“Doctor, I look tired.”
I hear this sentence multiple times every single day.
Most of the time, it isn’t tiring at all. It’s sagging.
As Dr. Devayani Barve, I explain this clearly to my patients—when the face starts to sag, it is not just the skin falling down. The real issue is deeper. The underlying support system of the face, known as the SMAS layer (the muscle-mask of the face), slowly shifts downward with age, gravity, and collagen loss.
This is why firming creams and tightening serums fail at a certain stage. They work on the surface, while sagging begins much deeper. Correcting sagging requires structural thinking, not cosmetic shortcuts. Choosing the Best Plastic Surgeon in Mumbai matters here—not for dramatic change, but for doing the right intervention at the right time.
Why Does Your Face Start Sagging?
Facial sagging is not sudden. It is gradual and cumulative. Over the years, collagen production declines, facial ligaments stretch, and fat pads descend. Gravity works relentlessly, and the face slowly loses its youthful support.
What you see as jowls, drooping cheeks, or a heavy lower face is the visible result of these deeper changes—not just loose skin.
Understanding the SMAS Layer: The Real Cause of Sagging
The SMAS layer acts like the internal scaffolding of the face. When it weakens or slips downward, the skin follows.
This is why treatments that only tighten skin give temporary or disappointing results. Long-lasting correction depends on how effectively we address this deeper structural layer—either indirectly with non-surgical methods or directly with surgery.
The Three Intelligent Levels to Fix a Sagging Face
Not every sagging face needs surgery. The solution depends on how advanced the sagging is. I categorise correction into three practical levels, each designed for a specific stage of ageing.
The “Liquid Lift” for Mild Sagging
When sagging is just beginning, fillers can be used intelligently to create lift.
Using a Liquid facelift treatment, we place fillers strategically along the cheekbones to create strong anchor points. By restoring volume at the top of the face, the skin and soft tissues are pulled upward from below.
This approach offers instant gratification and works best when sagging is mild and skin elasticity is still good. It is subtle, effective, and preserves natural expressions.
Thread Lifts for Moderate Sagging
When sagging becomes more noticeable but surgery feels premature, thread lifts act as a temporary suspension system.
With a Thread lift for the face, dissolvable threads are used to physically lift sagging tissues. As the threads dissolve, they stimulate collagen production, improving firmness over time. This option is especially popular for weddings, events, or when patients want visible improvement without surgery.
However, it’s important to understand that thread lifts are not permanent. They are a bridge—not a final solution. For patients seeking longer-lasting tightening without a full surgical facelift, FaceTite offers a more advanced option. It uses radiofrequency energy to melt fat and contract skin from within, delivering stronger and more durable contouring. FaceTite is often chosen when skin laxity goes beyond what threads alone can correct.
When Surgery Becomes the Smartest Choice?
For significant sagging, surgery provides the most definitive and long-lasting correction.
A Deep plane facelift surgery or MACS lift facelift addresses sagging at its source by lifting the SMAS layer itself rather than simply tightening skin. This avoids the tight, pulled, or “windblown” look associated with outdated facelift techniques.
The outcome is not an altered face—it is your face, repositioned to where it naturally belonged years ago.
My Honest Advice About Sagging and Creams- Dr. Devayani Barve
If you can pinch more than 2 cm of loose skin at your jawline, no cream, serum, or facial can fight gravity.
At this stage, structural lifting is required. Continuing to spend money on surface-level solutions only delays proper correction and leads to frustration. Smart treatment planning saves both time and money in the long run.
How We Decide the Right Treatment for You?
There is no universal solution for sagging. Facial anatomy, skin quality, age, and lifestyle all play a role.
A personalized plan may involve Sagging face treatment, Non surgical face lift, or surgical correction—depending on what your face truly needs. The goal is always the same: natural results that restore balance and confidence without exaggeration.
About Dr. Devayani Barve
Dr. Devayani Barve is an internationally trained Plastic, Aesthetic, and Reconstructive Surgeon based in Mumbai. She is widely respected for her ethical, anatomy-first approach and her belief that aesthetic treatments should enhance confidence without erasing individuality.
She completed her MBBS and MS in General Surgery from the prestigious KEM Hospital, Mumbai, followed by a super-specialty M.Ch in Plastic Surgery from PGIMER, Chandigarh—one of India’s premier medical institutes. Her training is further strengthened by extensive international exposure, including advanced aesthetic and breast surgery fellowships in Miami, USA.
Dr. Barve has also served as an Assistant Professor of Plastic Surgery at Christian Medical College, Vellore, and has multiple peer-reviewed publications to her credit. Her balanced blend of surgical precision and aesthetic judgement makes her especially trusted for facial rejuvenation procedures.
If you want to understand non-surgical rejuvenation in detail, I regularly share educational content and patient-centric explanations online.
🎥 Watch my breakdown of non-surgical rejuvenation on YouTube:
https://www.youtube.com/@DrDevayaniBarve
📸 See real patient results on Instagram:
https://www.instagram.com/doctorbarve/?hl=en
Patient Experiences
- Kavita M. – “I realised my problem wasn’t tiredness but sagging. The lift looks natural and balanced.”
- Shalini P. – “The explanation about gravity and facial structure changed how I looked at ageing.”
- Rekha T. – “Threads gave me confidence for an important family function without surgery.”
- Neha L. – “The facelift result looks subtle—people say I look happier, not different.”
- Sunita A. – “I appreciated the honesty. I wasn’t pushed into treatment I didn’t need.”
Frequently Asked Questions
Is sagging reversible without surgery?
Early sagging can improve with fillers threads or technologies like facetite, but advanced sagging usually needs surgery.
How long does a liquid lift last?
Results typically last 12–18 months, depending on fillers and ageing speed.
Are thread lifts painful?
Discomfort is mild and temporary, with quick return to daily activities.
Will a facelift look unnatural?
Not when deeper layers are lifted instead of simply tightening skin.
How do I know which option suits me?
A detailed consultation and facial assessment determine the best approach.
Sagging is not a skincare failure—it is a natural biological process. The solution lies in understanding structure and choosing the right level of correction at the right time. Whether non-surgical or surgical, the correct approach restores harmony, confidence, and facial balance.
Book Your Appointment
📍 Jewel Aesthetic Center, Juhu, Mumbai
📧 doctorbarve@gmail.com
📞 +91-9167334189 | +91-22-45038145
📲 WhatsApp: +91-9167334189
Gravity may be relentless—but with the right strategy, you stay in control.