Whether it is fear of surgery or the stigma of having surgery, almost everyone who comes in to my plastic surgery office tells me they want to look younger but they do not want a face lift.

Many new procedures are widely marketed today as a non-surgical face lift, including:

· Thermage™

· Titan™

· Mesotherapy

· Lipodissolve™

· Smartlipo™

· Threadlift™

· Photofacial

· Laser skin tightening

While the advertisements sound great, the reality is that only an expertly performed surgical face lift can achieve the beautiful results shown in the photo above.

Recent technological advances have resulted in new light based skin tightening devices which are being marketed as the non surgical facelift. While skin tightening technology is impressive, and does work, the results of skin tightening to date hardly qualify as a face lift, non-surgical or otherwise. Skin is tightened but best results are about 20% to 30 % of what a traditional surgical face lift can achieve.

The new skin tightening is called non-ablative to distinguish the new skin tightening technology form the old CO2 laser resurfacing, the Gold Standard for wrinkle removal.

To ablate means to surgically remove, and the CO2 laser resurfacing ablated or removed old damaged skin and new skin grew to replace the old. In the process of Laser Resurfacing, heat generated by the laser injured the deeper skin layers and when they healed, with new collagen, the skin was contracted or tightened.

The newer skin tightening technology uses radiofrequency energy or infrared energy to heat the deep layers of the skin to cause contraction and tightening but first cools the skin before the energy is applied to prevent injury and ablation of the superficial skin by the heat energy. Thus the skin is tightened but the surface is not ablated, thus non-ablative skin tightening. There is no down time following non-ablative skin tightening unlike the older CO2 laser resurfacing skin tightening.

Several new skin tightening machines are available. The new Lux IR Deep by Palomar and the Titan by Cutera utilize infrared energy for skin tightening. The Aluma by Lumenis and Thermage utilize infrared energy for skin tightening. Refirme by Syneron uses a combination of light energies with radiofrequency for skin tightening.

All of the machines achieve about similar results when used properly. Generally there is less discomfort with the Infrared skin tightening machines. Complications have been minimal although some serious complications occurred with Thermage skin tightening early on.

In my practice I find that non-ablative skin tightening is most helpful for younger patients who do not have severe aging changes and significant sun damage, people in their 30’s and 40’s who want to correct or tighten early skin sagging along the jaw line or jowl area, neck and cheeks. I use the LuxIR on these larger areas. For skin tightening around the eyelids I use the Aluma which has a smaller treatment head and a suction device that will pull the delicate peri ocular skin into the treatment chamber for skin tightening.

The field of non-ablative skin tightening is in its infancy and will definitely become more effective in the years ahead. The companies are improving their products frequently. For now however the people who benefit most from the skin tightening machines today are younger people who still have thick healthy skin with early aging changes.

There are new sophisticated skin tightening technologies in development and I am working on one with a major laser company, however we are 1-2 years away from an effective, approved product.

The use of the term non-surgical facelift to describe non-ablative skin tightening is an overstatement with technology available for skin tightening today. At best a 30% result is possible when compared to a traditional face lift. Many of the heavily marketed non surgical face lift procedures in the bulleted list above have no scientific basis for their claims.

Be a smart informed consumer. If it sounds too good to be true it usually is. Consult two board certified plastic surgeons if you have concerns about facial aging. To learn more read Save Your Face..

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Masachusetts,

Plastic surgical operations including the Facelift, Tummy Tuck and Breast Lift are still the most effective ways to tighten the sagging face, the sagging breasts, and sagging tummy skin. 

Above: Face lift; Below: Breast lift and implant

Below: Tummy Tuck-Bikini Tuck and Removal C-section scar

However recently new non-surgical skin tightening machines have been introduced to tighten sagging skin. Laser skin tightening was first introduced in 1995 and is very effective only on the face (See Photo Below). The CO2 laser resurfacing technique is excellent for tightening facial skin and removing wrinkles, but the procedure leaves the face raw for 10-12 days and pink for one to three months. In addition, complications such as hypo pigmentation, loss of skin color have limited the acceptance of the CO2 laser resurfacing technique.

Above: Before and After CO2 Laser Resurfacing

During the past 3-4 years new Non ablative skin tightening technologies have been developed that do not leave the skin raw and thus require no down time or recovery. These machines use infrared or radiofrequency energy to heat the deep layers of the skin and tighten the collagen and thus tighten the skin. These methods, LuxIR® Deep, Thermage®, Titan®, and Refirme® do work, but are not nearly as effective as CO2 laser resurfacing or the face lift. Usually 20-30% tightening of the skin is seen and, while visible in before-and-after photos, is not nearly as striking as seen after a face lift or tummy tuck. I use the LuxIR Deep® in my practice because it is equally effective as the other machines, but is much less painful. These skin tightening machines are used on the face, abdomen, arms, and buttocks and thighs, but have not been used successfully on the breasts. (See Photo Below-Courtesy Palomar and Dr. Kenneth Rothaus)

Above: Before and After LuxIR Deep Skin Tightening Jawline and Neck

Below: Before and After LuxIR Deep Skin Tightening Abdomen

Most recently new fractional laser resurfacing machines have been developed to produce the benefits of laser resurfacing without the difficult and prolonged recovery seen with CO2 laser resurfacing. The laser beam is fractionated, or broken up into many tiny beams, so that when it hits the skin skip areas are left with intact skin so healing is much faster: 4-6 days as opposed to 2-3 weeks with the older CO2 techniques. Skin tightening does occur, but at present much less tightening is seen than with the older CO2 lasers. I use the new 2940 fractional ablative laser to remove wrinkles and tighten skin, but the tightening is not as dramatic as that seen with the older CO2 laser resurfacing. At present this technique is limited to the face and neck.

Above: Before and After Lux2940 Treatment Around Eyes and Upper Lip

While the new skin tightening technology is exciting, the results are not as dramatic as those achieved with plastic surgery. If you need a face lift, breast lift, or tummy tuck, have it done by an experienced board certified plastic surgeon. If you just do not want surgery, have fairly healthy skin and are younger with thicker skin, and will be happy with 20-30% tightening, then you may be happy with non-ablative skin tightening.

Undoubtedly the new non-ablative skin tightening machines will be improved in the years to come and results will be more dramatic. I am working with combinations of different technologies to improve results.

For more information on skin tightening, non-surgical facial rejuvenation and plastic surgery, read Save Your Face or call 978-369-4499. Be sure to sign up for my free email newsletter which is published monthly.

DR. Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts