When you reach your 40s, you may notice a change in your appearance in the mirror.
People usually describe it as "sagging," but in the examination room, it's often more than just sagging.
It's a state where hollow areas are also present, making the sagging appear deeper.
Take just one minute to read this.
Two Changes Occur Together
From around the mid-40s, the volume in the cheeks and various parts of the face decreases, and at the same time, the supporting structures relax.
| Change | Visible Appearance |
|---|---|
| Volume Loss | Nasolabial folds and mouth area deepen, gaunt appearance |
| Relaxation of Supporting Structures | Jawline blurs and loses definition |
This period is sometimes described as a concentration of changes in a specific phase rather than a gradual aging process.
When these two changes overlap, in the mirror, it feels like just "sagging."
Hollowness Makes Sagging Appear Deeper
When the upper volume decreases, the lines below it become more defined.
Even with the same degree of sagging, the impression is different when the upper part is filled versus when it is hollow.
Therefore, if you only lift when there is hollowness, the lines may be refined, but the overall impression might still look tired.
Conversely, if you only fill and leave the supporting structures, the increased weight could make the sagging more prominent.
(※ Effects and reactions may vary depending on individual skin conditions, and the suitability of the procedure is determined through consultation with medical staff.)
Order of Assessing Balance
For consultations in the 40s, we check in the following order:
- Where are the hollow areas (temples, anterior cheekbones, lateral cheeks)?
- To what extent is there sagging, and in which areas is it concentrated?
- Which of the two is a greater cause of the change in appearance?
- Based on that, determine the proportion of filling and lifting.
The third point is key. If the proportion is not determined, you might do both without adequately addressing either.
Not All Procedures Are Done at Once
If all procedures are performed at the same time, recovery reactions may overlap, and it can be difficult to determine what changes were caused by which procedure.
By performing the procedure with the larger proportion first and observing the progress before deciding on the next step, unnecessary procedures can be reduced.
In particular, filling procedures may continue to improve over time, so reinforcing them later carries less risk of overcorrection.
The discussion about aging varying by layer was covered in Aging Does Not Happen in One Layer.
Frequently Asked Questions
Should I get Lifting & Tightening first in my 40s?
Since this is a period where sagging and volume loss occur together, it is better to first determine which is the greater cause of the change in appearance.
Can I just get filling?
If you only fill and leave the supporting structures, the increased weight could make the sagging more prominent. An approach that considers both by determining the proportion is recommended.
Can I get all procedures done at once?
Recovery reactions may overlap, and it becomes difficult to determine what changes were caused by which procedure. It is better to proceed by dividing the procedures, starting with the one that has a larger proportion.
Which hollow areas are primarily considered?
Temples, anterior cheekbones, and lateral cheeks are considered together. Filling only one area may result in an uneven height compared to the surrounding areas.
What are the post-procedure reactions?
Reactions vary depending on the method, but temporary swelling, bruising, and redness may occur. The degree and duration may vary from person to person.
Recovery and Downtime: Varies by Combination
Energy-based treatments primarily cause heat and swelling, while injection-based treatments mainly cause bruising and swelling.
If performed on the same day, these two reactions will be combined.
If you have a schedule, please inform us in advance during the consultation so we can plan the timing accordingly.
How is the Cost Determined?
The cost is not determined by the price of a single procedure.
It varies depending on the proportion of filling and lifting, the number of areas treated, the session plan, and whether diagnosis and post-care are included.
For an accurate cost, it is best to provide guidance after a consultation to assess the distribution of hollowness and sagging.
Visit and Consultation Information
O.N Clinic is conveniently located near Gangnam Station, making it easily accessible by subway.
If you have any questions before your visit, you can easily inquire via Chat Now for Consultation. Through a consultation, you can coordinate priorities, session plans, and appointment schedules.
It is more accurate to determine the proportions after assessing the entire face during an in-person consultation.
Author: Dr. Oh Seung-Min (Chief Director of O.N Clinic, Graduated from Seoul National University College of Medicine, Academic Committee Chairman of the Korean Laser Dermatology and Hair Society). For more details on his background, please refer to Medical Staff Introduction. First Published 2026-07-21 / Last Reviewed 2026-08-15
This article is for general informational purposes only, and suitable treatments and results may vary depending on individual conditions.
