Guide · Essen

In your 40s.

The decade in which most people come for the first time. The questions differ from those at 30 – and the answers need more distinction between expression, volume and skin.

InformativePhysician responsibleEssen-Rüttenscheid
Aesthetic medicine in your 40s
In short

Between 40 and 49 lines become static, cheeks and temples lose first support, the skin thins. What makes sense now

Orientation

Typical in this decade.

What shows: frown line and forehead lines remain at rest; crow's feet deepen. The mid-face begins to descend – the nasolabial fold becomes clearer, first shadows under the eyes, temples look flatter. The skin loses density, pigment spots appear, the neck shows first lines. In women perimenopause begins, in men the hair thins.

What can make sense: botulinum toxin in standard dose for the expression zones – now usually two to three zones. First targeted volume where support is missing: cheek or cheekbone (one to two millilitres), later tear trough or chin. Skin boosters or polynucleotides for face and neck. Microneedling with PRP for texture and pigment. PRP for the scalp with beginning hair loss.

What is usually too much: filling the nasolabial fold directly and generously (the cause lies in the cheek); more than three millilitres of filler in one session; every treatment at once. The face should change over a year, not over an afternoon.

Yearly plan: botulinum toxin two to three times, filler once, skin booster course plus refresh. Realistically 1,500 to 2,500 euros a year – considerably less depending on scope.

Orientation

At a glance.

What showsWhat can make senseWhat is usually too early or too much
Lines remain at restbotulinum toxin, 2–3 zonestoo high a dose (mask)
Nasolabial fold clearersupport cheek/cheekbone, 1–2 mlfill the fold directly and generously
Shadows under the eyestear trough carefully, after cheekfiller with eye bags
Skin thinner, pigmentskin boosters, microneedling + PRP, retinoidaggressive peels in summer
Neck first linesskin booster neck, sun protectionfiller in horizontal lines
Hair loss beginsdiagnosis, minoxidil, PRPsupplements without blood count

Age is a rough orientation, not a treatment plan. What matters is findings, skin condition and wish – after examination and consent (§ 630e BGB). Nobody 'must' do anything at a certain age.

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The essentials

The essentials.

botulinum toxin 2–3 zonesExpression
cheek first, 1–2 mlVolume
skin boosters, needling + PRPSkin
about €1,500–2,500Per year
Important note

Important note.

This text is general information. It replaces neither a medical examination nor the consultation required before any treatment under German law (§ 630e BGB). Whether and which treatment is suitable for you can only be said after examination and consultation. No treatment results are promised.

FAQ

Frequently asked questions.

Where to start if everything bothers me at once?

With what changes the overall impression most – usually botulinum toxin for the frown line and support of the cheek. Then reassess after three months.

Is 40 too late for prevention?

No. Sun protection and retinoid work at any age; botulinum toxin keeps preventing lines from deepening.

Sources

Sources and further reading.

External links open in a new window; their operators are responsible for their content. Medical responsibility for this page: Katayoun Mostaghimi, specialist in general medicine. Last updated: 2026-10-05.

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