Top Treatments to Tighten Aging Skin
When it comes to tightening loose facial skin, claims of “miracle cures” are a dime a dozen—and real results require matching the right treatment with each individual patient. Cut through the clutter by scheduling a consultation with a board-certified plastic surgeon. Plastic surgeons offer an invaluable level of medical expertise, while relying on your own research can often cause more problems than it solves.
“You can’t go by what worked for a friend, or a celebrity on a commercial, when it comes to skin tightening,” says Virtua plastic surgeon Bhupesh Vasisht, MD, FACS. “Many of my patients come to me after having spent thousands of dollars on drugstore products or medi-spa treatments that didn’t work.”
While there is no one-size-fits-all remedy for loose skin, Dr. Vasisht generally recommends one or more of the following treatments.
Creams and ointments
Be wary of most products’ promises, says Dr. Vasisht. There are a few topical treatments that can produce subtle results for a select few. For most, however, they won’t work in any noticeable way.
Intense pulsed light (IPL), ultrasound, and radiofrequency
To “ablate” is to remove something by destroying or damaging it. Ablative treatments are designed to damage the collagen layer beneath the skin, and tightening occurs through the healing process.
Non-ablative treatments, like IPL, are effective but don’t reach quite that deep into the skin. IPL, ultrasound and radiofrequency treatments direct a moderate level of energy (from light waves, sound waves, or radio waves) at the skin’s surface. This energy doesn’t destroy the collagen layer, but can “heat it up” and stir positive changes in the skin’s appearance.
Non-ablative treatments are more conservative, usually require multiple treatments and generally don’t produce dramatic changes. However, many patients are happy with the results. “In my practice, non-ablative treatments are very popular because they require very little downtime,” says Dr. Vasisht.
Fillers don’t actually tighten skin, but they can do exactly what their name suggests— fill some of the volume loss that causes aging skin to sag. They are injected into the face with a tiny needle in one or a series of treatments.
There are several levels of intensity to choose from among ablative laser treatments, which penetrate the surface of the skin to reach the collagen below. Both the degree of results and the downtime after treatment increase with the laser’s intensity. The laser that Dr. Vasisht most often uses in his practice is the Pearl, which is the least intense, but he also recommends the Titan and CO2 lasers, which have a higher intensity.
Though not as popular as they were before the introduction of laser technology, chemical peels are still used today and can produce great results for many patients. The TCA (trichloracetic acid) peel is what most patients choose due to its moderate intensity and minimal downtime. The phenol peel is much more powerful, but usually requires months of downtime and must be performed under anesthesia.
Smartlipo is the commercial name for a surgical procedure that combines minimally invasive liposuction with the use of a skin-tightening laser. With Smartlipo, the laser is applied from beneath the skin. This allows for deeper penetration of the collagen layer and better tightening of the skin.
During a facelift, the plastic surgeon cuts away loose skin and pulls and tightens before suturing. “Considerable downtime is required for a facelift, so it’s more commonly selected by people who can take off a few weeks,” says Dr. Vasisht. That said, a facelift can offer the most dramatic skin tightening of any of the available treatments.
In the end, the best advice is to schedule a face-to-face consultation with a board-certified plastic surgeon to get the most effective and economical results.
Updated December 19, 2017