Once upon a time, if you wanted to lift sagging skin or smooth early jowls, you had two options: commit to surgery or do absolutely nothing and live with it. But in 2025, we’re in an entirely new era, one that makes it possible to achieve some level of tightening without anesthesia, scars or weeks of recovery.
Today, we’re experiencing a new wave of energy-based devices that deliver results through ultrasound, radio frequency, muscle stimulation and precision laser energy. Here’s how the pros are using them to tighten, lift and rejuvenate.
Featured Experts
- Dr. Sue Ellen Cox is a board-certified dermatologist in Chapel Hill, NC
- Dr. Marianna Blyumin-Karasik is a board-certified dermatologist in Davie, FL
- Dr. Matthew Elias is a board-certified dermatologist in Fort Lauderdale, FL
The No-Downtime Favorite for Subtle Lift
If there’s one name that keeps coming up for noninvasive tightening, it’s Sofwave. According to Chapel Hill, NC dermatologist Sue Ellen Cox, MD, “Sofwave uses high-frequency ultrasound to stimulate neocollagenesis by targeting the mid-dermal layer, leading to gradual improvements in skin firmness and elasticity.” She emphasizes that while the results are impressive for mild laxity, they’re not a replacement for a facelift, but they are ideal for those seeking “subtle, natural-looking results.”
A major benefit? Sofwave is universally safe for all skin types. “Younger patients in their 30s to 40s tend to respond especially well,” Dr. Cox notes. “Older patients can see improvement too, but may need multiple sessions.”
What’s changed with this new generation of ultrasound? Comfort. Dr. Cox points to Sofcool technology, which cools the skin during treatment to protect the surface. Her practice also customizes pain management with everything from topical numbing and Pro-Nox (a nitrous oxide-based analgesia) to nerve blocks and cooling systems. “That level of comfort customization is a game-changer,” she says.
When helping patients choose between energy devices and surgery, Dr. Cox says honesty is everything. “If a patient is pulling their cheeks back in the mirror, I explain that surgery may be the only way to achieve what they’re picturing. Our job is to manage expectations and recommend what will truly get them to their goal.”
The Lunchtime Muscle-Lifter With a Cult Following
If you’ve ever wished for a nonsurgical facelift that works while you scroll through emails, Emface might be your new best friend. Davie, FL dermatologist Marianna Blyumin-Karasik, MD, swears by it. “It uses HIFES muscle stimulation and synergized radio frequency to strengthen the postural tone of the lifting muscles of the face while smoothing skin,” she says.
Dr. Blyumin-Karasik notes that Emface now has applicators to treat the neck and even eyelids, making it a comprehensive rejuvenation tool. She also frequently pairs it with Exion, which uses radio frequency and targeted ultrasound to tighten skin in stubborn spots like the upper arms and above the knees.
“It’s appropriate for all skin types,” she adds. “Younger patients usually need fewer sessions. Post-menopausal patients benefit, too, but maintenance is key.” Each session is only about 20 to 30 minutes with no downtime, which is why it’s become her go-to midday treatment. “It’s one of my favorites to do at lunch to maintain youthful facial sculpting,” she says. The one caveat? “It does require quarterly maintenance after the initial series.”
When surgery is on the table, Dr. Blyumin-Karasik guides patients toward the most realistic outcome. “If the skin laxity is too significant, I’m clear that plastic surgery will likely yield the most profound results,” she says. “But many of our patients are thrilled with the noninvasive path.”
The Energy-Packed Laser That’s Safe for All Skin Tones
For Fort Lauderdale dermatologist Matthew Elias, MD, the new laser device Avava Miria is a category of its own. “It’s currently my favorite for no downtime treatment for lifting, tightening and improving skin quality, while delivering a serious glow,” he says.
What makes it so different? “Avava is safe for all skin types and delivers more energy more precisely into the skin than any device the FDA has ever approved,” Dr. Elias explains. “It doesn’t just treat lines and wrinkles, it can volumize, tighten and lift. We’re just getting started with what this therapy can do.”
The innovation lies in its technology. “It allows you to target multiple skin layers up to 1.8mm deep while sparing the top layers,” he says. Translation: deeper results with faster recovery.
Dr. Elias’s approach is all about personalization. “Because we have so many energy devices in our practice, we can mix and match based on a patient’s needs. It’s never one-size-fits-all.”
