How to prevent face sagging: can massage stop it?
“It's not bad yet, but what should I do before it gets worse?” I've been hearing this much more often lately. Some of it can definitely be prevented. Not all of it, though. I think the honest answer starts with drawing that line for you.
The short answer
Nothing prevents face sagging completely, but some things can slow it: sun protection, not smoking, and avoiding rapid weight loss. I couldn't find a study showing that massage prevents sagging. Sagging involves more than skin. Facial fat shrinks compartment by compartment and the shape of the bone changes as well. A study comparing CT scans of the same people at least 7 years apart also confirmed changes in the midface bones. What has already come down is a matter for treatment rather than prevention, so it needs to be assessed by layer. At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700, we first look at which layer is the problem.
Why does the face sag?
| Layer | What happens | Can I change it? |
|---|---|---|
| Skin | Damage builds up from sun and smoking | Quite a lot |
| Fat | Each compartment shrinks and sinks differently | You can control the pace of weight change |
| Bone | Midface rotation, jawbone changes | Hardly at all |
A study that dissected 30 cadaver hemifaces confirmed that facial fat is made up of separate compartments. Bone doesn't stay put either. A study of 56 people comparing CT scans at an average age of 50 and 59 found the midface changed as if rotating clockwise, and women seemed to change earlier. In a study that scanned 21 people three times over about 20 years, the pace of change sped up in 8 of 21 measured items.
I have a reason for telling you this. However well you look after your skin, sagging still comes little by little, and that isn't your fault.
Can sunscreen prevent sagging too?
The research splits a little here. A study of 298 French women, divided into those who enjoy the sun and those who avoid it, tied pigment strongly to sun, but sagging was more related to age and didn't differ between the two groups. A study of 301 Chinese women, on the other hand, took the view that signs across the board, sagging included, were affected by sun. Both are observational studies by cosmetics company researchers.
In a randomised trial of 903 people, those who applied sunscreen daily had 24% less skin ageing over 4.5 years. But that trial measured the skin surface, not sagging. I still tell you to wear it. Even if it's unclear how much it does for sagging, your skin as a whole has nothing to lose.
Does massage help prevent sagging?
I couldn't find a study that looked at how much it slows sagging. The closest is the 34-person roller and gua sha trial, which only ran for 8 weeks and had no control group that went without massage.
Here's about as far as I go in the consulting room. Using it lightly on a puffy day is fine. But there's no evidence that pushing your flesh upward prevents sagging. I couldn't find a study showing that long, hard rubbing is harmful either, so there's no need to be scared of it. Still, there's no reason to go so far that you're left with bruises or redness.
→ More: How to firm up your face: can creams, exercise or massage do it?
Does losing weight make the face sag?
These days, with drugs like Mounjaro and Wegovy, I get this question constantly. A review of 40 papers on GLP-1 drugs and the skin reports loss of facial volume and firmness, and names rapid weight loss and older age as risk factors. But since it's a literature review, it's hard to put a number on how much sagging to expect.
If you're losing weight for your health, there's no need to hesitate because of your face. Health comes first. Talk with your own doctor about the pace, and once the weight loss is over and your weight has settled, then look at your face. I think that's the better order.
→ More: Does running make your face sag?
What if sagging has already started?
Prevention stops here. What has already come down depends on which layer is the problem. Where volume has gone, I consider dissolvable hyaluronic acid filler first. For sagging in the skin, we talk about lifting devices, and if it's more pronounced, thread lifting as well. When only one side has sagged, I look at the cause separately.
If you smoke, I'll bring this up first. In a study of 186 pairs of identical twins, the twin who had smoked longer looked older. That's a decision to make before any treatment consultation.
→ More: Only one side of my face is sagging: why?
→ More: Facial sagging and lifting: which layer is being adjusted
Face sagging: frequently asked questions
At what age should I start looking after face sagging?
There's no set age. In a study of 1,011 Japanese women, though, sagging differences began to show from the 30s and 40s. I'd suggest starting sun protection before then.
Does sleeping on my side make my face sag?
There's a review saying that the pressure of sleeping on your side or stomach creates sleep wrinkles. I couldn't find a study that measured whether it also causes sagging.
Will getting lifting early prevent sagging?
I couldn't find a study that compared people who started early with people who started late over the long term. If prevention is the goal, we first need to see whether your skin actually needs it.
Where can I get a face sagging consultation in Daegu?
At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00, closed Sundays and public holidays.
Read next
Product pages
Related treatments: Lifting · Wrinkles vs firmness · Types of facial wrinkles
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
- Changes in the facial bones — Fourgeot E et al. Intra-Individual Aging of the Facial Skeleton. Aesthet Surg J 2021;41(12):NP1907-15. PMID 33999176 (56 people) / Sifil MK, Kahn DM. Twenty Years of Facial Skeletal Aging. Aesthet Surg J 2026;46(4):415-27. PMID 41186165 (21 people).
- Facial fat compartments — Rohrich RJ, Pessa JE. The fat compartments of the face. Plast Reconstr Surg 2007;119(7):2219-27. PMID 17519724. 30 cadaver hemifaces.
- Sun and the signs of facial ageing — Flament F et al. Clin Cosmet Investig Dermatol 2013;6:221-32. PMID 24101874 (298 French women) / 2015;8:75-84. PMID 25709490 (301 Chinese women) / Int J Cosmet Sci 2019;41(5):425-36. PMID 31314913 (1,011 Japanese women). All by cosmetics company researchers.
- Randomised sunscreen trial — Hughes MCB et al. Ann Intern Med 2013;158(11):781-90. PMID 23732711. 903 people, 4.5 years.
- Randomised trial of rollers and gua sha — Ahn SH et al. Comparative Effects of Facial Roller and Gua Sha Massage on Facial Contour, Muscle Tone, and Skin Elasticity. J Cosmet Dermatol 2025;24(6):e70236. PMID 40439289. 34 people, 8 weeks, comparing the two methods.
- Rapid weight loss and the skin — Barone M et al. Effects of GLP-1 Receptor Agonists on Skin Quality: A Comprehensive Literature Review. Aesthetic Plast Surg 2026;50(13):5403-7. PMID 42162206. 40 papers.
- Twin study — Guyuron B et al. Factors contributing to the facial aging of identical twins. Plast Reconstr Surg 2009;123(4):1321-31. PMID 19337100. 186 pairs of identical twins.
- Sleep wrinkles — Anson G, Kane MAC, Lambros V. Sleep Wrinkles: Facial Aging and Facial Distortion During Sleep. Aesthet Surg J 2016;36(8):931-40. PMID 27329660.
- 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 practice guidelines — for hollow cheeks, dissolvable hyaluronic acid filler is considered first; no RF treatment that day if there are metal or electronic implants, pregnancy or skin inflammation; patients are advised to put off facial massage and gua sha for the first week after a procedure.
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.