Non-surgical skin tightening

Kelly O’Connor , Prasanthi Kandula , Michael Kaminer

Plastic and Aesthetic Research ›› 2021, Vol. 8 ›› Issue (1) : 64

PDF
Plastic and Aesthetic Research ›› 2021, Vol. 8 ›› Issue (1) :64 DOI: 10.20517/2347-9264.2021.60
Review

Non-surgical skin tightening

Author information +
History +
PDF

Abstract

Skin laxity is an unavoidable consequence of aging and chronic sun exposure. Patients are increasingly turning to non-surgical skin tightening measures for a more youthful look. Non-surgical methods can be effective in treating mild to moderate skin laxity, while offering decreased downtimes and fewer serious complications than surgical interventions. This article reviews the major non-surgical interventions for skin laxity: ablative and non-ablative lasers, radiofrequency, and microfocused ultrasound, noting their physiologic mechanism of actions, clinical benefits, and side effects. Regardless of the procedure, patient selection and expectation setting are crucial to achieving desired results and ensuring patient satisfaction.

Keywords

Skin tightening / ablative / non-ablative / radiofrequency / microfocused ultrasound

Cite this article

Download citation ▾
Kelly O’Connor, Prasanthi Kandula, Michael Kaminer. Non-surgical skin tightening. Plastic and Aesthetic Research, 2021, 8(1): 64 DOI:10.20517/2347-9264.2021.60

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Mazzoni D,Dubin DP.Review of non-invasive body contouring devices for fat reduction, skin tightening and muscle definition.Australas J Dermatol2019;60:278-83

[2]

Cole MA,Voorhees JJ.Extracellular matrix regulation of fibroblast function: redefining our perspective on skin aging.J Cell Commun Signal2018;12:35-43 PMCID:PMC5842211

[3]

Fleischmajer R,Timpl R.Collagen fibrillogenesis in human skin.Ann N Y Acad Sci1985;460:246-57

[4]

Gosline J,Carrington E,Ortlepp C.Elastic proteins: biological roles and mechanical properties.Philos Trans R Soc Lond B Biol Sci2002;357:121-32 PMCID:PMC1692928

[5]

Varani J,Rittie L.Decreased collagen production in chronologically aged skin: roles of age-dependent alteration in fibroblast function and defective mechanical stimulation.Am J Pathol2006;168:1861-8 PMCID:PMC1606623

[6]

Fisher GJ,Voorhees JJ.Looking older: fibroblast collapse and therapeutic implications.Arch Dermatol2008;144:666-72 PMCID:PMC2887041

[7]

Quan T,He T,Fisher GJ.Reduced expression of connective tissue growth factor (CTGF/CCN2) mediates collagen loss in chronologically aged human skin.J Invest Dermatol2010;130:415-24 PMCID:PMC2877594

[8]

Stadtman ER.Protein oxidation and aging.Science1992;257:1220-4

[9]

Golden TR,Melov S.Oxidative stress and aging: beyond correlation.Aging Cell2002;1:117-23

[10]

Fisher GJ,He T.Reduction of fibroblast size/mechanical force down-regulates TGF-β type II receptor: implications for human skin aging.Aging Cell2016;15:67-76 PMCID:PMC4717276

[11]

Fisher GJ,Purohit T.Collagen fragmentation promotes oxidative stress and elevates matrix metalloproteinase-1 in fibroblasts in aged human skin.Am J Pathol2009;174:101-14 PMCID:PMC2631323

[12]

Fisher GJ,Datta SC,Kang S.Pathophysiology of premature skin aging induced by ultraviolet light.N Engl J Med1997;337:1419-28

[13]

Weihermann AC,Brohem CA.Elastin structure and its involvement in skin photoageing.Int J Cosmet Sci2017;39:241-7

[14]

Naylor EC,Sherratt MJ.Molecular aspects of skin ageing.Maturitas2011;69:249-56

[15]

Alster TS.Nonablative cutaneous remodeling using radiofrequency devices.Clin Dermatol2007;25:487-91

[16]

Liu H,Wang Z,Ren Q.Laser induced collagen remodeling: a comparative study in vivo on mouse model.Lasers Surg Med2008;40:13-9

[17]

Longo C,De Pace B,Bencini PL.Laser skin rejuvenation: epidermal changes and collagen remodeling evaluated by in vivo confocal microscopy.Lasers Med Sci2013;28:769-76

[18]

Hayashi K,Massa KL.The effect of thermal heating on the length and histologic properties of the glenohumeral joint capsule.Am J Sports Med1997;25:107-12

[19]

el-Domyati M,Medhat W.Radiofrequency facial rejuvenation: evidence-based effect.J Am Acad Dermatol2011;64:524-35 PMCID:PMC6541915

[20]

Suh DH,Lee SJ,Song KY.Comparative histometric analysis of the effects of high-intensity focused ultrasound and radiofrequency on skin.J Cosmet Laser Ther2015;17:230-6

[21]

Kaplan I.The CO2 surgical laser.Photomed Laser Surg2010;28:847-8

[22]

Anderson RR.Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation.Science1983;220:524-7

[23]

Orringer JS,Shao Y.Direct quantitative comparison of molecular responses in photodamaged human skin to fractionated and fully ablative carbon dioxide laser resurfacing.Dermatol Surg2012;38:1668-77

[24]

Alster TS.Treatment of facial rhytides with a high-energy pulsed carbon dioxide laser.Plast Reconstr Surg1996;98:791-4

[25]

Ward PD.Long-term results of carbon dioxide laser resurfacing of the face.Arch Facial Plast Surg2008;10:238-43; discussion 244-5

[26]

Waldorf HA,Geronemus RG.Skin resurfacing of fine to deep rhytides using a char-free carbon dioxide laser in 47 patients.Dermatol Surg1995;21:940-6

[27]

Nanni CA.Complications of carbon dioxide laser resurfacing. An evaluation of 500 patients.Dermatol Surg1998;24:315-20

[28]

Manstein D,Sink RK,Anderson RR.Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury.Lasers Surg Med2004;34:426-38

[29]

Laubach HJ,Anderson RR.Skin responses to fractional photothermolysis.Lasers Surg Med2006;38:142-9

[30]

Hantash BM,Kapadia B.In vivo histological evaluation of a novel ablative fractional resurfacing device.Lasers Surg Med2007;39:96-107

[31]

Tierney EP.Fractionated carbon dioxide laser treatment of photoaging: prospective study in 45 patients and review of the literature.Dermatol Surg2011;37:1279-90

[32]

Alster T.Single-pass CO2 laser skin resurfacing of light and dark skin: extended experience with 52 patients.J Cosmet Laser Ther2003;5:39-42

[33]

Preissig J,Markus R.Current laser resurfacing technologies: a review that delves beneath the surface.Semin Plast Surg2012;26:109-16 PMCID:PMC3580982

[34]

Wanner M,Alster TS.Fractional photothermolysis: treatment of facial and nonfacial cutaneous photodamage with a 1,550-nm erbium-doped fiber laser.Dermatol Surg2007;33:23-8

[35]

Kim DG,Shin JS.Effectiveness of the pico-toning technique for the treatment of melasma with a low fluence 1,064-nm Nd:YAG laser in Asian patients.Medical Lasers2020;9:166-71

[36]

Saluja R.Evaluation of the safety and efficacy of a low fluence, picopulsed, alexandrite laser in a pico-toning technique with a diffractive lens optic for the treatment of photodamage and textural improvement in “off the face” applications.J Drugs Dermatol2016;15:1398-1401

[37]

Brauer JA,Alabdulrazzaq H.Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring.JAMA Dermatol2015;151:278-84

[38]

Hinshaw JL,Ziemlewicz TJ,Brace CL.Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why?.Radiographics2014;34:1344-62 PMCID:PMC4319523

[39]

Zelickson BD,Bernstein E.Histological and ultrastructural evaluation of the effects of a radiofrequency-based nonablative dermal remodeling device: a pilot study.Arch Dermatol2004;140:204-9

[40]

Kist D,Sanner R,Zelickson B.Ultrastructural evaluation of multiple pass low energy versus single pass high energy radio-frequency treatment.Lasers Surg Med2006;38:150-4

[41]

Wollina U.Treatment of facial skin laxity by a new monopolar radiofrequency device.J Cutan Aesthet Surg2011;4:7-11 PMCID:PMC3081495

[42]

Fitzpatrick R,Goldberg D,Kilmer S.Multicenter study of noninvasive radiofrequency for periorbital tissue tightening.Lasers Surg Med2003;33:232-42

[43]

Hsu TS.The use of nonablative radiofrequency technology to tighten the lower face and neck.Semin Cutan Med Surg2003;22:115-23

[44]

Alster TS.Improvement of neck and cheek laxity with a nonablative radiofrequency device: a lifting experience.Dermatol Surg2004;30:503-7; discussion 507

[45]

Dover JS.14-Physician Multispecialty Consensus PanelResults of a survey of 5,700 patient monopolar radiofrequency facial skin tightening treatments: assessment of a low-energy multiple-pass technique leading to a clinical end point algorithm.Dermatol Surg2007;33:900-7

[46]

Bloom BS,Goldberg DJ.Assessment of safety and efficacy of a bipolar fractionated radiofrequency device in the treatment of photodamaged skin.J Cosmet Laser Ther2012;14:208-11

[47]

Montesi G,Balzani A.Bipolar radiofrequency in the treatment of dermatologic imperfections: clinicopathological and immunohistochemical aspects.J Drugs Dermatol2007;6:890-896

[48]

Melia G. Electromagnetic absorption by the human body from 1 - 15 GHz. Available from: https://etheses.whiterose.ac.uk/4676/ [Last accessed on 2 Dec 2021]

[49]

Duncan DI.Basic radiofrequency: physics and safety and application to aesthetic medicine. In: Lapidoth M, Halachmi S, editors. Radiofrequency in cosmetic dermatology. Basel: Karger; 2015. p. 1-22.

[50]

Blaufox AD,Laohakunakorn P,Paul T.Catheter tip cooling during radiofrequency ablation of intra-atrial reentry: effects on power, temperature, and impedance.J Cardiovasc Electrophysiol2002;13:783-7

[51]

Kaminer MS,Alexiades-Armenakas M. In: Hruza GJ, Tanzi EL, editors. Lasers and lights. Elsevier; 2017. Available from: https://www.mea.elsevierhealth.com/lasers-and-lights-9780323480062.html [Last accessed on 2 Dec 2021]

[52]

Weiner SF.Radiofrequency microneedling: overview of technology, advantages, differences in devices, studies, and indications.Facial Plast Surg Clin North Am2019;27:291-303

[53]

Hantash BM,Chang H,Renton B.Bipolar fractional radiofrequency treatment induces neoelastogenesis and neocollagenesis.Lasers Surg Med2009;41:1-9

[54]

Chandrashekar BS,Mysore R,Shetty A.Evaluation of microneedling fractional radiofrequency device for treatment of acne scars.J Cutan Aesthet Surg2014;7:93-7 PMCID:PMC4134659

[55]

Harth Y,Ackerman E.Depressed acne scars-effective, minimal downtime treatment with a novel smooth motion non-insulated microneedle radiofrequency technology.JCDSA2014;04:212-8

[56]

Elawar A.Non-insulated fractional microneedle radiofrequency treatment with smooth motor insertion for reduction of depressed acne scars, pore size, and skin texture improvement: a preliminary study.J Clin Aesthet Dermatol2018;11:41-4 PMCID:PMC6122511

[57]

Pudukadan D.Treatment of acne scars on darker skin types using a noninsulated smooth motion, electronically controlled radiofrequency microneedles treatment system.Dermatol Surg2017;43 Suppl 1:S64-9

[58]

Harth Y.In vivo histological evaluation of non-insulated microneedle radiofrequency applicator with novel fractionated pulse mode.J Drugs Dermatol2013;12:1430-3

[59]

Sadick NS.Selective electro-thermolysis in aesthetic medicine: a review.Lasers Surg Med2004;34:91-7

[60]

Dubinsky TJ,Dighe MK,Hwang JH.High-intensity focused ultrasound: current potential and oncologic applications.AJR Am J Roentgenol2008;190:191-9

[61]

Fabi SG.Noninvasive skin tightening: focus on new ultrasound techniques.Clin Cosmet Investig Dermatol2015;8:47-52 PMCID:PMC4327394

[62]

Vaughan MG,Hill CR,Hopewell JW.Minimally invasive cancer surgery using focused ultrasound: a pre-clinical, normal tissue study.Br J Radiol1994;67:267-74

[63]

Ghassemi A,Riediger D.Anatomy of the SMAS revisited.Aesthetic Plast Surg2003;27:258-64

[64]

White WM,Barthe PG,Gliklich RE.Selective creation of thermal injury zones in the superficial musculoaponeurotic system using intense ultrasound therapy: a new target for noninvasive facial rejuvenation.Arch Facial Plast Surg2007;9:22-9

[65]

Minkis K.Ultrasound skin tightening.Dermatol Clin2014;32:71-7

[66]

Oni G,Teotia S,Kenkel JM.Evaluation of a microfocused ultrasound system for improving skin laxity and tightening in the lower face.Aesthet Surg J2014;34:1099-110

[67]

Suh DH,Lee SJ.A intense-focused ultrasound tightening for the treatment of infraorbital laxity.J Cosmet Laser Ther2012;14:290-5

[68]

Suh DH,Lee SJ.Intense focused ultrasound tightening in Asian skin: clinical and pathologic results.Dermatol Surg2011;37:1595-602

[69]

Alam M,Martin N,Yoo S.Ultrasound tightening of facial and neck skin: a rater-blinded prospective cohort study.J Am Acad Dermatol2010;62:262-9

[70]

Chen L. 510(k) Summary Sofwave Medical’s Sofacia System. U.S Food & Drug Administration. Available from: https://www.accessdata.fda.gov/cdrh_docs/pdf19/K191421.pdf [Last accessed on 2 Dec 2021]

[71]

Chan NP,Yu CS,Yeung CK.Safety study of transcutaneous focused ultrasound for non-invasive skin tightening in Asians.Lasers Surg Med2011;43:366-75

[72]

Alhaddad M,Bolton J.A randomized, split-face, evaluator-blind clinical trial comparing monopolar radiofrequency versus microfocused ultrasound with visualization for lifting and tightening of the face and upper neck.Dermatol Surg2019;45:131-9

PDF

252

Accesses

0

Citation

Detail

Sections
Recommended

/