Skin-Tightening Procedures Without Surgery: Do They Work?


April 23, 2012 - by

I will be appearing on Channel 15’s Health Zone to discuss non-invasive procedures that have been promoted to tighten lax skin without surgery. There are many companies promoting different devices on the market that claim to make skin appear more youthful without surgery. Much of the promotional information purports that there is little if any pain and no downtime, while the results are incredible.

My patients ask me questions about these procedures every day during their consultations in my offices. I have reviewed many studies, evaluated the results, and have come to the conclusion that some of these treatments may indeed be of benefit, but it is usually to a much smaller degree than what the patient was expecting. If it sounds too good to be true, it usually is. I hope this article will help explain what is and is not possible with non-invasive skin treatments.

As seen on ABC-15 KNXV TV, Phoenix, Arizona

First of all, what are these treatments? They are different types of devices that apply light or radio frequency to the skin alone or in combination, generating heat damage. The skin responds to the damage with additional collagen deposition and remodeling, which can improve the appearance and tightness of the skin.

Many of you are aware that laser light has been used for years in facial rejuvenation treatment. Many of these lasers, such as carbon dioxide (CO2) were very powerful, and while they erased the wrinkles and tightened the skin, they generally came with prolonged recoveries and sometimes even problems with excessive lightening of the skin or even scarring. In an effort to provide treatments with less pain, downtime and expense, and more predictable results, non-ablative lasers were developed. These lasers do not irritate the surface of the skin, but heat the deeper layers (called the dermis). This results in thermal damage to collagen in the skin, and subsequent re-modeling and additional collagen deposition then occurs. These procedures come with minimal downtime, but may require more than one treatment, can be quite expensive, and provide only minor improvements in the quality of the skin.

Radio frequency devices do not use light like lasers. Instead, alternating current is used to create the thermal damage in the skin. The most well known device on the market currently is the Thermage ThermaCool. This type of current is not scattered in the tissue or absorbed by the pigment in the skin, so all skin types can be treated. The protocol of treatment with this device has been improved so that less discomfort occurs and only one pass is required. Anesthesia is not required. Brief redness and swelling can occur. Once again, the downside of this treatment is that while the downtime is minimal, patient satisfaction in some studies has been less than 50%. It’s not that no result occurs; it is just that patients generally have greater expectations than what this technology can provide. Tissue tightening of 1 to 3 millimeters may occur, but when patients look at themselves in the mirror and gently pull their skin tighter, they are generally tightening it by ten millimeters or more. These procedures do not effectively re-position skin to the degree that would correct jowling or hanging skin in the neck, and they do not erase deep wrinkles that are visible when the face is at rest. That requires surgery.

So who do these procedures work for? Those who have very minimal signs of aging or skin laxity may benefit to a mild degree. For those of us over forty who have skin laxity and malposition of facial tissues that have responded to gravity, this may be a very disappointing path. After the treatment, your wallet is lighter, but your face looks the same.

I feel that the best results for treatment of facial aging are natural appearing results that combine skin care, fillers, and surgery when indicated. Consult with a board certified plastic surgeon such as myself to determine what the best treatment options are for your personal goals.

—Patti Flint, MD, PC

Patti Flint, M.D., P.C. is a board certified plastic surgeon that strives to ensure that all of her patients are thoroughly educated about the plastic surgery procedures they desire so that they can make a confident, well-informed decision. She is a devoted and experienced professional whose focus is to help her clients feel more beautiful and confident by delivering natural results. Learn more about Dr. Flint and read Dr. Patti Flint’s reviews.