Facial Aging in Perimenopause and Menopause

Why It Happens and How to Treat It

Many women notice more visible changes in their faces during their 40s and 50s.

The skin may feel thinner. The jawline may look less defined. The eyes can appear heavier or more tired. Volume in the cheeks and upper face may seem to fade.

This is not just chronological aging. Hormonal change can play a major role.

At LEA Plastic Surgery, Dr. Goretti Ho Taghva approaches facial aging in perimenopause and menopause as a combination of structural change, volume loss, and declining skin quality. Rather than treating one concern in isolation, she evaluates the face as a whole and recommends a combination of treatments that best fit your anatomy and goals.

What Changes During Perimenopause and Menopause

Facial aging during this stage is driven by multiple changes that occur simultaneously.

Estrogen Decline and Skin Quality

As estrogen levels decrease, collagen production declines. The skin becomes thinner, less elastic, and more prone to fine lines and laxity. Many patients also notice increased dryness and a loss of skin firmness.

Volume Loss and Fat Redistribution

Facial fat compartments can lose volume and redistribute over time. This can lead to:

• Flattening of the cheeks
• Hollowing under the eyes
• Increased heaviness in the lower face

These changes often make the face appear more tired or drawn, even without significant weight change.

Structural Support Changes

Facial aging is not limited to the skin. Over time, deeper support structures change, including ligaments and bone. This contributes to sagging in areas such as the jawline, neck, and midface.

Why One Treatment Is Often Not Enough

Many patients come in asking for a single solution.

Filler. Skin tightening. Or a facelift.

But hormonal facial aging affects multiple layers of the face at the same time. It can involve structure, volume, and skin quality together.

Treating only one layer often leads to results that feel incomplete or unbalanced.

The goal is to identify what has changed and address each component appropriately.

Dr. Ho Taghva’s Approach to Hormonal Facial Aging

Dr. Ho Taghva does not treat the face as a collection of isolated concerns.

During your consultation, she evaluates:

• Facial structure and support
• Patterns of volume loss
• Skin thickness and quality
• Your stage of aging and goals

This allows her to recommend a treatment plan that is tailored to your anatomy, rather than applying the same procedure to every patient.

Treatment Options for Perimenopausal and Menopausal Facial Aging

Structural Lifting

For patients with visible sagging in the midface, jawline, or neck.

A deep plane facelift repositions the deeper structures of the face rather than simply tightening the skin. This creates a more natural and longer-lasting result.

In some cases, an endoscopic brow lift may also be recommended to restore brow position and improve the upper face.

Volume Restoration

One of the most important components of facial aging during this stage.

Fat transfer restores lost volume using your own tissue. It is commonly used to improve:

• Cheeks
• Temples
• Under-eye hollows
• Lips

For appropriate candidates, fat transfer can provide natural-feeling volume restoration that often outlasts temporary fillers.

Nanofat may also be used to support skin quality while restoring subtle volume.

Skin Quality and Collagen Support

Changes in skin quality are a key part of hormonal aging.

Energy-based treatments such as:

• Ultherapy PRIME
• Thermage FLX
• Radiofrequency microneedling

May be used to support collagen production, improve skin firmness, and refine texture, and can be used on their own or as part of a broader treatment plan.

A Combined Approach

Most patients benefit from a combination of treatments rather than a single procedure.

For example:

• Structural lifting to reposition deeper tissues
• Fat transfer to restore volume
• Skin treatments to improve texture and firmness

This layered approach is designed to create balanced, natural-looking results.

Who This Is For

This approach is designed for women who:

• Are in their late 30s to 60s
• Have noticed more visible or accelerated facial aging
• Believe they look more tired or older than they feel
• Have tried fillers, but are not seeing the same results
• Want a long-term, natural-looking outcome

Why Patients Choose Dr. Ho Taghva

Dr. Ho Taghva combines surgical precision with a comprehensive approach to facial aging.

Her work integrates:

• Advanced techniques such as deep plane facelift and endoscopic procedures
• Fat transfer for natural volume restoration
• Non-surgical treatments to support skin quality

Her focus is on restoring structure and balance while maintaining natural facial expression and identity.

Start With the Right Diagnosis

If your face has changed and you are not sure why, the first step is understanding what is actually causing those changes.

A consultation with Dr. Ho Taghva allows you to explore the underlying factors and the treatment options that make sense for you.

Schedule your consultation at LEA Plastic Surgery to create a plan tailored to your face, your stage of life, and your goals.

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