New Technologies in Skin Tightening

The skin laxity component of facial aging has been traditionally addressed with surgical intervention. However, demand for alternative treatment options with less associated risk, scarring, downtime, and cost have driven advances in non-surgical tightening techniques. This article explores the recent advances in these non-surgical technologies for skin tightening including microcoring, hydroxyapatite fillers, and energy-based devices (lasers, ultrasound, radiofrequency, and plasma). Advances in non-surgical skin-tightening devices allow for effective skin tightening. Although fully ablative laser resurfacing devices are often considered the gold standard for non-surgical rejuvenation, important advances in this technology include fractionated energy delivery to decrease risk and shorten treatment recovery. In addition, studies have shown that optimal treatment temperatures for skin tightening are lower than those achieved with CO2, favoring radiofrequency devices as a more optimal choice for tissue tightening in terms of treatment results, skin types amenable to treatment, risks, and downtime. Ultrasound technology has the unique advantage of allowing for real-time tissue assessment and tailored heat delivery. Microcoring and hydroxyapatite treatment stimulate skin tightening without heat production. Advantages and disadvantages of various non-surgical skin tightening are reviewed and summarized in this article. A wide array of non-surgical skin-tightening techniques provide an attractive alternative to surgical intervention for modern cosmetic patients.