I'm a man in my 40s. Which lifting should I start with?
“In photos lately my jaw looks like it's collapsing, and my face looks stiff.” Men in their 40s often open a consultation this way. But when we look at the face together, it's usually not one kind of sagging. Two or three things overlap, so we start by pulling them apart.
The short answer
A man's face in his 40s usually looks saggy because a dropping jawline, deeper forehead and frown lines, and rougher, thinner skin texture all come at once. If the jawline has blurred, radiofrequency lifting such as Density, XERF or Oligio Kiss comes first. Expression lines and texture don't improve with lifting, so Botox and Lituo handle those. The combination I often suggest at Miso Clinic for men in their 40s is radiofrequency lifting plus Botox when there's sagging, and Botox plus Lituo when texture and lines come ahead of sagging. At Miso Clinic in Daegu, I look at front and side photos to see whether sagging or lines come first.
What changes in a man's face in his 40s?
Men's facial skin is usually thicker and oilier. In ultrasound measurements of 200 Chinese adults, men's skin was thicker in all 16 site and age combinations. That's why deep folding expression lines and a dropping jawline tend to stand out before fine lines do.
Strong expression muscles that deepen forehead and frown lines, frequent irritation from shaving, and skipping sunscreen are also common differences. When these three overlap in your 40s, people start saying your face “looks hard”.
→ Read more: Lifting for men: what is different?
What should I choose for each concern?
| Concern | Type of treatment | Combination at Miso Clinic | What to expect, and the limits |
|---|---|---|---|
| Blurred jawline, cheeks moving down | Radiofrequency lifting | Density · XERF · Oligio Kiss | Daily life the next day. Assessed over 2–3 months |
| Sagging + deep forehead and frown lines | Radiofrequency lifting + Botox | Radiofrequency lifting + Botox | Botox handles lines, radiofrequency handles sagging, separately |
| Rough, thinner texture and pores | Material-replenishing booster | Lituo (Re2O) + Botox | Texture and density. Does not add volume |
| Square jaw, wide lower face | Jaw Botox | jaw Botox | We check that losing side volume does not make the face look saggier |
| Cheeks and jawline that have dropped a lot | Dissolving thread lift | dissolving threads, and ligament injection for contour | Allow for bruising and swelling; book before a weekend |
→ Read more: Density, XERF and Oligio Kiss: how the three devices differ
Do men need stronger lifting?
I get this question a lot, and no, that's not how I decide. Studies of radiofrequency lifting have looked almost entirely at women. The 39-person XERF study included 2 men, the 16-person Density data included 1, and I couldn't find any study comparing shot counts or power by sex.
So I set the shot count by how deep the sagging is, how wide the area is, and the heat you feel on the day, not by sex. That's also why I don't numb away all sensation. The heat is the signal I use to set the power.
There are three things I talk through separately with men: how to handle the beard area, how much numbing to use, and which day it's fine to have some redness left.
→ Read more: Density and XERF for men: what differs from women?
Who I suggest each combination for
- In your 40s, with a blurred jawline and deep forehead lines → radiofrequency lifting + Botox for the forehead and between the brows
- Not much sagging, but rough skin that looks tired → Botox + Lituo
- A square jaw together with a sagging jawline → look at radiofrequency lifting first, and set the jaw Botox amount while watching side volume
- Nothing obvious, nothing that gets in the way of work → start with radiofrequency lifting alone, and book injections for a Friday evening or Saturday
I couldn't find trials showing that Botox and Lituo together work better than one at a time. We do two because there are two concerns. Lituo is made from human skin, so before treatment we check the genuine product and its human tissue labelling together, and if you'd rather not, we plan with Rejuran or Gouri instead.
→ Read more: Lifting by age
When I look at things differently
- If thick fat under the chin is the main concern, I don't start with radiofrequency. There's no human data showing it reduces fat. We don't offer liposuction.
- If hollow cheeks or temples are the main concern, I look at dissolvable hyaluronic acid filler before lifting.
- If you have metal or electronic implants in your face, or inflamed skin, I don't do radiofrequency that day.
- Ulthera, Thermage, Onda, InMode and Shurink are devices we don't offer.
→ Read more: A consultation for facial sagging
How does the consultation work, and how do I book?
On a first visit we take photos from the front, at 45 degrees and from the side, and together we pick the one concern that bothers you most. I'll ask about any medications you take, any metal or electronic implants in your face, and whether you might be pregnant, and then I split things into what we can do today and what can wait for later. It's completely fine to come in just for a consultation and go home.
| Item | Details |
|---|---|
| Booking | Naver booking · KakaoTalk chat · Phone +82-53-428-2700 |
| Location | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook National University Hospital Station, Line 3) |
| Hours | Weekdays 11:00–19:00 · Saturday 10:00–16:00, closed Sundays and public holidays |
Lifting for men in their 40s FAQ
Does lifting work for men too?
I assess sagging by the same standard for men and women. I'll also tell you that study participants were almost all women, so results looking at men alone are few.
Do men need more shots?
I don't set it by sex. I set it by the depth and area of the sagging and the heat on the day. I couldn't find studies comparing shot counts by sex.
Can I go to work the next day?
Radiofrequency lifting doesn't break the skin surface, so the next day is usually normal. Redness can last from a few hours to a day.
Can I have Botox and Lituo on the same day?
If the areas differ, the same day is possible. We don't overlap them on the same area.
When can I shave again?
After radiofrequency, gently from the next day. Where Lituo was injected, wait until the injection points have settled. I'll go over it on the day.
Where can I get a lifting for men consultation in Daegu?
At Miso Clinic in Daegu (4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Exit 1 of Kyungpook National University Hospital Station). You can book through Naver booking, KakaoTalk or by phone at +82-53-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00, closed Sundays and public holidays.
Read next
Product pages
Related care: Density · XERF · Oligio Kiss · Botox · Lituo (Re2O)
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Data on radiofrequency lifting in men — Miso Clinic column daegu-density-xerf-men: 2 men among 39 people in the multicentre XERF study, 1 man among 16 in the Density data, and all 16 papers in a review of ultrasound lifting studied women. In ultrasound measurements of 200 Chinese adults, male facial skin was thicker in all 16 site and age combinations. No study compares settings by sex.
- Human studies of radiofrequency lifting — Density: Oku 2025 (16 people, 24 weeks); XERF: Hwang 2025 (20 people), Weiss 2026 (39 people), Erlich 2026 (16 people); none had a control group. I could not find a clinical trial of the Oligio Kiss device itself.
- Aftercare following non-invasive radiofrequency — Miso Clinic column after-rf-care: the two clinical trials that wrote down post-treatment instructions advised an immediate return to daily life and continuing usual skincare; burns appear within 72 hours, and hollowing at 1–4 months (2 months on average).
- Cochrane review of botulinum toxin — Camargo CP et al. Cochrane Database Syst Rev 2021;7:CD011301. PMID 34224576. 65 studies, 14,919 people.
- Human trial of Lituo — Lee YI et al. Int J Mol Sci 2026;27(5):2193. NCT07155278. Split-face, double-blind, randomised, 20 people, 20 weeks.
- Adverse events with absorbable threads — Ojha AS et al. Dermatol Surg 2025;51(3):272-6. PMID 39442180. 19 studies, 1,406 people: bruising 19.49%, swelling 16.79%, tenderness 9.96%, infection 2.49%, haematoma 0.64%.
- When results show — Miso Clinic column when-results-show: at day 90, 92% of doctors versus 42% of patients. In biopsies after collagen-stimulating products, no new collagen at 2 weeks, type III at 2 months, type I at 3–4 months.
- Korean medical advertising law — Korean Medical Service Act Article 56(2) (no treatment testimonials, no comparisons with other clinics, no superlatives). This is why this column carries no prices, reviews or before-and-after photos.
- Miso Clinic treatment policy — What we have: Density Noir (ALPHA · BOOST tips), XERF, Oligio Kiss; Lituo (Re2O), CellReDM, Reallo; Rejuran; the full Juvelook lineup; Gouri; Everwrinkle and Everwrinkle V; Radiesse; Byryzn; D-Classy; hyaluronic acid filler; Botox (all areas, skin Botox); ligament injection; dissolving threads. What we do not offer: Onda, Thermage, InMode, Ulthera, Shurink, liposuction. Hollow cheeks get dissolvable hyaluronic acid filler first, sagging gets lifting first; no radiofrequency that day with metal or electronic implants in the face, pregnancy or skin inflammation; threads are the dissolving kind, used conservatively over age 50; we decide by the change that bothers you, not by age; results are judged after 2–3 months with photos taken under the same conditions.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.