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What about skin tightening procedures for the face?

In recent years there has been a gradual shift in efforts to tighten the aging face other than surgery. Besides the stage facelift, which is an adhesive pull to the skin, laser resurfacing has been used for sun damaged or wrinkled skin. This was popular in the 90’s and early 2000’s and is still used today to a much lesser degree because of the risk and protracted recovery time. Resurfacing the skin is a different technology than skin tightening devices, which are more frequently used today. Laser resurfacing employs primarily a thermal effect to the skin, essentially creating a superficial burn. In the early 2000’s, barbed sutures were used beneath the skin to lift tissues, however, the FDA recalled these sutures.

In 2002, radiofrequency skin tightening treatments were introduced to heat the deeper layers of the skin. This technology is still used today but also has been modified by many companies to control the depth of treatment in the skin. Additionally, there have been other devices introduced like an infrared light source to heat the deeper layers of the skin and cool the surface. Subsequently, there has been the introduction of micro needling devices used to penetrate the skin and promote collagen formation and subsequent skin tightening. In 2009, the FDA approved another device, which uses ultrasound to tighten the skin of the neck, forehead and chin. This type of device heats the deeper layers of the dermis and stimulates collagen formation. To makes things further interesting there has been the introduction of micro needling devices used with botanicals, pharmaceuticals and even a patient’s own plasma (PRP).

The idea is to create a controlled micro-wound and add tissue growth factors with the effects of collagen stimulation. To add to the confusion, micro needling is also being used with radiofrequency skin tightening treatments again to create a thermal micro-wound in the deeper layers of the dermis but spare the upper layers and the epidermis. Today, fractional or varying levels of dermal treatment are considered the latest technology. The goal of all of these treatments is to tighten the skin and minimize any significant down time. Also absorbable barbed sutures have been re-introduced to assist in lifting of the skin.

In summary, there is a plethora of technology in the field of plastic surgery and dermatology to offer patients an alternative to traditional plastic surgery. The results of skin tightening procedures are modest to moderate in terms of success. This suits some patients well because of the lower risks and downtime of surgical procedures.

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