Menopause And Perimenopause–Managing Challenging Changes Facial Plastic Surgeon Dr. Melanie Malone

Understanding The Shift

Nearly every woman is familiar with the idea and expectations of menopause. A less discussed stage of life is perimenopause, which is the lead up to menopause and can start as soon as a woman’s late 30s or early 40s. Perimenopause is often signaled by irregular periods, but the changes go way beyond your monthly cycle. Menopause may bring to mind mood swings and hot flashes, but it doesn’t stop there. In both menopause and perimenopause, hormonal fluctuations start disrupting multiple systems in the body, and one of the most noticeable impacts often includes changes related to your skin.

Many women are surprised to learn that these hormonal dips actually kick off an accelerated form of aging. This is usually not the gradual changes you might’ve seen between your 20s and 30s. These are often startlingly rapid changes that can affect how your skin looks, how your body feels, and even how you recover from surgery. The good news is, thanks to modern research and advanced techniques, you don’t have to be stuck with it. With aesthetic approaches, wellness support, and evidence-based supplements, we now have targeted ways to manage these shifts from the inside out.

How Menopause And Perimenopause Accelerate Skin Aging

So, what is the ultimate culprit behind this decline? Estrogen. Estrogen is the hormone that gives your skin a youthful plumpness and glow, but it starts to decline before you reach full menopause. As estrogen drops, so does your body’s ability to produce collagen, which is your skin’s structural support protein. Research has shown that as much as 30% of a woman’s collagen can be lost in the first five years after periods become irregular. That’s a major shift, and it helps explain why many women start to notice sudden changes in their faces.

You might notice fine lines deepen, cheeks look a little flatter, and the skin starts to feel thinner and more crepey. This isn’t your standard aging, and it explains why, for many women, previous skin care routines or maintenance treatments may not be as effective as they once were. Menopause and perimenopause bring a sharp, hormonally driven turn that accelerates visible aging, slows cellular turnover, and can even affect how well you heal.

Why This Matters for Facial Aesthetics and Surgery

If you’re considering facial rejuvenation, whether it’s a facelift, eyelid surgery, or injectables, it’s essential to understand how perimenopausal and menopausal changes may impact your results. When collagen and elastin are depleted due to a drop in estrogen, the skin doesn’t respond or recover the same way it did in your 20s or 30s.

Surgeons often see that outcomes vary significantly based on skin quality. A facelift may lift the deeper tissues, but if the overlying skin lacks elasticity or density, the final look might not be as smooth or long-lasting as desired. Eyelid surgery on thinner skin can lead to prolonged swelling or slower healing. That’s why patients who are experiencing hormonal changes due to menopause and perimenopause may benefit from taking a proactive approach by supporting collagen levels before and after any procedure. It’s not just about getting great results, it’s also about sustaining them.

What About the Body and Brain?

The effects of perimenopause and menopause, of course, aren’t limited to your skin. There’s a bigger picture here that includes your bones, muscles, and even your brain. During those early years of hormonal change, bone density is lost, muscle mass starts to drop, metabolism slows, and your body composition may start shifting in ways that feel out of your control.

Then there’s the mental side with symptoms like brain fog, difficulty concentrating, memory lapses, and disrupted sleep. These changes can make you feel like you’re losing yourself, or losing your mind, but the truth is, your brain and body are simply running on a new and different hormonal track. By supporting your skin, body, and brain through this shift with a personalized plan for wellness, many women can get to a comfortable place again for both mind and body.

Medical And Aesthetic Strategies That Can Help

Navigating menopause and perimenopause successfully means addressing all the systems that are changing, inside and out. Some whole-body solutions that blend medical aesthetics with wellness can be used to improve overall quality of life and fight back against the tides of time.

Collagen Induction Therapy With Radiofrequency Microneedling

This treatment combines microneedling with radiofrequency energy to stimulate collagen and elastin deep within the skin. It’s a dual-action answer for tightening and rejuvenation, especially for skin that’s starting to lose firmness. In addition, it pairs wonderfully with PRP (platelet-rich plasma) for enhanced regeneration.

LED Red Light Therapy

This non-invasive treatment uses red light wavelengths to activate fibroblasts, which are the cells responsible for collagen production. LED red light therapy is gentle, requires zero downtime, and is perfect for maintenance in between more intensive treatments.

Exosomes and Hormone-Responsive Regeneration

Exosomes are essentially cell-derived messengers that help your tissues naturally repair and regenerate. Initial research suggests that they may also play a role in hormone-related tissue health, which is particularly exciting as a potential means of easing the skin's aging process during hormonal changes such as menopause and perimenopause. Certain advanced facial treatments now include exosomes for rejuvenation on the cellular level.

Vitamins and Supplements That Make a Difference

There are a variety of supplements that can be incredibly helpful as part of a highly tailored wellness treatment plan. Some top picks include:

• Collagen peptides, which support the skin’s structure from within
• Creatine, which helps preserve muscle mass and boosts brain energy in menopausal and perimenopausal women
• Plant-based antioxidants that can help fight oxidative stress and support glowing skin
• Targeted multivitamins, especially those designed for women 40+, which support hormonal balance, cognition, and energy