Sagging facial skin results from the loss of volume from the face, and the aging of the superficial skin. Traditionally surgeons correcting the problem pulled the sagging tissue and cut away the excess. You can tell who those patients are when you see them walking down Rodeo Drive in Beverly Hills, Park Ave in Manhattan, and Collins Drive in Miami. Natural results can be obtained today by restoring volume to the face, and then by treating the face and neck with Fraxel repair. In the great majority of my patients, this will restore an amazing youthful, rested appearance to the face. This will not leave a patient as "tight" as they might be after a surgical facelift. In some cases of excessive skin "sag", traditional surgery may still be needed.