Loose, sagging skin on the face, stomach, arms, and other areas is very distressing for many of us. Loose skin or integument (integument – medical term for skin) makes us look old and out of shape, no matter how much we exercise and try to stay in shape. In the past, effective skin tightening required plastic surgical procedures such as facelifts and tummy tucks. However, in recent years, many new non-surgical and laser skin tightening methods have been developed. New skin tightening technology has been steadily improving as machines improve and doctors learn how to maximize the results achieved.
Today, often using a combination of different methods, substantial skin tightening can be achieved without surgery, a very different situation than just 3 or 4 years ago when Thermage, Titan, Refirme and LuxIR Deep were introduced. There are many skin tightening advertisements out there that can be misleading, so you really need to be an informed consumer and understand the technology if you want to achieve the result you want. Below I will explain how the new skin tightening technology works and which methods are the best.
How non-surgical skin tightening works
Tight and firm skin requires good elasticity. Elasticity means the ability of the skin or integument to recede or tighten after being displaced or torn from the body. Good elasticity depends on healthy collagen and elastin fibers that lie deep, near the bottom of the dermis, the deep layer of our integument below the surface. Collagen and elastin fibers act like little rubber bands that hold the integument tight against our body and pull loose tissue back when stretched or pulled.
Aging, sun damage from ultraviolet (UV) light, smoking, stress, excessive alcohol consumption, and an unhealthy diet and lifestyle destroy collagen and elastin in the dermis and cause the integument to shrink. loosen and sink. Stretching caused by pregnancy or rapid weight loss after dieting or gastric bypass surgery also destroys collagen and elastin in the dermis, leading to sagging and loss of tone.
All non-surgical and laser skin tightening methods work by stimulating the growth of new collagen and elastin in the dermis. When you heat collagen and elastin to 66 degrees Celsius, the collagen and elastin fibers shrink or tighten and remodel with new collagen and elastin formation. The effect of this tightening of the skin and the formation of new collagen and elastin is that the deep dermis contracts and becomes firmer and loose tissue tightens.
Elastin and collagen lie deep in the dermis, and the biggest challenge is getting enough heat into the dermis to reshape the elastin and collagen without burning the surface of the integument as the heat passes through the more superficial layers .
This has been achieved through the use of very effective cooling devices that cool the surface as thermal energy passes through the surface on its way to the deep dermis. Machines that have this capability are Palomar LuxIR Deep, Thermage, Titan, and Refirm to name a few.
A newer method applies heat to deep layers from below. New laser liposuction technology like SlimLipo uses a small laser cannula placed under the integument to melt away fat. The heat also causes the contraction and firming of the overlying loose tissue. This technique has been very effective for the belly and neck or double chin.
laser skin tightening
The erbium and CO2 laser resurfacing of yesteryear effectively tightened loose tissue. However, recovery was very difficult with prolonged healing time, prolonged redness, and hypopigmentation or discoloration after the procedure. These techniques are no longer widely practiced.
The new fractional laser resurfacing techniques are a great improvement. By splitting or splitting the laser into many small beams, untreated areas are left to speed healing and complications are less common. New fractional resurfacing techniques can also go deeper into the dermis to firm the deeper layers of collagen and elastin. Fractional laser resurfacing machines include the Starlux 1540 and 2940, Fraxel, ActiveFX, DeepFX, Profractional, and Affirm machines.
These skin tightening techniques can be used and are most effective on the face. Because healing of the integument is required, these fractional resurfacing techniques are less effective in other areas such as the neck, stomach, and arms.
Lasers are not the treatment of choice for flaccidity and laxity of the neck, abdomen, and arms. These areas require more heat energy that can only be delivered by infrared and radio frequency machines.
Infrared and radiofrequency skin tightening
Today’s most effective surface-applied skin tightening machines use radio frequency or infrared thermal energy to tighten loose, sagging tissue on the neck, arms, and tummy. These machines have sophisticated cooling handpieces to prevent burn injuries.
These machines can penetrate deep into the dermis, up to 2000 microns, where elastin fibers are most abundant. These deep treatments are necessary to firm and tighten the skin to the maximum. Commonly available machines are LuxIR Deep, Thermage, Titan, and Refirme from Palomar, among many others.
Understand that 4 treatments are usually required for best results with most machines. New collagen and elastin production will not occur until 6 months after your last treatment, so it takes time to see the end result.
In my opinion, the best results are an improvement of 20-30%. Even better results are possible at higher powers using LuxIR Deep, which has a great new cooling system that allows us to more than double the power we’re using. The new LuxIR Deep Cooling with higher energy supply also shortens the duration of treatments.
Still, infrared and radio frequency machines still can’t achieve the same results that I can achieve with a facelift, tummy tuck, or arm lift.
Laser Liposuction
Recently, new laser liposuction technology called SlimLipo has produced a remarkable tightening of loose fat and integrity during the fat dissolving process. Because the SlimLipo laser fiber is placed under the integument, the laser beam has closer and more direct access to subcutaneous elastin fibers.
Laser liposuction has been used successfully to firm up a loose tummy, a loose arm, a loose neck, and to firm the hips and thighs. This new method of laser liposuction will be very important in the coming years.
Which skin tightening method is best for you?
Your choice of a firming method will depend on how much loose skin you have and where the loose skin is located. If you have wrinkles, sun damage, and mild laxity around your cheeks and mouth, then fractional laser skin resurfacing with Starlux 1540 and 2940 combination lasers is your best option.
If you have good skin and mild to moderate skin laxity on your cheeks, neck, abdomen, or arms, infrared or radio frequency skin tightening will give you a 20-30% result. I use the LuxIR Deep Skin Infrared Skin Tightening Machine made by Palomar.
If you have oily, loose skin on your tummy, arms, neck, jowls, hips, or thighs, then laser liposuction is your best option for skin tightening. I use the Palomar SlimLipo laser liposuction machine.
How to find a doctor
Board-certified plastic surgeons and dermatologists are the laser experts, but all board-certified plastic surgeons and dermatologists are inexperienced with lasers.
Therefore, you will have to do your homework and consult doctors if they have experience with lasers and laser surgery. It is very important to consult an expert. Although the nurse or esthetician doctor can perform infrared or radiofrequency integument tightening, the doctor supervising the treatment must understand lasers and light technology. Laser liposuction and laser resurfacing should be performed by an experienced physician.
Today there are many non-plastic surgeons and dermatologists advertising light and laser services who are not experts in these techniques. You really need to ask the right questions and do your research. These new technologies can be dangerous and harmful in untrained hands.
Good places to look are the websites of the following organizations:
American Board of Plastic Surgery (ABPS)
American Society of Plastic Surgeons (ASPS)
American Society of Aesthetic Plastic Surgeons (ASAPS)
Visit these websites and search for board certified plastic surgeons in your area. Check their websites and see if the doctor offers non-surgical and laser skin tightening treatments. Consult at least two doctors and ask to see photos of the results on their own patients. Don’t seek out skin-tightening treatments at medical spas that don’t have a board-certified plastic surgeon or dermatologist with experience in laser surgery present on-site.
