# In your *40s.*

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

- Source: https://www.vivaderm.de/aesthetics-in-your-40s-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-05

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.

## 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.

## At a glance.

| What shows | What can make sense | What is usually too early or too much |
|---|---|---|
| Lines remain at rest | botulinum toxin, 2–3 zones | too high a dose (mask) |
| Nasolabial fold clearer | support cheek/cheekbone, 1–2 ml | fill the fold directly and generously |
| Shadows under the eyes | tear trough carefully, after cheek | filler with eye bags |
| Skin thinner, pigment | skin boosters, microneedling + PRP, retinoid | aggressive peels in summer |
| Neck first lines | skin booster neck, sun protection | filler in horizontal lines |
| Hair loss begins | diagnosis, minoxidil, PRP | supplements 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.

## The essentials.

- **Expression:** botulinum toxin 2–3 zones
- **Volume:** cheek first, 1–2 ml
- **Skin:** skin boosters, needling + PRP
- **Per year:** about €1,500–2,500

## 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.

## 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.

## Related.

- [How the face ages](https://www.vivaderm.de/guide-how-the-face-ages-en.html) – Guide
- [Cheeks & mid-face](https://www.vivaderm.de/cheeks-mid-face-en.html) – Treatment
- [Menopause & skin](https://www.vivaderm.de/guide-menopause-skin-en.html) – Guide

## Sources

- [NHS: non-surgical cosmetic procedures](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/)
- [Medical Association North Rhine – patient information](https://www.aekno.de/patienten)
- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)
- [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/)
- [AWMF – German clinical practice guidelines](https://www.awmf.org/)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.