Dr Rozina Ali is a multi-award-winning consultant reconstructive and aesthetic plastic surgeon with almost three decades of experience caring for women across every stage of life. Known for her patient-centred philosophy of “pro-ageing,” she believes aesthetic medicine should support the body’s biology and help women navigate life’s transitions with confidence rather than fear. In this blog, she reflects on the impact menopause can have on the skin and body, drawing on new international research as well as her own clinical experience working with women in their 40s and 50s.
Ageing is, of course, an inevitability for us all. Yet never before have women had greater control over how they navigate the changes that occur throughout their lives.
Menopause is one of the most significant of these transitions, and yet many women are still unprepared for the physical changes it can bring.
A recent article in Aesthetic Medicine Magazine, discussed new global research built from survey data of more than 4,300 peri- and post-menopausal women across nine countries. The findings confirmed something clinicians see every day: menopause can trigger multiple changes in the skin, yet awareness of these changes remains surprisingly low.
According to the survey, women experience an average of three noticeable skin changes during menopause, most commonly lines and wrinkles, loss of firmness and elasticity, dryness and a duller skin tone. These changes were rated six out of ten in severity, reflecting their visible impact on overall appearance.
Perhaps more strikingly, the study also highlighted the emotional dimension of these changes. Sixty percent of women reported feeling less attractive, 57% felt anxious, 55% experienced reduced confidence and 46% reported becoming less socially engaged.
These findings resonate deeply with what many women share in consultation.
The years between the mid-40s and mid-50s are often some of the most fulfilling and confident periods of a woman’s life. Experience, self-knowledge and personal clarity are often at their strongest. Yet at the very same time, hormonal changes may begin to alter the skin, body and hair in ways that feel unfamiliar or unsettling.
One of the challenges is that menopause is rarely discussed in advance. The survey found that more than half of women only learned about menopause-related skin changes when they began experiencing them, usually in their forties. Around 30% said they would have preferred to know about these changes earlier, in their thirties, when preventative strategies might have been considered.
From a biological perspective, the explanation lies largely in hormonal change.
As oestrogen levels fluctuate during the peri-menopausal phase and eventually decline, the skin undergoes measurable structural changes. Collagen, the protein that gives skin its strength and elasticity, begins to fall steadily. In fact, collagen naturally declines at around 1.5% per year from our early twenties, but this reduction accelerates significantly during menopause. At the same time, levels of hyaluronic acid, which helps skin retain hydration, also diminish.
The result can be skin that feels drier, thinner and less resilient, alongside a gradual loss of firmness and tone.
Hormonal changes during menopause also influence other parts of the body. Weight distribution may shift, with fat accumulating more around the abdomen and waist. Breasts often lose structural support as glandular tissue shrinks and is replaced by fat. Skin may become more fragile or crepey, and hair may thin as hormonal balance changes.
For many women, these changes can feel sudden, even though they have been developing slowly over time.
In my practice, I encourage women to view menopause not as a problem to be “fixed,” but as a biological transition that deserves understanding and support. My philosophy has always been one of pro-ageing rather than anti-ageing. The aim is not to erase the passage of time, but to help women age with confidence, vitality and self-assurance.
Encouragingly, the research found that aesthetic treatments were among the interventions women reported the highest satisfaction with when addressing menopause-related skin changes. Nearly half of respondents expressed interest in anti-wrinkle treatments, while 41% were interested in hyaluronic acid treatments, 39% in treatments designed to improve skin quality, and 30% in biostimulators that stimulate collagen production.
This reflects a broader shift in aesthetic medicine. Women are increasingly interested in treatments that improve skin quality and tissue health, rather than dramatic changes in appearance.
Over the past decade, advances in regenerative aesthetics have provided new ways to support the skin during hormonal transitions. Treatments such as microneedling, polynucleotides, exosomes, collagen-stimulating injectables and skin-quality boosters work by encouraging the body’s own repair mechanisms. Chemical peels and radiofrequency technologies can also help stimulate collagen production and improve texture and tone.
These approaches are particularly suited to menopause because they focus on restoring the quality, resilience and hydration of the skin, rather than simply masking symptoms.
Regenerative techniques also extend beyond the skin. Procedures such as fat transfer, which uses the body’s own stem-cell-rich tissue, can help restore volume and improve tissue health in areas such as the face, breasts and even the scalp in cases of hair thinning.
The goal is always natural harmony.
For many women, however, the most important part of the process is not the treatment itself but the conversation that comes before it. I have always believed that consultations should be a journey of discovery. Together we explore what changes are occurring, what concerns are most meaningful, and what approaches may be helpful.
Sometimes that may involve non-surgical treatments performed gradually over time. Occasionally surgery may be appropriate. In many cases, education and reassurance are equally valuable. What I emphasise with my patients is Menopause is not the end of vitality or beauty. It is simply another chapter in a woman’s life, one that brings its own challenges but also its own strengths.
With greater awareness, better research and thoughtful care, women can approach this stage not with uncertainty, but with knowledge and confidence.
Because ageing well is not about stopping time. It is about understanding the changes that come with it and responding to them with intelligence, care and respect for the remarkable biology of the female body.
