Skin Care and Medical Aesthetics in Your 40s: Volume, Elasticity and Realistic Expectations

What is happening in your skin in your 40s?

With age, the collagen and elastic fibres in the skin decrease, the skin becomes thinner and begins to lose its elasticity. At the same time, the fat tissue in the face shifts and decreases in some areas, and slow changes also take place in the bone structure that supports the face. The combination of these changes can lead to hollowing under the eyes, more visible lines running from the side of the nose to the corner of the mouth, and softening of the jawline.

Sun damage accumulated over the years also becomes more visible at this stage: sun spots, uneven skin tone and fine wrinkles may increase. In women, towards the end of their 40s, hormonal changes associated with the years before menopause may also begin to affect the skin.

The role of skin care: the basics still apply

Before talking about procedures, it is important to know this: sun protection and regular skin care are still the most basic steps at this age. No procedure gives a lasting improvement in skin that is not protected from the sun.

• Use a broad-spectrum sunscreen every day.
• If your skin is becoming drier, it may help to switch to a richer moisturiser.
• Retinoids are among the most researched skin care ingredients for fine lines and skin texture related to sun damage; because the skin may be more sensitive at this age, it is advisable to start them with care.
• Smoking is one of the main factors that speed up skin ageing.

You can find the basics about retinoids and sun protection in our article “Skin Care and Medical Aesthetics in Your 30s”.

Different problems, different methods

Because the changes seen in your 40s take place in different layers, each may call for a different approach. The table below gives a general framework; which method suits you can only be decided after an examination.

You can find detailed information on each of these methods in our related articles; for example, our articles “Hyaluronic Acid Filler” and “Radiofrequency Skin Tightening and Radiofrequency Microneedling” explain what these methods can and cannot do.

What does a combined approach mean?

At this age, physicians may often discuss, instead of a single procedure, several methods targeting different problems, applied within a plan and spread out over time. For example, expression lines, volume loss and skin texture may each be addressed separately.

• A combined approach does not mean having many procedures on the same day. Which procedures are done, in which order and at what intervals is planned by the physician.
• Each additional procedure brings its own risk and recovery time.
• The plan should be made according to your priorities. It is possible to start with what bothers you most and decide whether to continue after seeing the result.
• Do not hesitate to ask about the reasoning behind a plan offered to you, its alternatives and the consequences of doing nothing.

Be cautious about plans that suggest many procedures in a short time or are offered as a package. A plan should be presented by giving you time to think, not by putting pressure on you.

Realistic expectations

Medical aesthetic procedures can soften certain changes and help your skin look more rested. However, they do not stop ageing and do not turn your face back by years.

• The effect of non-surgical procedures is mostly temporary, and repeat treatment is needed to maintain it.
• The effect of energy-based skin tightening methods is generally mild to moderate and varies from person to person.
• With significant sagging, the effect of non-surgical methods is limited; in this case, a plastic surgeon’s opinion may be needed.
• Too much filler or too frequent treatment can lead to an unnatural look in the face. Less often looks more natural.
• Results vary with skin quality, lifestyle habits and genetic make-up.

If you are considering a procedure, review your health first

In your 40s, the number of regularly used medicines and chronic diseases may increase. At the examination, it is important to tell your physician about:

• Blood-thinning medicines, aspirin and some painkillers, and herbal supplements (these can increase the risk of bruising; do not stop these medicines on your own)
• Health problems such as diabetes, autoimmune diseases and bleeding disorders
• Fillers, threads or surgical procedures you have had before
• A history of cold sores (some procedures can trigger cold sores)
• Allergies and problems experienced with previous procedures

Final word

Your 40s may be a time when you strike a balance between accepting the changes in your skin and improving them. Whichever path you choose, sun protection and regular skin care are fundamental. If you are considering a procedure, it is advisable to decide with a physician with whom you can openly discuss your expectations and who, when appropriate, can tell you that a procedure is not necessary for you. When choosing a physician, you can use our article “A 10-Point Safety Checklist for Choosing a Clinic and Physician for Medical Aesthetics”.