Nonsurgical treatments have come so far in recent years that traditional surgical procedures—think facelifts to tighten skin on the face, or tummy tucks to smooth out a belly—may become a thing of the past. Rather than facing an invasive procedure, a long recovery time, and the potential for scars or other permanent unwanted effects, patients now have numerous options for skin tightening without surgery. One point worth noting: Younger patients are the most likely to see results from any treatment that uses heat generation. If you’re older, these may be less effective, which makes choosing the one that will get you the best results even more important. But which one is best? Keep reading for a breakdown of some of the most popular noninvasive skin tightening treatments.
Ultherapy
What It Is: Ultherapy uses focused micro-sound waves (ultrasound) to achieve the deepest and strongest level of tightening. Sound waves can penetrate well below the surface level of skin; when used on the face, Ultherapy can reach the same levels as a surgical facelift (the SMAS). The sound waves are carefully used to trigger your body’s own natural healing processes at a deep tissue level, so that skin actually lifts, tones, and tightens over time.
How It Works: Ultherapy uses sound energy, the unique properties of which allow it to bypass the skin’s surface to reach and treat tissue at depths that can otherwise only be affected by surgical treatment. The ultrasound technology allows Dr. Tang or Alexandra to see the exact areas being targeted with a high level of specificity. Ultrasound energy has been used in medicine for over 50 years and is extremely safe; it’s the same technology that is used to view infants in the mother’s womb. The sound waves are able to reach this SMAS layer, which is the fascial layer beneath the skin above the muscle. These ultrasonic waves cause immediate contraction that lifts the face, neck, or chin. The ultrasonic waves then heat the deep skin at the ideal temperature of 65-70 degrees Celsius to denature or break down the skin. This stimulates collagen production (neocollagenesis) in your skin’s foundation so that your body produces new collagen. This results in a clinically significant enhancement in 3 to 6 months, as the skin is naturally lifted and tightened without fillers.
Best for…: Ultherapy is the only non-invasive treatment cleared by the FDA that truly lifts skin in the face and neck, and it’s the only non-invasive procedure that the FDA has indicated for improving wrinkles and lines on the chest. Ultherapy can be used to tighten and lift the skin around your eyebrows (helping you look younger and less tired), tauten loose skin beneath the chin or around the neck, and smooth wrinkles and lines on the décolletage (chest).
Pros: Ultherapy is completely natural, with no fillers or toxins used. It can be used on any skin tone from all ethnic backgrounds, and it is also safe for people with pacemakers or other implanted devices. Ultherapy works beneath the skin rather than on the surface, so it can be used in conjunction with laser treatments for skin texture, sun damage, or skin tone that treat only the upper layers of the skin. It can also be combined with injectables (like Botox) and fillers (like Juvederm, Restylane, or Voluma) to customize and enhance your results. There’s little to no downtime from the single 60- to 120-minute in-office treatment.
Cons: Ultherapy gives excellent results that are natural and long lasting. Depending on your individual characteristics, the results can last 1-3 years. However, because it takes your body time to develop new collagen, it can take longer (3 to 6 months) to achieve your full results. While it’s an exceptional treatment, if you’re looking for a “quick fix” Ultherapy may not be for you. In addition, because Ultherapy reaches so deep some patients may find the treatment uncomfortable. Dr. Tang pays great attention to this, personalizing your treatment to make the experience as pleasant as possible.
Venus Freeze
What It Is: Venus Freeze is one type of radiofrequency (RF) treatment that uses this type of energy combined with pulsed magnetic fields to heat skin from the inside out. Heating the collagen fibers results in skin tightening, improved skin texture, and smoothing of fine wrinkles. The procedure can tighten any area including the face, neck, arms, abdomen, buttocks, and thighs. It is non-invasive and has no downtime.
How It Works: Venus Freeze combines multipolar RF and magnetic pulsed fields to achieve skin tightening and wrinkle reduction. The multipolar RF heats the tissue, stimulating the body’s natural healing response. New elastin and collagen fibers are formed, and at the same time active collagen contracts and elastin fibers unravel. This makes the skin on and around the face look and feel firmer, and also makes it more elastic. The magnetic pulses help generate an electric current which helps improve blood circulation. This increased blood flow also helps to increase collagen and elastin.
Best For…: Venus Freeze is FDA cleared for the treatment of facial wrinkles, and the Venus Freeze system has been extensively studied in numerous clinical trials by trained physicians and researchers. It can be used for stretch marks and acne scars as well as facial skin tightening. The magnetic pulses have been used to temporary reduce the appearance of dark circles around the eyes.
Pros: Venus Freeze uses radiofrequency, which does not lead to a risk of increased pigmentation. It can be used on any skin tone and any ethnic skin. The pulsed magnetic fields help the RF to heat the skin evenly from the inside out, so there is not the concern of potential laser burns. The heating sensation from Venus Freeze has been compared to getting a hot stone massage. The treatment is noninvasive and you can immediately get back to your regular routine.
Cons: There are minimal side effects from the treatment. The most common side effect is just that the area that was treated will feel warm, and may have a slightly flushed appearance, though this will resolve within an hour. The treatment does not treat sun spots or age spots, so if that’s a concern a laser such as IPL will also be needed. The other potential downside to Venus Freeze is that to maintain your results, it’s recommended to have the treatment repeated approximately every three to six months.
Thermage
What It Is: Thermage is another RF treatment that has been used in the past for facial skin tightening. It uses monopolar RF energy to heat the skin, again triggering changes in the collagen and elastin.
How It Works: Thermage is an example of a treatment that uses what’s referred to as “bulk heating.” Bulk heating is pretty much exactly what it sounds like: The area treated is not as finely targeted as it would be with a treatment like Venus Freeze, nor can it penetrate as deeply as a sound treatment like Ultherapy. With monopolar RF, the heat that is sent into your skin disperses instead of narrowing, meaning more is needed to get the same level of results that could be obtained with more focused heat.
Best For…: Thermage uses RF to address surface imperfections in the skin that result from age and environmental factors. It can be used to smooth wrinkly or uneven skin and to better define facial features. It can also be used to smooth and tone bulges, dimples, or wrinkles on your body.
Pros: Patients who respond well to Thermage can actually begin to see results quickly — in some cases, in as little as one day. As with other treatments that encourage natural collagen production however, it’s a longer wait to see full results (up to six months). That said, generally only one in-office, non-invasive treatment is needed.
Cons: Again, because of the way that the RF heat disperses, more intense treatment may be needed to get results. The nature of bulk heating means that the treatment may be painful for some patients. Also, while some get excellent results from Thermage, it does not reach as deeply. Ultherapy, for example, can reach the deep, supportive layers of tissue within the face (SMAS), which Thermage doesn’t address. If you’re really looking for facial tightening, this is vital—the SMAS level is what plastic surgeons work with to achieve facial tightening via a facelift.
Traditional Ablative Laser CO2 Treatment
What It Is: This older type of laser treatment is an intense way to literally resurface the face — it’s like a facial peel on steroids. Compared to other treatments (including non-ablative lasers), ablative laser treatments require anesthesia or sedation and have a considerable recovery time. Though it’s not invasive, in many ways an ablative laser treatment is not unlike outpatient surgery.
How It Works: Ablative lasers use an intense wavelength of light that literally vaporizes damaged skin. There are two kinds of ablative lasers, carbon dioxide (CO2) and Erbium (YAG). These do penetrate deeply into the skin’s surface (though not as deeply as Ultherapy) to remove skin imperfections. Subsequent damage (like dark spots or fine to moderately deep lines due to aging) will be improved.
Best For…: Ablative lasers are used mainly for facial skin resurfacing, wrinkles, acne scars, pores, targeting uneven tone and wrinkles on the superficial level. Deep wrinkles or sagging skin can’t be addressed with an ablative laser. Some kinds of ablative lasers can penetrate slightly deeper, but the deeper the laser goes the more intensive the procedure is.
Pros: Ablative lasers actually blast your face, so technically they are one of the most effective ways to improve your skin. You are pretty much getting brand new skin, so the results can last up to three to five years.
Cons: To say that these treatments aren’t for everyone is an understatement. Whether you can even consider an ablative laser treatment depends on your skin. These lasers are not effective on darker skin (they not only deliver poorer results, but can actually cause discoloration and/or scarring), and they cannot be used on sensitive skin. There is also a risk that your skin may hypopigment (lose pigment) due to the intense heat or there may be a line of demarcation where there’s a visible difference between the areas where the skin was and was not treated. Ablative laser treatments are intense and require lots of downtime. It’s less like a spa treatment and more like an outpatient surgical procedure. Depending on what laser is used and what area is being treated, you may need sedation or even anesthesia, and you may need pain medication afterward. After the procedure, you’ll have uncomfortable, raw, oozing skin (doing a Google image search for “ablative laser” is not for the faint of heart) that will take two to four weeks to fully heal. You’ll need a full-face mask bandage for the first day or two, and you’ll need to stay out of the sun and apply healing ointments throughout your recovery.
Fractional CO2 featuring the SmartXide
What It Is: SmartXide is a fractional CO2 laser that treats the dermis (the layer of skin beneath the outer epidermis) spot by spot. It creates microthermal zones of heat, stimulating new collagen without breaking the skin’s outer layer. This prompts new collagen to form, improving skin texture, scarring, and lines or wrinkles.
How It Works: SmartXide (and other fractional lasers) work by treating small fractions of the skin at each time. This allows your skin to heal faster than it would if the entire area were treated at once, as in the bulk heating you get with traditional CO2 lasers. The microscopic thermal zones cause denaturization of the collagen, prompting your body to produce new collagen. It also forces darker pigmentation up and out of the skin. By treating just small fractions of the skin, the surrounding skin remains untreated. That means that even though the treatment goes relatively deep (though not as deep as Ultherapy), your skin is able to recover more quickly.
Best For…: Fractional lasers can be used to treat a number of skin conditions, including acne scars, sun spots or age spots, wrinkles around the eyes (crow’s feet), upper eyelids, and sun damage and wrinkles in the décolletage (chest).
Pros: Compared to traditional ablative laser treatments, a fractional laser like SmartXide is less painful. A topical numbing cream is applied 60 minutes before the treatment, and the treatment itself takes about 30 minutes. Afterward, you’ll have a faster healing time than a traditional ablative CO2 laser — your skin will heal within five to seven days. Patients will not need to take any pain medications afterwards. Prior to that though, skin will appear sunburned and then flake away. The fractional laser does treat sunspots and age spots unlike Ultherapy or RF devices such as Venus Freeze or Thermage. With the use of a protective ocular device, it can be used to treat sagging, crepe-y skin in the upper eyelids. This can help alleviate the “droopy eyelid” look, possibly allowing you to avoid surgery.
Cons: A healing time of five to seven days might be faster than what you’d get with a traditional CO2 laser, but it’s a much longer recovery period than you can get with many other treatments. If you want to be able to be right back to work the same day or the next, a fractional laser probably isn’t for you. Additionally, because it is still a CO2 laser, SmartXide can’t be used on darker skin tones. If you are a candidate, since it’s not as an intense as a traditional CO2 laser, you may need two to three treatments to achieve your optimal results.
Skinfinity
What It Is: Skinfinity is a more refined ablative laser treatment — though it is still removing skin (that’s the ablation), it’s considerably more gentle. It uses fractional ablative RF to treat wrinkles and fine lines on the face as well as issues like loose skin and stretch marks on the body. Skinfinity allows for more controlled ablation and thermal effects, so specific areas can be more finely targeted than with other lasers.
How It Works: Skinfinity uses a patented technology that delivers focused RF through rows of pyramid-shaped electrodes. The electrodes send precise energy to the area being treated, creating multiple controlled micro perforations within small zones of thermal energy. These stimulate a healing response, encouraging skin rejuvenation. There is less damage to the skin’s surface, so there is less healing time than with traditional CO2 lasers. The two-part process that Skinfinity uses is highly customizable, allowing the treatment to be adjusted to better work with your skin and your goals.
Best For…: A major advantage of Skinfinity is its versatility. It can be used on both the face and the body. As with regular ablative lasers, Skinfinity can be used to address skin texture, fine lines and wrinkles, skin resurfacing, and rejuvenation. It is also effective, however, on skin problems like stretch marks, atrophic acne scars, and non-keloidal hypertrophic scars.
Pros: Unlike other CO2 lasers that use fractional RF, Skinfinity does not have a target chromophore—that means that people with all skin tones can uses Skinfinity. Especially if you have darker skin and are worried about scarring, it may be a better option for you. Compared to traditional ablative CO2 lasers, Skinfinity has a lower risk of complications (including laser burns, hyperpigmentation, and hypopigmentation or a loss of pigment). There’s less discomfort and downtime as well. Again, a major pro is that Skinfinity can be used to address more issues, including skin tightening and stretch marks.
Cons: Skinfinity is less intense than other ablative lasers, which on the plus side means no general anesthesia. However, that also means that you are more likely to need multiple treatments to achieve your desired results. Last, it doesn’t penetrate as deeply as other skin tightening treatments (like Ultherapy). It does have downtime that includes redness, swelling, and some minor peeling. It takes on average 4-5 days to recover after a typical Skinfinity treatment. Skinfinity can treat sun spots or age spots, but not as well as an IPL or non-ablative laser such as Fraxel.
SkinPen/MicroPen
What It Is: SkinPen/MicroPen uses a somewhat similar idea to fractional lasers — focusing on one small area of skin at a time — but it’s not a laser. Instead, it uses micro-needling to create tiny microchannels within the skin. SkinPen/MicroPen can be used to retexture aging skin and repair damaged skin. Additionally, the microchannels help increase the efficacy of topical skincare products like lotions and serums because these tiny breaks in the skin allow products to penetrate more deeply.
How It Works: The SkinPen/MicroPen uses twelve tiny microneedles to create microchannels in the skin. These tiny punctures trigger your body to form new collagen, but not scar tissue. Treating one small area at a time, SkinPen/MicroPen can be used to improve the texture and appearance of your skin.
Best For…: SkinPen/Micropen has a wide range of uses and can treat a variety of skin issues, including acne scars, skin tightening, skin texturing, sun damage, and stretch marks. It can be used on any skin area that needs cell regeneration or intense repair. Though most commonly used on the face, SkinPen/MicroPen can also be used on other parts of the body (for example, to remove liver spots on the backs of hands).
Pros: SkinPen/MicroPen is a highly customizable treatment (the depth of penetration can be easily adjusted), allowing Dr. Tang or Alexandra to minimize your discomfort and most effectively treat the targeted area. SkinPen/MicroPen gets especially good results for skin texturing, acne scars, and enlarged pores. As your body continues to produce new collagen, you may continue to see improvement for up to six months following your final treatment.
Cons: SkinPen/MicroPen isn’t a one-and-done treatment. It’s generally recommended that patients receive three treatments each spaced four weeks apart, but depending on your needs you may require as many as eight treatments. SkinPen/MicroPen cannot be used on darker skin, and it doesn’t provide a lift (though to get lifted skin, it can be combined with Ultherapy). SkinPen/MicroPen also has some downtime, with skin having a pink appearance for two to four days following each treatment. Patients with darker ethnic skin do have to be careful since it can cause hyperpigmentation in some patients.
In the end, deciding which skin tightening treatment is best for you really comes down to, well, you. There’s both your personal medical history to consider, as well as your treatment goals. A one-on-one consultation with Dr. Tang will give you expert advice that takes both into account. If you’re looking for skin tightening Bay Area residents trust, call Rejuvé today at 480-740-5320 to make an appointment.