The Real Causes of Facial Ageing

Facial ageing is not caused by loose skin alone and involves gradual changes in the skin, fat, ligaments, muscles and facial structure.

In questioning the cause of why faces age, you may have noticed that the answer is more layered. Skin laxity is part of it, but deeper changes also affect facial shape, folds, jowls and neck definition.

For patients considering facelift surgery in Melbourne, understanding these layers can help you walk away from consultation feeling more informed. More informed about what surgery can address, what it cannot and why individual assessment with a Specialist Plastic Surgeon, like Dr Jeremy Richardson, is valuable.

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What causes facial ageing?

The face changes over time because the structures that support facial shape change too. Genetics, sun exposure, smoking or vaping, weight changes, hormones, general health and the natural ageing process can all influence how the face ages. Visible changes include:

Jowls along the jawline
Deeper folds around the nose and mouth
Lower cheek heaviness
Loose skin around the face and neck
Changes in skin texture or pigmentation
Reduced definition between the jawline and neck

These changes develop gradually, and for most people, the first signs are subtle shifts in facial volume and support before skin laxity becomes more obvious.

Skin changes

Skin changes are usually the most visible part of facial ageing. Over time, skin becomes thinner, less elastic and more prone to fine lines, pigmentation and surface texture changes.

In Australia, sun exposure is one of the major contributors to visible skin ageing and can appear as pigmentation, rougher texture, redness, thinning skin or fine lines.

Facelift surgery can remove or redrape selected loose skin, but it does not treat every skin quality concern. Pigmentation, sun damage and fine surface lines usually need different treatment planning, skin care or non-surgical skin treatments.

Fat and facial volume

Facial fat is arranged in compartments across the cheeks, temples, under-eye area, jawline and neck. With age, some of these reduce in volume, shift or descend. Facial ageing looks different from person to person, but can include:

Hollowing around the eyes or temples
Flatter cheeks
Deeper nasolabial folds (the creases in your skin from your nose to the corners of your mouth)
Heaviness around the lower face
Jowls (excess skin and soft tissue that hangs from the jawline or chin)
Fullness under the chin or neck

A facelift can reposition descended soft tissue in selected areas. It does not treat every type of volume loss, so other options may be discussed if volume or skin quality is part of the concern.

Bone and facial structure

Facial bones provide the foundation for the soft tissues above them. With time, the facial skeleton can change in shape and volume, around the eye sockets, cheeks, jawline and chin.

As bony support changes, overlying tissues can appear less supported, accentuating hollowness around the eyes, flatter cheeks or reduced definition in the lower face.

A facelift does not change bone structure, so for concerns about facial support, proportion or projection, Dr Richardson may discuss a different procedure to facelift, a combined surgical plan or non-surgical treatment after assessment.

Ligaments and soft tissue support

Facial ligaments help hold the soft tissues in position and with ageing these support structures can loosen. When this happens, facial tissues can descend, contributing to cheek descent, jowls and deeper folds.

Facelift techniques are designed to address soft tissue descent. Depending on your anatomy and surgical plan, this could involve repositioning deeper tissue layers and not just relying on skin tightening alone.

The distinction is important to Dr Richardson’s practice. Facelifts are not only about removing or tightening loose skin – the surgery is planned around support beneath the skin just as much as it is around the skin itself.

What facelift surgery can address

Facelift surgery (rhytidectomy or meloplasty), is used to address ageing changes in the lower face, jawline and sometimes the neck. Based on your anatomy, goals and the technique used, facelift surgery can address:

Jowls
Lower face laxity
Loose skin along the jawline
Soft tissue descent in the cheeks or lower face
Reduced definition between the face and neck
Neck laxity, when a neck lift is included

A facelift may sometimes be combined with neck lift surgery, though for others, a different procedure or staged plan may be more appropriate.

What facelift surgery cannot address

A facelift cannot stop ageing or create the same change for every patient. It does not change bone structure, fully correct deep volume loss or treat all skin surface concerns.

Concerns such as pigmentation, sun damage, fine lines, rough texture and some forms of volume loss may need separate treatment planning. Skin quality, facial structure, previous surgery, smoking history, health and healing can all influence what is realistic.

Consultation with Dr Jeremy Richardson can help separate concerns that surgery can address from those better suited to another option.

FAQs about Facial Ageing and Facelifts

Can facelift surgery change the shape of your face?
Facelift surgery can change the appearance of face shape by addressing jowls, lower face laxity and reduced definition along the jawline. It does not change bone structure, so concerns about facial support, proportion, projection or volume may need a different procedure, a combined surgical plan or non-surgical treatment.

Can a facelift address loose skin and jowls?
Facelift surgery can address areas of loose skin, lower face laxity and jowls, especially when these concerns relate to soft tissue descent.

Does facelift surgery improve skin texture?
Facelift surgery can reposition skin, but it does not treat every skin quality concern. Pigmentation, sun damage, fine surface lines and texture changes may need specific skin care or non-surgical treatment.

How long is recovery after facelift surgery?
Recovery varies, but swelling, bruising, tightness and social downtime are expected in the early stages. Dr Richardson will discuss your recovery timeframe based on your procedure, health, work demands and if a neck lift or other surgery is included.

Considering facelift surgery in Melbourne?

Facial ageing is layered, so surgical planning should be individual. A consultation with Dr Jeremy Richardson can help you understand which changes relate to skin, fat, soft tissue support or facial structure, and what surgery can and cannot address.

Dr Jeremy Richardson, MED0001204528, is a Melbourne-based Specialist Plastic Surgeon with qualifications including MBBS (Hons), BMedSc (Hons), DipSurgAnat and FRACS (Plast). He has a special interest in facial cosmetic and reconstructive surgery, including facelift, neck lift, brow lift, blepharoplasty eyelid surgery and rhinoplasty nose surgery.

To discuss facial ageing, facelift surgery or neck lift surgery, contact Queens Parade Specialists in Fitzroy North, Melbourne, to book your consultation with Dr Richardson.

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References

Advanced Cosmetic Surgery & Laser Center. (2026). Facelift Recovery | The First 14 Days What’s Normal & What’s Not. YouTube. https://www.youtube.com/watch?v=OlJf8eGi4vs

Lalwani, A. K. (2020). Access Medicine. Current Diagnosis & Treatment Otolaryngology | Head and Neck Surgery (A. Moyer, Ed.; 4th ed., Vol. 76). https://accessmedicine.mhmedical.com/content.aspx?bookid=2744&sectionid=229681625

Mayo Clinic. (2026). Face-lift – Mayo Clinic. https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059

The McIndoe Centre. (2026). Can Plastic Surgery Change Your Face Completely? https://www.themcindoecentre.co.uk/news/can-plastic-surgery-change-your-face-completely/

This article is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. All surgery carries risk and results may vary. Consult Dr Jeremy Richardson, MED0001204528, MBBS (Hons), BMedSc (Hons), DipSurgAnat, FRACS (Plast), Specialist Plastic Surgeon, for personalised advice and tailored treatment.