Menopause, Collagen and Your Skin: Botox, Fillers, Laser or Microneedling?

The Ēgo Edit | By Marilyn Capote, Founder, Ēgo Medical Aesthetics Bar | Gilbert, Arizona

There comes a time when a woman looks in the mirror and notices something has changed. Menopause changes skin biology, and the result shows up as fine lines around the eyes, less definition along the jawline, and skin that looks thinner, drier or less firm.

Skincare products used for years may stop delivering the same results, and women in that position ask: What happened to my skin? For many women, the answer involves more than birthdays. It involves biology.

Whether Botox, dermal fillers, laser skin resurfacing or RF microneedling is the right answer depends on what is changing. The table below matches each common concern to the options we discuss in a personalized plan at Ēgo Medical Aesthetics Bar in Gilbert, Arizona.

Concern	Treatment option	What it does	What it does not do
Expression lines (forehead lines, frown lines, crow’s feet)	Botox and other botulinum toxin treatments (tox)	Temporarily relaxes the targeted muscles responsible for expression lines	Does not replace lost collagen, restore facial volume or correct significant skin laxity
Volume loss (cheeks, temples, lips, jawline)	Dermal fillers	Restores volume or improves facial contours for selected patients	Is not a universal solution for loose skin, and overfilling can create an unnatural appearance
Texture, sun damage, fine lines	Laser skin resurfacing, including ResurFX and IPL	Addresses texture, fine lines, photoaging and pigmentation, depending on the device and the patient’s skin	Is not right for every patient; it depends on skin, goals and medical history
Skin texture and mild laxity	RF microneedling and other collagen-focused procedures	Supports skin texture and mild laxity	Does not replace surgical lifting when significant tissue laxity is present
Skin texture, fine lines, certain acne scars	Microneedling treatment series	Starts a wound-healing response that can support collagen remodeling	Is not a complete solution after one treatment

How Does Menopause Change Your Skin?

Menopause changes skin through estrogen decline. As women move through perimenopause (the transition before menopause) and menopause (12 months after the last menstrual period), falling estrogen levels are strongly associated with collagen loss and with changes in hydration, elasticity and skin thickness.

A 2007 review in Menopause International by J. Calleja-Agius, Y. Muscat-Baron and M. P. Brincat reports that as much as 30% of skin collagen (types I and III) is lost in the first five years after menopause, and that total collagen content then declines by an average of 2.1% per postmenopausal year over 15 years.

The changes may appear gradually, but they can become particularly noticeable during the menopausal transition. Some women experience increased dryness. Others notice fine lines, changes in facial volume or worsening skin laxity. Not every woman experiences these changes in the same way.

That is why I believe the conversation around aesthetic medicine needs to evolve. We cannot approach every woman over 40 with the same treatment plan.

What Does Botox Do for Dynamic Wrinkles?

Botox temporarily relaxes the muscles that create dynamic wrinkles, the expression lines that form from repeated facial movement. Botox and other botulinum toxin treatments, called tox for short, target the muscles behind forehead lines, frown lines and crow’s feet.

Botox Cosmetic (onabotulinumtoxinA, made by AbbVie) is FDA-approved for the temporary improvement in the appearance of moderate to severe forehead lines, frown lines (glabellar lines) and crow’s feet (lateral canthal lines) in adults, and since October 2024 for platysma bands, the vertical bands that connect the jaw and neck.

Neuromodulator injections such as Botox, Dysport, Xeomin, Jeuveau and Daxxify were the most popular minimally invasive treatment in the US in 2024, with 9,883,711 procedures, according to the 2024 Procedural Statistics from the American Society of Plastic Surgeons (ASPS). ASPS also reports that patients ages 40 to 54 accounted for the largest share of cosmetic procedures that year. In 2025, neuromodulators accounted for roughly half of all minimally invasive procedures, ASPS reports.

But Botox does not replace lost collagen, restore facial volume or correct significant skin laxity. That is an important distinction.

For patients exploring Botox in Gilbert, Arizona, the first step is a personalized assessment, not simply choosing a number of units. The objective of that assessment at Ēgo Medical Aesthetics is to understand facial movement, anatomy and the patient’s individual goals. Ēgo’s neuromodulator options include Botox, Dysport and Xeomin, and you can meet our team before you book.

When Are Dermal Fillers the Right Choice for Volume Loss?

Dermal fillers are injectable treatments that restore facial volume and improve facial contours for selected patients. Sometimes what a patient describes as sagging skin is partly related to changes in facial volume: over time, changes in facial fat, bone and supporting structures can affect the cheeks, temples, lips and jawline.

Hyaluronic acid fillers accounted for about 30% of minimally invasive procedures in the US in 2025, according to ASPS.

But fillers are not a universal solution for loose skin. Overfilling can create an unnatural appearance, and all injectable treatments carry risks that require careful patient selection and qualified medical providers.

The best treatment is not necessarily the most treatment.

At Ēgo Medical Aesthetics in Gilbert, our philosophy is that facial balancing begins with understanding the face, not with adding more product.

Why Does Collagen Matter for Skin Laxity?

Collagen matters for skin laxity because collagen and elastin provide the skin’s structure and elasticity. Skin laxity, a loss of skin firmness, becomes increasingly relevant as women age, and changes in collagen and elastin, along with facial volume and other tissues, influence how firm the skin appears.

This is where collagen-focused treatments become part of a personalized plan, including the non-surgical skin tightening options Ēgo offers. Depending on the patient’s needs, options include:

• RF microneedling combines microneedling with radiofrequency energy for selected concerns involving skin texture and mild laxity. Ēgo uses Legend Pro for this treatment.
• Laser skin resurfacing addresses appropriate concerns involving texture, fine lines and photoaging.
• Collagen-stimulating injectables, such as Radiesse, suit appropriate patients.
• Medical-grade skincare and medical-grade facials support skin health and maintenance, alongside our skincare line.

These treatments work differently, and none should be presented as a replacement for surgical lifting when significant tissue laxity is present.

What Can Laser Skin Resurfacing Treat Beyond the Surface?

Laser skin resurfacing can treat uneven texture and tone, sun damage, fine lines and visible signs of aging, depending on the device, treatment settings and individual skin characteristics. These are the concerns that often bring patients searching for laser skin resurfacing in Gilbert, Arizona.

At Ēgo, our laser options include ResurFX fractional laser resurfacing and IPL, which is often used for sun damage and uneven skin tone.

The important question is not which laser is popular. It is whether the technology is appropriate for the patient’s skin, goals and medical history.

Why Does Microneedling Need a Treatment Series?

Microneedling needs a treatment series because results develop over time. Microneedling creates controlled micro-injuries that start a wound-healing response, and that response can support collagen remodeling. It is an option for patients concerned about skin texture, fine lines and certain acne scars.

Depending on the concern, multiple sessions may be recommended, and improvements develop over time. For patients searching for microneedling in Gilbert, Arizona, Ēgo offers RF microneedling and microneedling with PRP. We typically recommend a series of 4 to 6 treatments spaced 4 to 6 weeks apart, adjusted to each patient’s concern.

But one treatment should never be marketed as a complete solution for every patient. At Ēgo Medical Aesthetics, we build realistic treatment plans instead of encouraging patients to chase isolated procedures.

Botox, Fillers, or Laser: Which One Is Right After 40?

The right treatment after 40 depends on what is actually changing:

• Expression lines are treated with neuromodulators such as Botox.
• Volume loss warrants consideration of dermal fillers.
• Changes in skin texture or sun damage can be addressed with appropriate laser treatments, such as ResurFX and IPL.
• Mild skin laxity leads to a discussion about collagen-focused procedures, such as RF microneedling.
• Skin health first: for some patients, improving skincare and maintaining healthy skin is the most appropriate starting point.

Different concerns require different solutions. That is why consultation matters.

Is Ēgo a Spa or a Medical Aesthetics Clinic?

Ēgo Medical Aesthetics is not a spa. It is a medical aesthetics clinic focused on results, founded by Marilyn Capote in Gilbert, Arizona. You can read more about Ēgo and our approach.

Across my years in the medical aesthetics industry, I have learned that patients do not simply need more treatment options. They need better education. They need to understand why a procedure is being recommended, what it can realistically accomplish, and how it fits into their long-term goals.

At Ēgo Medical Aesthetics, we focus on individualized treatment planning, appropriate technology and ongoing skin maintenance. We believe in plans, not one-offs, and we believe women deserve informed, thoughtful care at every stage of aging.

No fluff. Just results.

What Is the First Step Toward a Personalized Skin Plan?

The first step toward a personalized skin plan is a professional consultation. If you are exploring Botox, dermal fillers, microneedling, laser skin resurfacing, skin tightening or other anti-aging treatments in Gilbert, Arizona, begin with a consultation at our Gilbert clinic, because understanding your skin is the first step toward choosing the right treatments.

Aging is not one-dimensional, and your treatment plan should not be either.

This article is for educational purposes and is not medical advice. Results vary, and the right treatment depends on your skin, health history and goals. Treatment recommendations are made after an in-person consultation.

Sources

• Calleja-Agius J, Muscat-Baron Y, Brincat MP. Skin ageing. Menopause International. 2007;13(2):60-64. University of Malta repository.
• American Society of Plastic Surgeons. Plastic Surgery Statistics 2024.
• American Society of Plastic Surgeons. 2025 plastic surgery by the numbers.
• Allergan Aesthetics, an AbbVie company. Botox Cosmetic receives FDA approval for platysma bands, October 18, 2024.