Skin firmness depends primarily on two proteins: collagen, which provides tensile strength and structure, and elastin, which gives skin its ability to recoil after being stretched or compressed. Both are produced by fibroblasts in the dermis. Both decline with age.

From the mid-twenties onward, collagen production decreases by approximately one percent per year. Elastin production slows even earlier. As this scaffold degrades, the skin no longer has the internal support to maintain its position against gravity.

UV radiation is the single largest external contributor to premature skin laxity. UV exposure degrades existing collagen fibres and stimulates the production of metalloproteinases, enzymes that actively break down the dermal matrix. Smokers experience accelerated laxity because nicotine impairs blood supply to the skin and disrupts fibroblast function.

Rapid weight loss removes the fat that contributes to facial volume and can outpace the skin’s ability to contract. High sugar diets contribute through glycation, where sugar molecules bind to collagen fibres and make them brittle and dysfunctional.

Skincare ingredients such as retinoids, peptides, and certain growth factors can support collagen synthesis and slow the rate of degradation. They are valuable as part of a maintenance routine. But they cannot generate the level of collagen remodelling needed to meaningfully reverse established laxity. The molecules in most topical products cannot penetrate to the depth in the dermis where structural collagen remodelling occurs.

HIFU, or High-Intensity Focused Ultrasound, directs focused energy to a precise depth within the skin and generates localised thermal injury that triggers the body’s natural collagen repair response. The results build progressively over three to six months as new collagen is synthesised and organised.

Thread lifts provide a more immediate mechanical lift by repositioning tissue while simultaneously stimulating collagen production along the thread tract. For moderate to significant laxity, combining energy-based treatments with biostimulators and structural threads typically delivers the most comprehensive and lasting outcome.