Perimenopause marks one of the most significant transitions in a woman’s life—and it often begins earlier than many expect. For most women, hormonal changes start as early as your late 30s but for most their early 40s, and the effects on the skin accelerate dramatically during this time and the first five years after menopause.
This isn’t “just aging.” It’s a biologically intense period where collagen, elastin, bone structure, and facial fat pads change rapidly—and addressing these shifts requires more than filler alone.
Let’s break down what’s happening beneath the skin and explore the most effective strategies for maintaining healthy, lifted, radiant skin through this transition.
The Hidden Changes of Perimenopause
1. Collagen Loss Skyrockets
During perimenopause and early menopause, the skin experiences a 30% reduction in collagen.
Collagen is responsible for firmness, elasticity, and youthful structure. When it declines this quickly:
- Skin becomes thinner, drier, with less spring
- Fine lines deepen
- Sagging begins earlier than expected
- Skin looks less resilient and more crepey
- Makeup won’t stay put and starts to look dull and caked on
This is why women often feel like they “aged overnight” during their 40s and early 50s.
2. Elastin Begins to Fragment
Elastin gives skin its ability to “bounce back.” As elastin fibers break down:
- Skin loses snap and recoil
- Jawlines begin to soften asnd jowling appear
- Under‑eye and lower‑face laxity become more noticeable, deepening dark circles
Elastin loss is extremely difficult to rebuild, which makes early intervention especially important.
3. Bone + Fat Pad Changes Alter Facial Structure
Most people think wrinkles cause an aged appearance—but deeper structural changes play an even larger role.
Bone Loss
As hormone levels decline, bone density decreases in the cheekbones, jaw, and around the eyes, subtly changing your facial shape. Early DXA scans can help with detecting overall bone loss. Suspect something is going on if you are losing height.
Fat Pads Shifting
Facial fat pads begin to:
- Deflate
- Shift downward
- Separate from neighboring fat pads
This contributes to:
- Hollowness under the eyes
- Deepening of nasolabial folds
- Jowling
- Flattening of the cheeks
Why Filler Alone Isn’t the Solution
While fillers can restore some volume, relying solely on them in perimenopause can:
- Look unnatural if overused
- Fail to address skin quality and laxity
- Ignore the root causes (collagen, elastin, bone, and fat changes)
A more comprehensive and natural‑looking approach blends volume restoration, skin rejuvenation, and tissue tightening.
A More Effective Approach: What Really Works
✔ Advanced Medical‑Grade Skincare
Stimulates collagen, improves texture, supports cell turnover. You can do this with procedures as well, but both back each other up. We offer 4 lines of medical grade skin care that has made a number of advances to what you can accomplish.
✔ Photofacials or Lasers
Address pigmentation, redness, fine lines, and early laxity. Rather than playing catch up and having Ozempic face, treat early to stay looking healthy, fresh, rested.
✔ Skin Tightening Procedures
Devices such as ultrasound or radiofrequency strengthen the deeper support layers and improve firmness.
✔ Biostimulation
Treatments like Sculptra or hyperdilute Radiesse stimulate the body to rebuild collagen—ideal during the rapid collagen‑loss phase of perimenopause. We can use this on your neck, your arms, your legs. Minor discomfort with treatment and temporary bruising are all most women report as side effects.
When combined strategically, these treatments work synergistically to restore youthful contours, improve skin quality, and slow the aging process from multiple angles.
The Bottom Line
Perimenopause brings rapid, multisystem changes that affect how the face looks and ages. Filler has its place—but it must be part of a broader strategy that supports the skin, deep tissues, and structural integrity.
A personalized, multi‑layered approach helps women look refreshed, confident, and naturally lifted through every stage of hormonal transition.
