Radiofrequency for neck and jowls
There are plenty of topical products that promise to firm and tighten the appearance of neck skin, but when you want to see real change in the mirror, most experts agree that radiofrequency (RF) energy is the best way to go. RF energy heats the collagen under the skin’s surface, causing it to contract as well as to create more collagen naturally. Collagen is one of the building blocks of healthy, youthful skin that dwindles with advancing age.
For sagging jowls and necks, Inmode’s new FaceTite RF device packs a solid one-two punch, says Hardik Doshi, MD, a facial plastic surgeon at Discreet Plastic Surgery in New York City. “We tighten skin from the inside out and the outside in, sandwiching it between two wands,” he explains. “One wand goes on top of the skin, causing collagen to contract and tighten, and the other goes underneath the skin where it liquefies the fat.” The process is known as radio-frequency assisted lipolysis.
A tiny puncture in the skin is needed to access the deeper level. Results appear gradually within six weeks to three months, he says. More than one treatment may be needed if skin is extremely lax. Dr. Doshi may combine FaceTite with other treatments for maximum results. “I can do chin liposuction because the fat is easier to remove since it has already been emulsified by the RF energy.”
FaceTite is not the only RF-based tightener in town. “Thermi RF is like a sparkler delivering RF energy under the skin,” he explains.” You have an external camera checking heat to make sure you don’t get too hot, so there is limited fat-melting. It is more for skin tightening.” With FaceTite, however, the two wands allow for different internal and external temperatures, which can lead to more substantial fat melting.
Radiofrequency for the body
Inmode’s BodyTite device earns high marks for tightening excess skin in the arms, tummy, and thighs from Christopher T. Chia, MD, the surgical director of Bodysculpt in New York City. “RF is the king of the energy modalities, and with this device, I get a lot more oomph,” he says. “We do it with local anesthesia, and there are no scars because it involves no more than a quarter-inch incision through which we pass the straw underneath the skin.” It’s not for everyone, he says. “If you lost 100 pounds, your skin won’t contract enough with this technology, but for those who may not be candidates for liposuction, this is an impressive alternative.” And one treatment is usually all it takes. Today’s liposuction techniques may also offer some skin-tightening benefits.
Ultrasound skin tightening
Ultrasound energy delivered via a treatment called Ultherapy employs sound waves to boost collagen stores under the skin’s surface, firming skin. It certainly has its fair share of advocates for tightening the neck, chin, and brow. “Ultherapy can penetrate at different depths based on how we focus the energy,” Dr. Doshi explains. “Proponents of Ulthera skin tightening say that because it can skip the superficial layer of the skin and go deeper, you can get more heat without burning the inside of the skin.” Here are some non-surgical tricks to mask the signs of aging on the face.
Microneedling with other technologies
Some newer procedures combine multiple technologies in one device to tighten skin. For example, Vivace is a new treatment that starts with microneedling and adds radiofrequency and laser light. “It is the first device to use a robotic motor to gently push the needles into the skin, allowing smooth, precise control, no downtime, complete comfort, and the optimal delivery system post-treatment,” says Sejal Shah, MD, founder of SmarterSkin Dermatology in New York City. “Both the microneedling and the radiofrequency components stimulate collagen, resulting in skin tightening,” she says. “I use the treatment primarily on the face, neck, and chest but have used it in other areas of the body as well, such as hands, knees, abdomen.” And so far, so good. “Most people have noticed immediately that skin appears more radiant and even tighter. Over time, the skin should appear smoother and firmer, with improved texture and reduced fine lines and wrinkles,” she says. Some people also notice improved tone and more even pigmentation. The number of treatments needed varies but typically ranges from three to six. Here’s why microneedling is such a hot skin-care trend right now.
Surgical skin tightening
Plastic surgery is the gold standard when it comes to skin tightening. “There is nothing more effective than a surgical mommy makeover, tummy tuck, lower body lift, or arm lift for patients who have excess skin after childbirth or massive weight loss,” says Mark H. Schwartz, MD, clinical assistant professor of plastic surgery at Weill Cornell Medical College in New York City. There are always trade-offs. These procedures may have longer recoveries, require general anesthesia, and leave scars. “The results, however, are immediate, long-lasting, and can be very dramatic when performed by a board-certified plastic surgeon,” Dr. Schwartz says. (A word of caution: If you’re considering plastic surgery, you might want to stay off social media when searching for a doctor. Only 18 percent of plastic surgery Instagram posts are by qualified doctors.)
Spillover skin tightening
With some procedures, firmer skin is more of a bonus than a goal. The results are not as dramatic as what can be achieved with procedures specifically designed to tighten skin, but for the right person, these benefits may be enough to make a meaningful difference. “Both Kybella and Coolsculpting yield some skin tightening of the submental (chin) area, but they are primarily for volume reduction of fat,” explains Jeffrey S. Dover, MD, a dermatologist of SkinCare Physicians in Chestnut Hill, MA. Kybella injections work by gradually melting away pockets of unwanted fat, while Coolsculpting freezes fat cells to death. Coolsculpting’s Coolmini, in particular, got a nod from the U.S. Food and Drug Administration for reducing lax tissue in the double chin area. Bonus Coolsculpting is one of the beauty treatments you could get on your lunch hour.
Here’s what doesn’t work: laser skin tightening. “Lasers are generally not ideal for skin tightening,” Dr. Dover says. “While we get some tightening after ablative and ablative fractional resurfacing, they are really better for texture.”