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  • Aesthetic Medicine

Correcting skin sagging in the areas that can betray your true age

  • 22nd April 2019
  • Thierry PIOLATTO

By Dr. Benjamin Cozanet

Over time, and with dieting, cryolipolysis treatments and pregnancy, the skin stretches and loses its elasticity on the belly, neck, décolleté and knees. These areas are also prone to dehydration, but a combined treatment can recover their tonus and firmness.

The stomach, a symbol of seduction?

Regardless of our age, the stomach and belly button are always associated with sex appeal, both in men and in women. To treat moderate sagging, the Ulthera micro-focused ultrasound treatment is effective for firming up the skin after weight loss, in one or two sessions spaced six months apart. In the case of sagging skin above the belly button, associated with a fatty bulge just underneath (a common problem), I first perform cryolipolysis on the area followed by an Ultherapy treatment two months later. I pass two ultrasound transducers across the area twice, penetrating to 1.5mm and 3mm, to stimulate the collagen in the mid and superficial dermis. I schedule follow- up appointments after 3 and 6 months. The first results can be seen after 2 months, and these gradually develop until 6 months after treatment.

Sagging skin

Toning and plumping the neck and décolleté, smoothing the knees

The skin in these areas is constantly subjected to mechanical constraints – bending and folding – day and night. These movements affect the skin’s elasticity and collagen density, and even more so because these areas are prone to dehydration. To offer the best solution to this double problem, I have devised a pain-free protocol that involves an Ultherapy treatment immediately followed by the “nappage” injection technique, using a cannula and fluid hyaluronic acid.

In sagging, dehydrated and crumpled skin, the ultrasounds have a firming and lifting effect. Since some of the SMAS fibres run down into the neck and the base of the décolleté, Ulthera’s DeepSee technology (which allows us to visualise the ultrasound scan in real time) helps improve our precision when directing the ultrasounds, and thus gives better-quality results with regard to the lifting effect achieved. I first pass over the area with a transducer that penetrates to a depth of 4.5mm, to firm up the muscles. A second passage to a depth of 3mm tightens up the dermis and, in the case of a more damaged neck or décolletage, another passage to a depth of 1.5mm allows us to smooth the skin further. With regard to the knee area, which more and more people are asking to treat, Ultherapy provides great results by emitting its ultrasounds to a depth of 4.5mm and 3mm. The second part of this protocol involves the nappage technique using a cannula and hydrophilic hyaluronic acid, such as Belotero Hydro, which offers great hydrating properties thanks to its glycerol. Thanks to this protocol, we achieve immediate results from the nappage, followed by new collagen and elastin production over the following weeks, brought about by the ultrasounds.

The three vital components for regenerated skin are thus restored: hydration, elasticity and density.


Dr Benjamin Cozanet aesthetic doctorDoctor Benjamin Cozanet

Award-winning graduate of the Paris Medical Faculty, former registrar at Paris Descartes University. Graduated from the International College of Aesthetic Medicine. Member of the French Society for Morphological and Anti-Aging Medicine, and the French-speaking Society for Medical Lasers.

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