Skin Tighteners

Quick Facts About Skin Tighteners

Average Treatment Cost: $3,500-14,000
Procedure Time: 1-3 hours
In/Outpatient: Usually Outpatient
Anesthesia: General or local with sedation
Recovery Time: 10-14 days; strenuous activity in 3-6 weeks
Duration of Results: Long-lasting
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What you should know

What Are Skin Tighteners

A noninvasive doctor-administered procedure, skin tighteners employ radio frequency (RF), ultrasound energy or infrared light to tighten the skin below the surface. By heating the dermis, new collagen growth is stimulated (by the activity of fibroblasts, the cells that create collagen) and produced.

Skin tighteners are good for firming up minimally loose skin and can even get rid of small, unwanted areas of fat in some patients.

For the lucky few who just need a minor bit of tweaking, a skin-tightening treatment can help. “To non-surgically treat loose skin, we can use a combination of methods like a prescription-strength retinol cream, to produce collagen, followed by lasers that help build collagen,” says New York dermatologist Jody Levine, MD.

Here are some top skin tightener device brand names to look for:

  • Accent Your Body
  • Thermage
  • Ulthera

On average, the results from skin tighteners are not permanent. Maintenance sessions need to be done about once a year and results are not predictable since not everybody responds to skin tightening. Also, if you have excessively loose skin you may not see much of a change in how the skin looks. 

How Skin Tightener Devices Work

  • Step 1. The skin is cooled with either a cooling tip or a built-in plate (both of which are built-in to the head of the treatment wand) to prevent burning. “You’re inundating the skin with heat, so the cooling mechanism makes the treatment more comfortable and helps prevent blistering,” says New York City, New Jersey and Boca Raton, FL, dermatologist David Goldberg, MD.
  • Step 2. Energy/heat is quickly emitted and passed deep down to the cells that are responsible for creating collagen. The skin is then cooled again to prevent burning. The bottom layers of the skin react to the heat, causing a slight injury and inflammation that signals the existing collagen to contract and for new collagen to be made.
  • Step 3. New collagen production begins during the next 90 days, which is about how long it takes to see results. Some patients don’t see results for up to six months, while others see little, if any, change.

Many doctors recommend doubling up on surgery and a skin tightener for optimal improvement. Even if the skin is pulled tight to a natural position, if the quality of the skin isn’t good, then results from your surgery may not be the best that they could potentially be.

“Combining a skin-tightening treatment with surgery, like a tummy tuck, really helps in terms of how the skin looks,” says Fairfax, VA plastic surgeon Victoria Suh, MD. “Three to four weeks after surgery, once you’re healed, we do the skin-tightening treatments to control laxity that may have resulted from post-op swelling.”

Historically, plastic surgeons and dermatologists observed that ablative lasers tightened the skin—from there, a whole crop of nonablative skin-tightening machines came to the market. “CO2 lasers were used primarily for wrinkle reduction on the face, and they tightened the skin to some degree. How long the results lasted was debatable,” says Dr. David Goldberg. But carbon dioxide (CO2) lasers couldn’t be used on the body because of potential scarring. “Some of the first CO2 lasers used for skin tightening achieved significant tightening, but do so at the expense of increased thermal damage, prolonged healing and redness,” says Montclair, NJ, plastic surgeon Barry DiBernardo, MD. The current crop of skin tightening devices is targeted strictly at tightening without damage to the outer layer of skin and with no downtime. 

Body Contouring Laser

Accent Your Body uses advanced radio frequency (RF) technology to treat wrinkles and smooth skin non-invasively. This treatment is known for tightening loose skin, promoting healthy collagen production and improving body contours. Good results are achieved quickly.

 “Accent Your Body is still the most widely used machine for the body,” says New York City, New Jersey and Boca Raton, FL, dermatologist David Goldberg, MD.

This skin tightener can be used on the entire body except for the face and chest area. The heat therapy is said to feel like a hot stone massage. Each treatment takes about 45 minutes depending on the treatment area. It can take four to six treatments to achieve your desired result.

Radio Frequency Skin Tightening

Thermage is considered by many to be the preferred treatment for tightening the skin.

“I find Thermage to be particularly useful, not just for facial tightening, but also for body contouring, especially for the abdomen, buttocks, thighs and upper arms,” says Washington, DC, dermatologist Tina Alster, MD. “Some feel there are unpredictable and minimal results,” says La Jolla, CA, plastic surgeon Robert Singer, MD.

Skin tighteners are used for smoothing the skin and creating more collagen, but they are also now being used to address loose skin on the hands. “I like to use a radio-frequency treatment like Thermage for the hands,” says New York, NY,  dermatologist, Dr. Heidi Waldorf.

Thermage target areas include the face, eyes and body.

Only one treatment is needed.

Each treatment lasts about 45 minutes when treating the face; up to an hour and a half for other parts of the body, depending on the size, location and condition of the area being treated.

Ultrasound Skin Tightening

Ulthera has received FDA clearance for noninvasive eyebrow lifts. Some doctors are using it to treat the lower face as well, but the device is still too new to measure long-term efficacy.

 

Different from an ultrasound used during pregnancy, this machine uses high-frequency ultrasound to deliver energy deep below the skin to target the muscle layer, typically addressed in a surgical facelift, in one treatment.

Purported to feel like a pinprick, Ulthera also contains a special technology known as DeepSEE, which acts as an X-ray of sorts, mapping out exactly what areas need to be treated so that your doctor can properly assess the areas without having to make an incision or disrupt the tissue.

Are They For Me

The market is booming with surgery-free skin-tightening treatments, but are they really the answer to smoother, firmer skin while improving the quality of it?

Although the verdict is still out—some experts tout skin tighteners as the next best thing while others feel these treatments offer very little improvement. If your skin is not extremely saggy, a noninvasive skin-tightening treatment may offer some temporary improvement. 

Who they are for

Most doctors recommend skin-tightening or skin-resurfacing treatments for younger women who have been pregnant or those who are in their 30s or early 40s or 50s and are starting to notice the first signs of skin laxity. “The skin can be somewhat slack, but in order to see some results, the muscle can’t be loose,” says New York City, New Jersey and Boca Raton, FL, dermatologist David Goldberg, MD.

Washington, DC, dermatologist Tina Alster, MD adds that you’ll need to have a fair amount of dermal thickness in order for your skin to respond to skin tightening and for results to be noticed. Consult with your doctor about this.

Skin-tightening treatments are also good for someone who can’t endure a procedure that requires downtime. “The nice thing about skin tighteners is that they’re more gentle, they don’t break down the top layer of skin, and usually there’s a low risk of scarring, blistering or pigment changes,” says Montclair, NJ, plastic surgeon Barry DiBernardo, MD.

If you are aiming for “slight improvement” as opposed to dramatic results, opt for less-invasive or nonsurgical treatments. Try out a skin tightener before you go in for a tummy tuck, if you’re not quite ready for surgery. “It won’t give the same exact result but it may be able to hold you over until you can afford to do surgery. And, the cost is much less,” says Miami Beach, FL, plastic surgeon Leonard Tachmes, MD. 

Who they are not for

One thing’s for sure, a skin-tightening procedure won’t offer much of a benefit if your skin is extremely loose and saggy, if you’re experiencing a loss of facial volume or if the underlying muscle is lax. If the skin is loose, wrinkly, heavily textured and hanging, you may need surgery. The same goes for the skin on the body—if it is overly slack and unresponsive to treatment, your best bet may be surgery, which excises any loose skin.

What To Expect With Skin Tighteners

“At best skin tighteners can only tighten the skin by about 20 percent,” says Los Angeles, CA, plastic surgeon Daniel Yamini, MD. He adds, “Results are not permanent. Our skin has a memory based on accumulated damage cause by aging and hormonal changes. It will decide how much it will stretch back out no matter what procedure—invasive or not—we do.”

But these types of treatments do have a place. Duxbury, MA, plastic surgeon Christina Hamori, MD, explains that skin tighteners work for superficial wrinkling of the abdomen around the belly button and lower abdomen in slimmer body types.

The bottom line: Chances are you’ll probably see an effect on how tight the skin on your stomach is—hard-to-tame areas may also be improved—but the results are not perpetual and upkeep is necessary.

Post-Treatment Care: Skin Tighteners

Post-Treatment Care

While a series of treatments is usually necessary for results, skin tightening procedures typically don't require any downtime.

Inside Tips: Skin Tighteners

  • Skin tighteners are not good for fixing weak muscle tone, reducing moderate to large amounts of excess skin and fat or eliminating stretch marks. 
  • “Collagen production can be stimulated with fractional resurfacing to smooth the skin and improve its appearance,” says Hunt Valley, MD, dermatologist, Dr. Karen Beasley, adding that, if the skin is somewhat saggy, a radio-frequency treatment, like Thermage, may minimally tighten the skin. 
  • Just because a skin-tightening device maker claims that a topical anesthetic doesn’t need to be used doesn’t mean your skin tightening procedure won’t hurt. You may want to ask your doctor about a topical anesthetic, especially if you have a low pain threshold.
  •  “There is not a one-size-fits-all type of treatment, and, in my opinion, there is not one single system available that’s going to target all of your concerns,” says Washington, DC, dermatologistTina Alster, MD. “It’s really a matter of mixing and matching the different technologies to get the best result.”

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