Skin Tightening Treatments – Are Non-surgical Methods Effective?

We all begin to see loose and sagging skin as we age or after weight loss or having babies. Skin tightening treatments seem like such an ideal solution. The new non-surgical skin tightening machines like Thermage, Titan, Refirme, LuxIR and others offer treatments often advertised as a non-surgical face lift.

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:

Before and After Photo Mini Tummy Tuck and SlimLipo

Before and After Photo Mini Tummy Tuck and SlimLipo Front View

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

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