Dr. Jacqueline Watchmaker shares her experience with non-surgical facial skin tightening devices, including candidate selection, realistic expectations, and optimal outcomes.
Jacqueline Watchmaker, MD, FAAD, is a cosmetic dermatologist at Southwest Skin Specialists in Scottsdale, Arizona
“Some of my favorite nonsurgical skin tightening devices are radiofrequency and micro-focused ultrasound devices. One of the commercially available radiofrequency devices is called Thermage [Solta Medical], which uses radio waves to create heat in the skin, which causes new collagen formation and collagen contraction. And I think especially on the lower face it can lead to some good skin tightening,” said Jacqueline Watchmaker, MD, FAAD, who presented “Nonsurgical Skin Tightening: Who, What, Where, and When?” at the Innovations in Dermatology meeting in Scottsdale, Arizona.
“Micro-focused ultrasound, which is Ulthera [Merz Aesthetics] or the newer generation which is called Sofwave [Sofwave], similarly uses heat but instead uses micro-focused ultrasound waves to induce heat and cause that skin tightening and contraction. That also works very well on the lower face area.”
Today’s noninvasive technologies are good, but dermatologists shouldn’t over-promise, said Dr. Watchmaker.
“I never promise that these devices are going to give facelift- or neck lift-like results. I think they can do about 20% or 30% of what surgical interventions can do.”
The treatments are easy to perform, they’re not painful for patients, and there’s no downtime. Those are the upsides, said Dr. Watchmaker.
“Patients typically rate the pain on a scale of like 2 to 3, especially for the radiofrequency devices. There really isn’t any swelling. The skin stays fully intact. It’s a very easy thing to do that gives good improvement.”
Patient Selection and Protocols
Dr. Watchmaker said she usually reserves nonsurgical skin tightening devices for patients who have mild to moderate skin laxity.
“I think patients that have significant sagging skin would be underwhelmed with results from these devices. But for patients—especially in their 40s, 50s and even some patients in their 60s—these are great alternatives to surgical intervention.”
Skin tightening benefits from treatment are long lasting, as the collagen that these devices build, stays, according to Dr. Watchmaker.
“Typically, these don’t require a series of treatments. I recommend using these devices about once every 1.5 to 2 years because with time you do get a little more sagging and skin laxity, so just to keep up with the natural aging process. But these aren’t something that require a series of treatments, and they don’t require too much maintenance.”
Safety isn’t generally a concern, said Dr. Watchmaker.
“Occasionally patients can get a little burn but especially the newer generation devices are very safe.”
If there is a drawback, it’s that these devices don’t provide as much tightening as some patients would hope, according to Dr. Watchmaker.
“That’s why I counsel them before and only pick those patients with mild to moderate skin laxity.”
Combination treatments can help to enhance skin tightening results, said Dr. Watchmaker.
“I do love combination treatments. In some patients, putting a little bit of filler in the jawline or cheek can lift the lower face a small degree. And sometimes lasers, especially the more aggressive lasers, can provide a little bit of tightening, especially on the neck but on the lower face, as well.”
There is buzz about a potential new option in nonsurgical skin tightening called dermal micro-coring, said Dr. Watchmaker.
“It basically is where this device takes out very small micro-cores of skin and causes some skin tightening. I’ve seen some good results on the lower face and look forward to using that in the future.”
Disclosures: Dr. Watchmaker reports no relevant disclosures.
Callouts:
“I never promise that these devices are going to give facelift- or neck lift-like results. I think they can do about 20% or 30% of what surgical interventions can do.”
Dr. Watchmaker said she usually reserves nonsurgical skin tightening devices for patients who have mild to moderate skin laxity.
Combination treatments can help to enhance skin tightening results.
