Loss of firmness in facial skin: what solutions?

1. Adopt a suitable skincare routine.

To firm up the skin on one's face, the first step is to establish a skincare routine that is well-structured, consisting of at least a cleanser, a moisturiser, and sun protection, and incorporating certain key actives, such as antioxidants. These are indeed essential for maintaining skin firmness as they combat free radicals, unstable molecules that are particularly generated following exposure to UV rays or pollution. However, these free radicals can accelerate skin ageing by degrading collagen and elastin, the protein fibres present in the skin's extracellular matrix that give it its suppleness and elasticity. By neutralising these free radicals, antioxidants, such as ferulic acid or astaxanthin, help to maintain skin firmness.

Furthermore, retinoids, such as retinol, are also interesting active ingredients for firming the face. Studies have shown that these molecules can stimulate the production of collagen and elastin by fibroblasts, as well as improve skin elasticity by eliminating non-functional elastin fibres. In addition, retinol is capable of inhibiting matrix metalloproteinases (MMP), enzymes that degrade the constituents of the skin's extracellular matrix, including collagen and elastin, and promote the synthesis of tissue inhibitors of metalloproteinases (TIMP). The retinoids are thus allies in maintaining firm skin for as long as possible.

Finally, wearing sun protection daily is essential. Indeed, sun exposure is the main cause of photoaging of the skin, which among other things, results in a loss of skin firmness. As explained earlier, UV rays generate free radicals in skin cells, which can damage the supporting protein fibres. Applying a sunscreen every day, regardless of one's age, is a simple but effective way to firm up the skin. A study conducted with 32 volunteers aged 40 to 55 years demonstrated the benefits of this habit. After one year, several photoaging parameters were evaluated, and significant improvements were observed, particularly in terms of skin firmness, affecting 68.8% of the participants.

2. Try facial gymnastics.

Some people also advocate that facial gymnastics could be an effective technique for strengthening the muscles of one's face and improving the flexibility and firmness of one's skin. There are several types of exercises, most of which work the orbicular muscles, around the eye contour, and the masseters, the jaw muscles. These exercises are believed to increase the production of collagen and elastin, the supportive protein fibres of the skin, and to stimulate blood flow. However, the currently available scientific data is insufficient to assert that facial exercises can indeed help to tighten the skin of the face.

Indeed, the few studies that have examined the effect of facial gymnastics on skin ageing have numerous limitations. They were all conducted with very small samples, of less than ten people, and did not use a randomisation process, nor a control group. Furthermore, the evaluations of the effectiveness of facial gymnastics were purely subjective, carried out by the authors and/or the patients themselves, without measurement instruments. More research, conducted on a large scale and implementing a rigorous protocol, is necessary to conclude on the effectiveness of facial gymnastics for firming the skin of one's face.

If you are tempted to try facial gymnastics to firm up the skin on your face, you can find here most of the recommended exercises.

3. Taking care of one's diet.

Diet can also be an interesting lever to firm up the skin on one's face. Indeed, certain nutrients, particularly antioxidants such as vitamin C and omega-3s, actively contribute to the protection of dermal structures against external aggressions. By limiting oxidative damage and modulating the enzymatic activity involved in collagen degradation, these compounds can help slow down skin sagging and maintain firmer skin. A study conducted by MEINKE and his team with 33 volunteers over four weeks showed that oral intake of vitamin C (100 to 180 mg/day) significantly increased the skin's ability to eliminate free radicals, thus reducing structural damage.

Furthermore, omega-3s, found particularly in vegetable oils, nuts, and fatty fish, play a key role in modulating the inflammatory and enzymatic processes involved in skin sagging. A study by EZZEDINE and his team involving 2919 volunteers showed that a higher intake of omega-3s was associated with a reduction in photoaging. This action is based particularly on the ability of these molecules to reduce the activity of matrix metalloproteinases, and thus the degradation of collagen and elastin, by inhibiting the MEK1/ERK/c-Fos and SEK1/JNK/c-Jun signalling pathways.

Beyond its crucial impact on overall health, a balanced diet could also contribute to firming the skin of the face.

4. Resorting to aesthetic medicine.

Finally, although the techniques mentioned above may contribute to improving skin firmness, aesthetic medicine remains today the most effective method for visible and rapid results. Techniques such as hyaluronic acid injections, botulinum toxin, microneedling, radiofrequency, or even laser, can restore skin volume, improve its tone and stimulate collagen production. However, these procedures have certain drawbacks: they can be quite invasive and lead to more or less significant side effects, ranging from simple redness to bacterial infections, and even oedema. Lastly, aesthetic medicine comes at a cost, which can sometimes be high.

The advantages and disadvantages of various aesthetic medicine methods for tightening facial skin are compiled in the table below.

Technique	Benefits	Drawbacks
Hyaluronic Acid Injections	Restores volume and hydrates the skin, provides an immediate and natural effect, gently stimulates collagen production.	Temporary results (6 to 18 months), risks of swelling, bruising or asymmetry, high long-term cost.
Botulinum toxin injections (botox)	Smooths expression lines, prevents the emergence of deep wrinkles, visible effect within a few days.	Temporary results (3 to 6 months), risk of a frozen appearance in case of overdosage.
Microneedling	Stimulates the production of collagen and elastin, improves the texture and radiance of the skin, minimally invasive.	Multiple sessions required, temporary redness and irritation, risk of infections if poorly executed.
Radiofrequency	Stimulates collagen production by heating the tissues, a gradual and natural effect, non-invasive and without social exclusion.	Progressive results requiring multiple sessions, less effective on very loose skin, sensation of heat sometimes uncomfortable.
Laser (fractional, ablative, non-ablative)	Enhances the firmness, texture and radiance of the skin and significantly stimulates collagen production.	May require social avoidance depending on the intensity, temporary redness and swelling, high cost and multiple sessions often necessary.
Thread Lifts	Immediate effect, stimulation of collagen production, results that can last up to 2 years.	Risks of irregularities or asymmetry, progressive resorption of the threads, possible discomfort or pain after application.
Surgical Facelift	Spectacular and long-lasting results (10 years and more), effectively acts on advanced sagging, overall effect on the facial contour.	Invasive intervention requiring a recovery period, risk of complications (bruising, infections), very high cost.