menopause
SEPTEMBER 2026
Why Has My Face Changed So Much Since Perimenopause?
By Eliza Clark, Advanced Nurse Prescriber
Why does my jawline suddenly look different?
This is one of the changes women often notice first.
And again, there isn't necessarily one single cause.
Changes in skin elasticity, facial fat, underlying structure and the effects of gravity can all alter the appearance of the lower face over time.
You may notice less definition between your face and neck or areas around the jaw that weren't particularly noticeable before.
And once you've spotted them?
Good luck not checking them in every mirror for the next fortnight.
But this doesn't mean something has suddenly gone wrong with your face.
It means your face has changed.
There is a difference.
There’s a particular moment many women seem to have somewhere around perimenopause.
You catch yourself in a photograph or glance in the mirror and think:
Hang on. When did my face change shape?
It’s not necessarily that you suddenly look dramatically older. You just look… different.
Perhaps your cheeks seem flatter than they used to. Your jawline isn't quite where you remember leaving it. Your under-eyes look more hollow or your lower face seems heavier, despite the fact that you haven't actually gained weight.
And because we're generally taught to think of facial ageing as wrinkles, these changes can be surprisingly confusing.
But here's the thing.
Your skin isn't the only part of your face that changes as you get older.
There's quite a lot going on underneath it too.
Your face is more than just skin
We spend an enormous amount of time talking about collagen, skincare and wrinkles, but your face is made up of layers.
There's skin, of course, but underneath that you've also got fat, muscle, connective tissue and bone, all working together to create the shape and structure of your face.
And all of those things can change with age.
Which means the face you see at 48 isn't simply your 28-year-old face with a few extra lines drawn on it.
The actual architecture is changing.
This feels mildly unfair given nobody gave us the architectural plans in the first place.
So what happens to facial volume?
When we're younger, facial fat tends to help give the face some of its softness and fullness.
As we age, the amount and distribution of that fat can change. Some areas can lose volume while others may appear heavier or sit differently.
That can contribute to things like flatter-looking cheeks, hollows around the temples or eyes and changes through the lower face.
This is why you can look at yourself and feel that your whole face has changed without being able to identify one particular wrinkle responsible for it.
There isn't one.
You're noticing a change in shape. You can read more about how we approach volume loss here.
And yes, our bones change too
We know.
Nobody asked for this information.
But the bones of the face also change as we age. Over time, changes to the underlying facial skeleton can affect the support available to the soft tissues sitting above it.
So when people talk about facial ageing, we're not simply talking about what's happening on the surface.
This is also why there are limits to what skincare can realistically achieve.
A brilliant skincare routine can support the health and appearance of your skin.
It cannot persuade your facial skeleton to reconsider its life choices.
Your moisturiser hasn't failed.
It just can't negotiate with your bones.
What does perimenopause have to do with it?
This is where things get slightly complicated, because perimenopause doesn't arrive in isolation.
It's happening at the same time as normal age-related changes to your face.
Changes in oestrogen can affect things such as collagen, skin thickness, elasticity and hydration, so the skin covering all of that changing facial structure may be changing too.
Put the two together and it can feel as though quite a lot has happened in a relatively short space of time.
Perhaps your cheeks look less full and your skin feels less firm.
Maybe your jawline has changed and the skin around it doesn't have quite the same elasticity.
So while it's tempting to blame absolutely everything on perimenopause, what you're often seeing is a combination of hormonal changes and the completely normal process of getting older.
Bloody hormones haven't helped.
But we can't give them all the credit.
What if I've lost weight too?
Weight loss can make facial changes more noticeable for some people, particularly if you've lost a significant amount of weight or lost it relatively quickly.
Less facial fat can mean areas that previously looked fuller appear more hollow or less supported.
And because many women are navigating changes in weight, hormones and ageing at roughly the same stage of life, it can be difficult to separate one thing from another.
This is also why treating what you think is the problem without looking at the face as a whole isn't always helpful.
A hollow doesn't automatically need filling.
A changed jawline doesn't automatically need treating.
And a face that looks different doesn't automatically need fixing.
Can skincare put the volume back?
No.
And we say that with enormous affection for good skincare.
There are brilliant ingredients that can improve hydration, texture, pigmentation and the appearance of fine lines. Skincare can support your skin barrier, protect against further UV damage and help your skin look healthier.
What it can't do is replace significant lost facial volume or fundamentally alter your underlying facial structure.
So if you've spent six months applying an expensive cream to your jawline and wondering why it hasn't returned to its 2007 position, please don't blame yourself.
Or necessarily the cream.
It was never a fair job description.
Does that mean I need filler?
Also no.
This is where aesthetics can become a little too simplistic.
Volume has changed? Add volume!
Except faces aren't paint-by-numbers.
Dermal filler can be useful for particular concerns in carefully selected people, but it isn't automatically the answer to every age-related facial change. Depending on what you're noticing, a completely different treatment might make more sense.
Or skincare might be the priority.
Or doing absolutely nothing might be the right answer for you.
This is why we prefer to start with what is bothering you, rather than deciding that every woman of a certain age needs a particular treatment.
“I just don't quite look like myself”
We hear versions of this a lot.
And it's an interesting thing to try to explain because sometimes there isn't one feature you desperately want to change.
You simply feel that the face looking back at you isn't quite the one stored in your head.
There's nothing vain or ridiculous about noticing that.
Our faces are incredibly tied up with how we recognise ourselves. When they change, particularly over what feels like a relatively short period, it can take a while for our internal picture to catch up.
But different doesn't mean worse.
And unfamiliar doesn't mean something needs fixing.
Sometimes understanding why your face has changed is enough to make those changes feel a little less alarming.
You don't need your old face back
Because it was attached to an earlier version of you.
Your face now has lived more life. It's laughed more, probably worried more, perhaps cried more and almost certainly spent more time awake at 3am than you'd have chosen.
It's going to change.
That doesn't mean you can't choose to do something about a particular part of that change if it bothers you.
You absolutely can.
But the goal doesn't have to be recreating your face at 30.
It can simply be looking in the mirror and thinking:
Yep. There I am.
Not quite sure what's changed?
Sometimes you know your face looks different but can't put your finger on why.
Take our Skin Check and tell us what you're noticing. We'll help you make sense of what's changing and give you personalised guidance on what might be worth exploring.