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Skin Tightening

What conditions are treated with lasers/energy-based devices?

Any areas of the skin that are noticeably sagging, drooping or thinning are candidates for skin tightening with lasers/energy-based devices. Droopy jowls, crepey skin on the back of the hands, loose saggy skin on the elbows, arms, thighs and knees are generally thought of in this category.

When should lasers/energy-based devices be used for skin tightening?

The visible outer layer on the skin surface called the epidermis acts as a protective barrier. Underneath that is the elastin and collagen-rich tissue called the dermis. The subcutaneous layer below that is the fat layer, with a web of collagen fibers running through it. Aging, weight fluctuations, and sun exposure contribute to the break down of the elastic tissue and collagen in these skin layers. This causes the skin to sag, and wrinkles, jowls and “bags” form. 

Naturally, treatments that work on just the surface can't do anything to restore the collagen or elastic tissue in the under-layer, or the deep dermis of your skin. Fortunately, there are noninvasive treatments that can help many patients postpone invasive surgical tightening of the skin. 

Description of treatments

A microfocused ultrasound treatment breaks up fat by causing non-selective thermal injury underneath the skin, bypassing the surface. A radiofrequency treatment emits heat energy to stimulate collagen production and kill fat cells. These skin-bypassing technologies can be effective with a wide range of patients, including those with darker color skin that may experience discoloration with a laser.

For complete patient satisfaction, many of the device treatments are part of a total rejuvenation program, which typically includes hyaluronic acid and other fillers to lift the face and neuromodulators to help with dynamic wrinkles, those created by muscle movement. With the device treatments, the process of demolishing old collagen and reconstructing new collagen can take several months. Using these injectables in combination with the device treatment will provide a more satisfying and immediate result during the energy-based remodeling process. Volume restoration with fillers—an injectable gel formula—focus on treating fine lines and wrinkles by restoring hyaluronic acid to the face. Results can last up to two years, depending on the area of the body.

What outcome should patients expect? 

  • Minimal pain
  • Quick session (15 to 45 minutes)
  • No downtime

Updated March 3, 2016


Skin Tightening
Christopher B. Zachary, MBBS, FRCP discusses how energy-based devices and other methods are used for tightening the skin. Recorded in 2012.

The views expressed and materials presented in this video represent the personal views of the individual speaker(s) and do not represent the opinion of the ASLMS. The ASLMS assumes no responsibility for the content of the videos made by the speaker or group of speakers.

The American Society for Laser Medicine and Surgery is the world’s largest scientific organization dedicated to promoting research, education and high standards of clinical care in the field of medical laser applications. It provides a forum for the exchange of scientific information and participation in communicating the latest developments in laser medicine and surgery to clinicians, research investigators, government and regulatory agencies, and the public.

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