4 Essentials You Need to Know About Skin Tightening

I love all of your questions!  I truly wish I could answer all of them.  The marketing on these devices is getting more intense.  And consequently, how do you…the consumer….figure out which systems will actually DO what they are saying they can do.   As more and more systems come out, you don’t want to waste your time or or money!  How do you think about these?  Most of these systems are based on radiofrequency which are sound waves. Here’s what to ask and think about:

1.  Is this a deep or superficial system?

Is this system acting putting energy superficially (on top of the skin) or deeply (down in the dermis) where the collagen is.  Thermage, Ultherapy, Exilis, Pelleve, etc. are superficial systems which apply energy through the outer layer (epidermis).  They are great for skin tone maintenance, and some tightening.  They work best in younger (45ish or less) patients and there is no downtime.  Deeper radiofreqency is newer, and allows us to put the energy with tiny microneedles right down into the deeper layer (the dermis).  This causes more tightening, especially in the over 40-50 group.  Approximately 25% of a surgical facelift.  Our office uses Profound for deeper treatments.

2. Is there downtime?

 Every treatment that truly delivers energy into the dermis will cause some bruising, swelling and downtime.  The more superficial treatments don’t.  If a website is claiming that there is no downtime or pain, they are NOT working in the dermis, where the blood vessels, collagen, elastic fibers and nerves are.  Remember …if there is no downtime and no discomfort, you generally will get little to no tightening.  Even more superficial systems like Thermage or Ultherapy will cause occasional “zingers.”

3. Your provider and your consult.

Who is providing the treatment?   Ideally, an MD, mid level provider (ARNP, PA-C) or an RN, not a “technician”.   Who is going to educate you  and answer questions about the system?  The front desk (unless they have a medical license) should never be the ones to provide the consult or answer medical questions.  Do they have a way with a direct phone number (not a call center) or email, for you to communicate with them?  Be suspicious if they hedge on questions about this.

4. The clinic. 

Is this clinic established and in business more than 5 years, and have a board certified dermatologist or at least a doctor onsite several days a week?  Many clinics claim to have a “medical director” who is never there, and often works even in another city. Many “mall” clinics are springing up and are very happy to take your money. And then pressure you to buy a series of treatments, only to provide shoddy or even dangerous treatments.  Usually they are out of business or shut down by the state in 2-3 years.  Look for a minimum or 5 years in business, and more than 10 is even better.

Bottom Line:   For your question above……filler is usually better for this problem than the Instalift.

Hope this helps,

Dr. Brandith Irwin