Summer Re-modeling: The Non-surgical Nip and Tuck
With summer going strong, skin rejuvenation seems far off focus. Tans and parties seem to take the front seat. For now, sun damage, discolorations and broken vessels must wait till fall to get attended (for their treatments are too aggressive in times of intense sun exposure). As disappointing as holding off on your favorite beauty solutions may be, we CAN improve skin quality during these happy but skin-taxing months! Its true sunspots and redness make skin look old but NOTHING is as concerning as when you start to see your skin sag, eyes droop and skin crinkle.
It’s for this reason why summertime can be an ideal time to work on this loss of skin structure and strengthen the skin from within. The “non-surgical lift and tuck” requires use of technologies that don’t sensitize melanocytes or cause risky inflammation, even if your agenda may include trips to the beach. It is for this reason that I feel that we should take advantage of the off-laser season and focus on rebuilding what may have been torn down over the years. By working with Radio Frequency or Ultrasound, we can stimulate collagen production, induce dermal remodeling and improve skin health. If you choose to undergo these procedures you can recreate a more youthful, tightened and lifted version of yourself. Best yet, this is done all without surgery and enhances your skins propensity to age prematurely.
Below, I list some of my favorite skin tightening treatments. From head to toe, you can smooth out imperfections and contour your skin to a place where you now only imagine it was once!!
Thermal
Thermage is the pioneer is non invasive skin tightening with over a million treatments performed, it is the most trusted device of its kind!
The Technology:
Thermage uses Monopolar Radio Frequency for deep and safe volumetric dermal heating.
Best for:
In my opinion, it has unsurpassed results for facial shaping, jaw defining and eyelid tightening. Thermage is also great for body skin rejuvenation, however is an expensive option.
Benefits:
- Clinical Research: Like mentioned above, Thermage is the pioneer in non-invasive skin tightening and because of this has more studies backing up it’s science, safety and effectiveness than any other device of its kind.
- CPT for Comfort: Thermage uses Comfort Pulse Technology which involves strategically coordinated bursts of cooling and vibration to improve comfort and safety . The CPT also allows Thermage to use higher and more effective doses of RF in the deep skin layers.
- Single Treatment: Most can achieve substantial results after only a SINGLE TREATMENT. While most Radiofrequency treatments require several treatments to achieve similar results, most patients are satisfied after only one treatment of Thermage . Thermage is famous for its “One Treatment Once a Year” to maintain skin health and firmness.
- Non-Surgical Blepharoplasty: Only FDA approved treatment for tightening of eyelid. It’s results are NOT as effective as a surgical blepharoplasty but, for those wild mild to moderate eyelid hooding and refuse to go under the knife, Thermage is a great option.
The Procedure:
After assessing where your skin would most benefit from strengthening, tightening and slight lifting, your practitioner will place a treatment guidance grid on those areas of your skin. The grid is used as a map for the doctor to assure delivering the correct dose of Radio Frequency energy to each square centimeter we desire to strengthen and plump. Throughout the treatment, coupling gel is placed on the skin surface to make sure the RF energy is delivered evenly and safely from the hand piece into the skin. The hand piece is moved in a sequential and strategic fashion along each square of the grid while delivering RF in one square, before moving on to the next. Once the area is sufficiently heated, your practitioner will use the same hand piece to deliver RF to specific sites in order to achieve a contouring and lifting effect. The treatment can take between 45 min – 90 min, depending on the size of the area to be treated. Improvements post treatment can be appreciated as early as a day after treatment and can continue to improve up to 6 months after.
Drawbacks:
- Slight Discomfort: Most pulses of RF are painless but in a few sensitive areas you might feel a sharp deep heating sensation. On a positive note, if you do feel any discomfort, it quickly dissipates as soon as the pulse is over.
- Costly for Large Areas
The Cost:
Average cost 2000-3500 Euros per treatment.
Where?
- Spain: I love my Spanish doctors and will vouch for many! Try Dr Montserrat Serra, Dr Ana Molina Lacasa, Dr Adriana Ribe in Barcelona. In Madrid try Dr. Maria Dolores Anton (also has a clinic in Valencia) or famous esthetician Maribel Yebenes. In the Canary Islands I have sweet and enthusiastic Dr. Ma Dolores Madan in Santa Cruz.
- Europe: Try Dr Shirin Samimi in Düsseldorf, The Kiprov Clinic in Vienna, Dr. Alexandrides or Dr. Rita Rakus in London and The Matignon Suisse Clinics in Switzerland.
- USA and World: Please see Thermage Find a doctor.
Ulthera
Ulthera is an alternative treatment for single session skin tightening and remodeling. Ulthera is indicated to lift, tone, and tighten loose skin on the brow, neck, and under the chin.
The Technology:
Ulthera uses Ultrasound to tighten skin and muscle by initiating healthy metabolic activity and reparative processes.
Best for:
I like it best for the neck and brow area.
The Benefits:
- “See it than treat it approach”: It’s the only device of its kind that so accurately previews exactly at what depth going to treat in the skin. Using diagnostic US Ulthera can image and project on-screen where the SMAS muscle layer is. The doctor can then use the data concerning the thickness of your skin and location of this muscle layer (SMAS) to make sure we treat at an adequate depth to tighten both skin and muscle.
- More Similar to Surgical Lift: As mentioned above, the Ultrasound energy is focused on the SMAS muscle layer. The SMAS is an important target as it will create the tightening of the skin to the muscle and give results more similar to surgical correction of neck and face.
- Neck and brow area: Again, with Ulthera, there are incredible lifting results seen for the neck and brow area. I prefer Ulthera for the neck area over Thermage (mentioned above) or Elixis Elite. (discussed below).
The Procedure:
Once skin is assessed and Ulthera device correctly calibrated for your treatment, another layer of ultrasound gel is placed on the skin. The hand piece is then passed section by section to the area you desire to improve, until the whole treatment zone is treated. Once the entire zone is treated, your Ulthera therapy is complete. The treatment time is usually between 60-90 minutes. The improvement appears gradually over 2-3 months and may take up to 6 months post treatment to appreciate full improvement. The skin will visually appear healthier and you will notice a shifting of the skin to a more youthful position.
Drawbacks:
- Discomfort: Most patients need to take some sort of oral pain medication. The treatment is quite uncomfortable for many patients. Additionally, sensitivity may persist days after treatment in some sensitive individuals. For this reason, I feel best for smaller areas of concern.
The Cost:
2000-3000 Euros per treatment
Where?
- Europe: Dr Tracey Bell in the UK, Dr Jaime Tufet in Barcelona and ML Esthetics in Paris.
- USA: Try Laser & Skin Surgery Center of New York, Aesthetic Dermatology and Laser in Chicago , Dr Suzel Vazquez Miami, for the San Francisco Bay area try the California Skin Institute or check Check Find doctor for more doctors and other areas.
Elixis Elite
Exilis Elite uses volumetric heating of the deep skin layers to and produce long-term benefits to the skin. The heating stimulates the collagen and helps empty localized fat deposits. The final result is smoother, firmer and defined skin.
The technology:
Elixis effectiveness is primarily based on a high frequency Monopolar RadioFrequency energy. Effective doses of RF are possible because of a sophisticated cooling system. This feature allows the doctor to measure and modify temperature and intensity as it aims to treat different areas of the body.
Best For:
Elixis can be performed on both the face and body, but, in my opinion, is best for the décolleté and body areas. Elixis is very gentle for the thin skin of the décolleté and is much more affordable for those who want an effective treatment for body skin toning. I especially like Elixis for the saggy leg skin as it is a difficult and expensive to treat with other modalities.
The Benefits:
- NO Pain: The procedure is painless and no medication or anesthesia is ever required. Using an Energy Flow Control System (EFC), Elixis assures homogenous treatment of the entire treatment zone. This avoids energy peaks which could put the patient at risk for over-treatment and side effects in certain areas.
- Effect on Fat: Additionally Elixis Elite may have some effect on Fat, shrinking the volume of the treatment zone as well. For this reason, your doctor may insist you do a bit of exercise post treatment to aid in the lymphatic systems removal of fat from your system!
- Rapid Treatment: Each area can be treated in 15-20 minutes making treatment of several areas in the same session possible.
The Procedure:
During treatment skin temperature is assessed to stay within range of therapeutic but safe heating profiles. The applicator will cool the skin externally while stimulate the deep skin layers from within. During an Exilis treatment, precisely controlled radio frequency energy heats the deep skin layers. This heat causes fat cells to shrink and contracts the skin tissue, stimulating new collagen production in the process. You may feel a deep but tolerable heating sensation during treatment. Patients usually. start seeing the results after only a month post treatment. Like Thermage and Ulthera, patients may continue to improve months after the last treatment.
Downside:
- Multiple Treatments: Exilis must be repeated 3-6 times over 2 months to obtain maximum results.
The Cost:
150-250 Euros per treatment. (remember 3-6 treatments most often necessary)
Where?
- Spain: Dra Elvira Rodenas and Dr Moises Aselems in Madrid, Dr Tapan Patel in and
- USA: Dr Brandt in Miami, Dr Rebecca Fitzgerald in Los Angeles, Allure Medical Spa in Detroit and Dr. Turk in Manhattan.
Some Additional Facts
- All devices are considered “without downtime”: You can continue on with your normal life right after treatment. The only precautions are taken for the first 24 hours where we advise avoiding direct sunlight and intense exercise.
- You may experience a flash improvement. This occurs immediately after the procedure and is due to either slight swelling or temporary contraction of the collagen fibers! You will love your fresh look post treatment but know that this may go away within a day of your treatment! I often tell patients to take advantage of this and plan a social event that evening!
- Unlike laser, these treatments are colorblind!! They can be used on all skin types without any risk! In fact, the darker your natural skin type, the more likely you have high fibroblastic activity! This means you produce collagen faster and are more likely to get fantastic outcomes!
- The degree which you improve from these skin-tightening wonders can vary based on your bodies own genetic potential to heal and regenerate collagen. This is affected by your genetics, diet and lifestyle.
- You can help enhance your results by eating foods that encourage collagen production. Check out my post here “Eat Yourself Beautiful”.
- There are also fantastic supplements, which supply primarily amino acid building blocks. Providing the right amino acids assures that our body has the supply it need to construct new collagen we have encouraged with the treatment. Try Proglyme.
- Finally, preparing the skin with treatments such as PRP or Fraxel can help initiate the health and circulation of skin prior to your skin tightening treatment. This prepping process will help assure you get the most of your Skin Tightening procedure. Since Fraxel is not recommended until after the summer months PRP would be an excellent option. For more on PRP check our my previous post “PRP and the Vampire Facelift”
- Finally for some recommendations on products which help encourage body skin health and tone please check “The Body Project: Skin Essentials”. Vitamin C is a core ingredient which you should look for when choosing a collagen protective cream. Those organic creams with natural plant anti-inflammatories can also protect your skin from stress and accelerated degradation of your skins natural collagen.