Nonsurgical Skin Tightening

Also known as laser skin tightening or ultrasound skin tightening

Skin tightening procedures have become very popular in recent years because they provide a nonsurgical alternative to more invasive procedures for correcting skin laxity and improving skin quality. Today your plastic surgeon can choose among a number of different devices and technologies that provide noninvasive skin tightening solutions.

When to Consider Nonsurgical Skin Tightening

  • If you have mild to moderate loose skin on your face, neck, arms or abdomen
  • If you have residual skin laxity after an operative procedure
  • If you would like an improvement in the quality of your skin
  • If you are unable (or unwilling) to undergo a more invasive, surgical procedure to correct skin laxity

Considerations

Pros

  • A noninvasive, nonsurgical technique that tightens facial or body skin
  • Performed with no incisions, minimal discomfort and little to no downtime
  • May be used for all skin types

Cons

  • Results are less extensive and dramatic than those obtained with a facelift or body contouring procedures
  • Multiple treatments are usually needed for optimal results
  • Skin redness, temporary swelling or numbness or volume loss around the treated area may occur

These are the top three pros and cons to weigh when considering nonsurgical skin tightening. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for a nonsurgical skin tightening?

The following are some common reasons why you may want to consider nonsurgical skin tightening:

  • You have mild to moderate loose skin on your face, neck, arms and abdomen
  • You have residual skin laxity after an operative procedure
  • You would like an improvement in the quality of your skin
  • You are unable (or unwilling) to undergo a more invasive surgical procedure to correct skin laxity

Multiple treatments are usually required for maximum benefit.

Detailed Procedural Info

How is a nonsurgical skin tightening procedure performed?

Depending on your skin quality and the area being treated, your surgeon may choose one of the treatments described below. Before the procedure begins the area to be treated is cleaned of makeup and skin lotions. Some treatments require a thin coat of ultrasound gel during treatment. Oral or intravenous pain medication may be required depending upon device, treatment area, and your individual needs.

Radiofrequency

  • The treatment area is measured and marked
  • Your skin is cooled for comfort and safety
  • A specially designed treatment tip is placed against your skin
  • Radiofrequency energy penetrates deep into the skin's tissue, heating the treatment areas and stimulating collagen production
  • You will feel a gentle vibration as well as cooling and heating sensations during each pulse
  • The upper layer of your skin is cooled

Intense pulsed light (IPL)

  • If your face will be treated, you will be provided with protective eye covering
  • A handpiece is used to administer a continuous cooling while an infrared light heats the deep dermis (deep layer of your skin)
  • One or more passes may be performed

Ultrasound

  • The treatment area is measured and marked
  • An ultrasound gel is applied to your skin
  • A smooth handpiece is placed on your skin and an image of the tissue beneath is projected on a screen so your surgeon can see the treatment area
  • The ultrasound emits small thermal bursts to stimulate the deep structural support layers of the skin without disturbing the skin's surface

What are my options?

There are three general options for nonsurgical skin tightening. After evaluating your skin quality and the area being treated, your plastic surgeon will choose the option that is best suited for your particular situation and will recommend an approach based upon your aesthetic goals.

Radiofrequency and intense pulsed light treatments heat only the deep layer of your skin. The epidermis or outer skin layer is not damaged. Your body's natural wound healing response causes collagen changes in the skin which results in skin tightening. A series of treatments is usually performed.

Ultrasound treatments focus ultrasonic energy to the dermal layer (the deep layer of your skin). Your skin above the focus point and tissue below the focus point are protected. New collagen growth is stimulated, which gradually lifts and tightens the skin. Like radiofrequency and IPL, multiple treatments may be needed.

What are the brand names for nonsurgical skin tightening?

Radiofrequency

  • Thermage
  • Accent
  • Pelleve

Intense Pulsed Light (IPL)

  • Titan
  • Sciton's St
  • VelaShape (combines radiofrequency and IPL)

Ultrasound

  • Ultherapy
  • VaserShape

Selecting a Surgeon

Select a surgeon you can trust

It's important to choose your surgeon based on:

  • Education, training and certification
  • Experience with nonsurgical skin tightening
  • Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.

After finding a board-certified plastic surgeon in your area who is experienced in performing nonsurgical skin tightening, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for nonsurgical skin tightening and clarify what a nonsurgical skin tightening can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered (see related procedures).

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

  • Previous surgeries
  • Past and present medical conditions
  • Allergies and current medications, including skin care products utilized

Your treatment plan

Based on your goals, physical characteristics and the surgeon's training and experience, your surgeon will share recommendations and information with you, including:

  • An approach to your treatment, including the type of procedure or combination of procedures
  • The outcomes that you can anticipate
  • Your financial investment for the procedure
  • Associated risks and complications
  • Options for anesthesia and treatment location
  • What you need to prepare for your treatment
  • What you can expect to experience after the procedure
  • Show before and after photos of cases similar to yours and answer any questions, so you can make the most informed and intelligent decision.

Questions to ask your aesthetic plastic surgeon

For a general list of questions to ask your plastic surgeon about his or her background, find out about plastic surgery safety, and to plan your procedure visit the Planning Toolkit.

We developed these questions to help you:

  • Make the most informed and intelligent decisions about your procedure
  • Confirm that you have the right surgeon for your procedure
  • Make your initial consultation as rewarding as possible
  • Understand your options, potential outcomes, and risks

It is important for you to take an active role in your treatment, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for nonsurgical skin tightening?
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • What kind of anesthesia do you recommend for me?
  • What will be the costs associated with my treatment?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect, and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing for Your Procedure

How do I prepare for a nonsurgical skin tightening procedure?

Your surgeon will provide you with pretreatment instructions, answer any questions that you may have, take a detailed medical history, and perform a physical exam to determine your fitness for treatment.

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking for at least six weeks before undergoing treatment to promote better healing
  • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications can cause increased bleeding
  • Discontinue any topical skin products that might increase your risk of complications from treatment
  • Regardless of the type of treatment to be performed, hydration is very important before and after surgery for safe recovery

Nonsurgical skin tightening is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after your treatment and to stay with you at least the first night following your procedure.

What can I expect on the day of nonsurgical skin tightening treatment?

Your nonsurgical skin tightening treatment may be performed in an accredited hospital, free-standing ambulatory facility, or office-based surgical suite. Most nonsurgical skin tightening procedures take at least thirty to ninety minutes to complete but may take longer.

  • Medications are administered for your comfort during the surgical procedure.
  • Oral, local anesthesia, or intravenous sedation may be desirable in some instances.
  • For your safety during the procedure, various monitors will be used to check your heart, blood pressure, pulse, and the amount of oxygen circulating in your blood.
  • Your surgeon will follow the treatment plan discussed with you.
  • After your procedure is completed, you will be taken into a recovery area where you will continue to be closely monitored.

You will probably be permitted to go home after a short observation period unless you and your plastic surgeon have made other plans for your immediate post-treatment recovery.

Aftercare and Recovery

Nonsurgical skin tightening procedures have minimal recovery and you are usually able to resume full activity immediately after treatment.

Your surgeon will discuss whether there are any immediate restrictions on your activities and if so, how long it will be before you can return to your normal level of activity. After treatment, you and your caregiver will receive detailed instructions about the care of the treated areas, including information about:

  • Normal symptoms you will experience
  • Potential signs of complications

See options for short-term recovery locations in Aftercare and Recovery (Planning Toolkit).

Immediately after nonsurgical skin tightening

You may notice an immediate improvement in your skin, but your results will unfold over the course of two to six months.

When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact your physician immediately. Depending on the device your surgeon used you may experience skin reddening, swelling, and numbness at the treatment area(s). Contact your surgeon to find out if your pain, redness, swelling, and numbness are normal or a sign of a possible problem.

Recovery time frame after nonsurgical skin tightening

Nonsurgical skin tightening procedures have minimal recovery time and you are usually able to resume full activity immediately after treatment unless otherwise directed by your surgeon. It is vitally important that you follow all patient care instructions provided by your surgeon. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

The first two to six months

Because the natural process of creating new collagen builds over time, your results will become more evident over the course of two to three months. You may see continued improvement and contouring for up to six months as new collagen is formed. Contact your surgeon to discuss if additional treatments are needed.

How Long Will the Results Last?

Most nonsurgical skin tightening results will last one to three years on average. Subsequent procedures may need to be repeated periodically in order to maintain the benefits.

Maintain a relationship with your aesthetic plastic surgeon

For safety, as well as the most beautiful and healthy outcome, it's important to return to your plastic surgeon's office for follow-up evaluation at prescribed times and whenever you notice any changes in the skin that has been treated. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs

The cost of nonsurgical skin tightening varies from doctor to doctor and from one geographic area to another. It is important that you consult with a board-certified plastic surgeon to get details about your various nonsurgical skin tightening options.

See the national average for physician fees per procedure.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments or other miscellaneous costs related to nonsurgical skin tightening.

Because nonsurgical skin tightening is an elective treatment, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.

Choose your surgeon based on quality, training, and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.

Limitations and Risks

Fortunately, significant complications from nonsurgical skin tightening are infrequent. Your specific risks for nonsurgical skin tightening will be discussed during your consultation.

All procedures have some degree of risk. Some of the potential complications of all nonsurgical procedures are:

  • Adverse reaction to anesthesia, if applicable
  • Changes in sensation
  • Contour irregularities
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures

Other risks specific to nonsurgical skin tightening are outlined below:

  • Small burns
  • Skin reddening, swelling, and numbness of the treatment area(s)
  • Pigment (skin color) changes
  • Loss of volume beneath the treatment area(s)

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your nonsurgical skin tightening.

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