Nonsurgical Skin Tightening

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 or other conducting gel during treatment. Topical, oral or intravenous pain medication may be required depending upon device, treatment area, and your individual needs. Radiofrequency

• For certain devices, 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 may 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) or Broad Band Light (BBL)

• You will be provided with protective eye covering
• A handpiece is used to administer a continuous cooling while light heats the deep dermis (deep layer of your skin) and addresses dyschromias (brown and red discoloration) in the skin
• Multiple passes are performed and multiple treatments will be necessary

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 provider can see the treatment area and underlying structures
• Small thermal bursts stimulate the deep structural support layers of the skin without disturbing the skin’s surface
• Multiple passes are performed at varying depths within the skin

What are my options?

There are three general options for nonsurgical skin tightening. After evaluating your skin quality and the area being treated, your provider 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. Some technology combines radiofrequency with the benefits of microneedling. 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
• Viva
• Vivace

Intense Pulsed Light (IPL) and Broad Band Light (BBL)

• Titan
• Halo
• VelaShape (combines radiofrequency and IPL)

Ultrasound

• Ultherapy
• Venus Legacy
• VaserShape
• Exilis (combines Radiofrequency and Ultrasound)

Select a surgeon you can trust

It’s important to choose your provider based on:

• Education, training and certification
• Experience with nonsurgical skin tightening
• Your comfort level with your treatment provider

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 with the surgeon or one of the physician extenders. 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 provider 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 provider’s training and experience, they 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

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 for the procedure I am undergoing?
• What kind of anesthesia do you recommend?
• What are the costs associated with my treatment?
• How can I help to achieve an optimal result?
• What kind of recovery period can I expect, and when can I resume normal activities?
• What are the risks and possible 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?

How do I prepare for a nonsurgical skin tightening procedure?

Your provider will prepare 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 provider 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. Depending on the treatment performed, you may need 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 procedure 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.
• If a procedure is more invasive, various monitors may be used to check your heart, blood pressure, pulse, and the amount of oxygen circulating in your blood.
• Your provider will follow the treatment plan discussed with you.

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

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

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 treatment provider immediately. Depending on the device your provider used you may experience skin reddening, swelling, and numbness at the treatment area(s). Contact your provider 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 provider. It is vitally important that you follow all patient care instructions. You will receive 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 provider to discuss if additional treatments are needed.

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.

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 or their physician extenders to get details about your various nonsurgical skin tightening options. These numbers only reflect the provider 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.

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:

• Sensitivity to sun
• 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 and physician extenders, both before and after your nonsurgical skin tightening.

Left side upper lip not moving correctly after facetite.

Will wearing a corset/spanx help skin tightening during weight loss?