While the promise of non-surgical skin tightening is very appealing, an objective comparison of a well performed surgical face lift with the results of a non-surgical skin tightening treatment is often disappointing. In my experience the best skin tightening treatment achieves only 20-30% of the standard face lift result. Skin tightening results on the tummy and arms are equally disappointing in my experience.

Exciting new subcutaneous laser treatments are now, in my experience, achieving better skin tightening than the currently available surface treatments using Thermage, Titan, Refirme and Lux IR. In this blog I am going to review how skin tightening works, what methods are available, and what I think the future of skin tightening treatmentswill be. See new laser induced skin tightening with laser liposuction in photo below:

New Laser Skin Tightening with Liposuction


How Do Skin Tightening Treatments Work?

Skin elasticity is what holds our skin tightly to our face and body. Skin elasticity depends on collagen and elastin, two components of the deeper layer of our skin called the dermis. The elastin and collagen responsible for tight skin are found in the deepest part of the skin, just above the fat layer which lies beneath our skin.

Skin tightening is based on the fact that when collagen is heated to 66 degrees centigrade, the collagen contracts and the skin is tightened. This is called remodeling and occurs over many months after the collagen has been heated.

The method used by non-surgical skin tightening treatments is to heat the deep collagen of the skin to cause contraction of the collagen, remodeling, and then skin tightening. To accomplish this deep skin heating, radiofrequency energy (Thermage), infrared energy (Titan, LuxIR Deep), or a combination of both (Refirme) is passed into the skin to heat and remodel the collagen. These machines have sophisticated cooling devices to cool the surface of the skin to prevent a burn while the energy is passed through the skin into the deep dermis.

How Effective Are Non-surgical Skin Tightening Treatments?

These non-surgical infrared and radiofrequency based treatments do tighten the skin. However 3-4 treatments scheduled 4-6 weeks apart are usually required for a visible result. In my experience a 20-30 % tightening is the best I can achieve. See photos below:

In my experience the skin tightening results are not nearly as effective as a face lift. I usually have to show a patient a before photograph next to a 6 month after photograph for the patient to see the difference. This is very different from a face lift or tummy tuck result which the patient can see a significant difference immediately after surgery.

What Do These Treatments Cost?

Costs vary, but typically treatments cost about $1000.00 per treatment. Four treatments are usually discounted to $3500.00. In my experience, four treatments are necessary to see the best result.

What New technologies are on the Horizon?

The new laser liposuction technique is achieving impressive skin tightening after laser liposuction. I cannot give an objective percentage of skin tightening following laser liposuction treatments. Anecdotally, I am seeing very significant, visible skin tightening after laser liposuction treatments, and results have been maintained at least eight months, which is the longest experience I have to date. See first photo in article.

This new laser technology is not truly non-surgical but is certainly minimally invasive. A small laser fiber is placed beneath the skin into the fat. Heat from the laser dissolves the fat and tightens the skin.

I believe that I am seeing better tightening of the skin because the laser energy is being delivered more closely to the deep collagen and elastin layer of the skin which lies just above the fatty layer.

My prediction is that this new minimally invasive technique will gradually replace the current transcutaneous (from on top of the skin) technique used by the radiofrequency and infrared techniques mentioned earlier.

How to Decide Which Method is Best for You

I am a board certified plastic surgeon and my goal is always the best result for the patient. Currently if you have loose sagging facial skin and you want to look significantly younger, an expertly performed face lift will unequivocally give you the best result. See before and after face lift below:

If you are adamant that you do not want surgery then I would recommend one of the non-surgical radiofrequency or infrared methods. However I will warn you that you will need to study your face carefully to see the benefit. I do use the non-surgical technique frequently around the mouth where face lifting is less effective. I also use the infrared device on the neck to treat recurrent laxity after a face lift.

To learn more about non-surgical skin tightening treatments call 978-369-4499 or email us. Read our free newsletter to learn about new laser and non-surgical rejuvenation methods. Read Save Your Face to learn how to prevent facial aging.
Dr. Seckel
Concord, Massachusetts
Boston, Massachusetts

Plastic surgical operations including the face lift (See Photo Below), 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 Lux2940® fractional 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 contact me. Be sure to sign up for my free email newsletter which is published monthly.

Dr. Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts