether the two work best together.
Can tightening replace a facelift?
They do different jobs. A facelift removes excess skin and repositions deeper tissue; Endolift and XERF make the tissue you keep firmer, with no operation and no stay in hospital. When laxity is early to moderate, firmer tissue is often all the face needs. At your consultation we talk through how far yours has gone, and what each approach would give you.
Is there a gentle place to start?
Yes. Where laxity is early, XERF involves no needles and little downtime, which makes it an easy first treatment, and Profhilo is another light start where the skin has thinned as well. Your consultation shows which suits you, and the plan moves at your pace.
Will people notice I've had something done?
Not in the way most people worry about. Neither Endolift nor XERF moves your features or removes skin: both aim to make the tissue you have firmer, and the change builds over months, so it tends to read as you looking well. Neither takes you out of your day: Endolift leaves a little swelling from the local anaesthetic, and any redness after XERF usually settles within a day or two.
Does it hurt?
Most people find both comfortable. For Endolift, local anaesthetic numbs the area first; the numbing is a brief sting, and during the treatment most people feel only warmth and gentle pressure. XERF needs no needles or numbing: each pulse arrives with a burst of cooling spray and feels like a brief wave of warmth, and the energy is adjusted to your comfort. You can pause at any point.
Will I need more than one treatment?
Endolift is usually a single treatment, and XERF is one visit. Biostimulators take one to three sessions depending on the product, because the support they add builds gradually and is judged between visits. Your practitioner will tell you how many appointments your plan involves before you commit to any of them.
How long do the results last?
That differs from one person to the next, and your face keeps ageing alongside any result. That is why results are reviewed over time rather than repeated to a timetable.
Can my neck be treated?
Yes. The neck and the area beneath the chin can be treated with Endolift, XERF or both, and Profhilo can improve thin, loosening skin there. Where the neck also shows bands or deeper folds, your practitioner will explain how each part of it is approached.
Is tightening suitable for men?
Yes. For many men the concern is the jaw and neck: loss of definition along the jawline, jowling, or looseness beneath the chin. Endolift and XERF can both treat these, with results that build gradually and don't announce themselves.
For men
Who does tightening suit, and what do you check beforehand?
It suits adults whose face, jaw or neck shows early to moderate laxity, as well as people with a little more laxity where fullness or fat sits alongside it. Before any treatment, we go over your health, any medication (particularly blood thinners), implants such as a pacemaker, permanent filler in the area and any treatment you've had there before. We wait until pregnancy and breastfeeding are over, and until any skin infection has cleared.
Is it safe?
Yes, in trained hands, and the usual effects are mild and short-lived: minor swelling from the local anaesthetic after Endolift, a little redness after XERF that fades within a day or two, and perhaps a small bruise where a biostimulator was placed. Less common effects, such as a patch of numbness after Endolift or a small lump under the skin after a biostimulator, usually settle with time, and serious complications are rare. Each is explained in full before you consent, and we are on hand afterwards for any question you have.
What does tightening cost?
Each tightening treatment has its own line on our Price List. Your fee depends on the treatment and the areas it covers, and it is set at your consultation, once you know what will work.
Full price list
I've had tightening treatment elsewhere. Can I continue at ART Clinic?
Yes. The first appointment is a consultation, where your practitioner looks at your laxity as it is today and at how it responded to what you had before. If you know what was done, when, and to which areas, bring those details: they help us decide what will work next.
Doctor-led, because sagging is easy to misread
Loosened skin, lost volume and a receding jaw can all show up as the same heaviness in the mirror, but they need different treatments. Tightening only helps the first, and filler placed where the real change is laxity can make a face look heavier still. That is why the assessment comes before anything else here: what you are offered should be the treatment for the cause you actually have.
Dr Priya and the teamWhere else to start
If the change you've noticed is more about definition along the jaw, lost fullness, the skin's surface or the body, one of these may fit better.
Jawline & Lower Face
Loss of contour and definition, jowling or heaviness in the lower face and neck.
View →First, an assessment of what has loosened
A comprehensive diagnostic consultation: a thorough assessment leading to a truly bespoke treatment plan, created by you and your practitioner. You don't need to arrive knowing whether you want Endolift or XERF, and if you already have one in mind, that is a good place for the conversation to start. Tell us what you've noticed in your jaw, cheeks or neck, and we will show you what is causing it, which treatment will firm it, and how the plan would run. You won't be sold to, and you won't be pushed.
Request a consultation How a consultation works