How Can I Tighten Sagging Skin Without Surgery?

My jowls are dropping along with my other facial features. ARRGH! Can you suggest some skin tightening procedures that don't require going under the knife?

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Laser Skin Tightening, Fat Injections and Other Options for Skin Tightening

Laser skin tightening is a no-downtime procedure that is very effective in improving facial skin tone and reducing fine lines and wrinkles, and it can also reduce the effects of fine or superficial acne scarring in many patients. We have come to view it as effective ‘facelift insurance’ for some patients, as it can put off the need for a more invasive procedure for many years. Lasers, Botox, injectable fillers and fat grafting are not a replacement, of course, for facial... more

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Michael Law, MD

Raleigh-Durham Plastic Surgeon

ASAPS ASPS

Multimodality approach is best for skin tightening - Titan, skin resurfacing, fillers

I have a large practice with patients who ask this same question. Additionally, I myself ask the same question when I look in the mirror, as the years pass by. I have a formula for success. It begins with the basic foundation-effective medical skin care -skin care products that have therapeutic agents in them in concentrations that can truly effect changes in the collagen- laden dermal layer of the skin. Other vital ingredients boost the vitality of the skin in both the epidermal and... more

Christine A. Petti, MD

Torrance Plastic Surgeon

ASAPS ASPS

Tightening sagging skin without surgery - expect small benefits

People should not expect facelift results from non-facelift treatments. Radiofrequency, fractional laser and CO2 laser all help to tighten skin slightly but won't restore the youthful architecture to the face the way a volume restoring facelift does. Many patients are happy with minimally invasive treatments, but not patients who have been expecting facelift results.

Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Sagging skin can usually be improved with a combo approach

Sagging skin may be due to a combination of factors. In today's world of patients wishing less invasive procedures, we have had quickly and extensive experience of using combinations of liposuction, various fillers, and the Mixto laser in the "shrink Mode" to create improvements that we could not achieve even two years ago. For instance the "soft round face with jowling and good skin" Submental and jowl smartlipo Naso labial fold augmentation with Radiesse Full face... more

Nathan Mayl, MD

Fort Lauderdale Plastic Surgeon

ASAPS ASPS

Thermage is the way to go for tightening sagging skin

Aging and loss of elasticity often leads to sagging skin. With the help of non-surgical technology patients can reverse the signs of aging and delay going under the knife. For example, Thermage treatment can successfully tighten the neck and jaw line areas, and enhance facial appearance. It is a non invasive procedure that requires minimal to no downtime and almost immediate results. By delivering radio frequency to the dermal layer of the skin the collagen starts to form and the skin... more

Gregory Turowski, MD, PhD

Chicago Plastic Surgeon

ASPS

Talk to a doctor who offers non-surgical & surgical options for sagging skin

I've been performing facelift surgery for 18+ years, but I continue looking for effective non-surgical alternatives. I use many other techniques as well. You should seek the advice of someone who can look at your facial bone structure, muscle, deep fibrous support, fat and skin, and then offer you options that best suit you. Lasers that work to firm or tighten the fibrous portion of the skin (dermis) can give mild to dramatic results, depending on how deep they treat the skin. The most... more

Sutton Graham II, MD

Greenville Plastic Surgeon

ASAPS ASPS

Treating the jowls without surgery

The cheapest easiest way to fix it is with scotch tape. Yes, I am kidding. Many movie stars use tape to pull, primp and prop there physical features on short notice without any surgery. But for the rest of the world, interested in improving their features without going under the knife, I would suggest a filler. The fillers include Restylane, Juvederm, Radiesse and Fat. They should be placed inside the jowl to camouflage the depression on the inside part of the jowl. Other options... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Sagging is the manifestation of aging through a number...

Sagging is the manifestation of aging through a number of mechanisms. First, your skin and soft tissue lose volume, thereby causing you to "deflate" in certain regions of your face, therefore causing the redundant skin to sag. Second, the skin itself loses the tightness and elasiticity exhibited during youth because of sun damage and the loss of dermal matrix. Third, weight gain can result in fat being preferentially gained in areas that have sagged already. Fourth, some sagging in... more

Thomas T. Le, MD

Baltimore Facial Plastic Surgeon

Skin Tightening, yes - Jowl elimination, no

This is another question that would be much easier to answer had you included a photo. As we grow older, the cumulative effects of sun, gravity, genetics, and other factors cause facial structures to descend, producing jowls and other physical signs of aging. Surgery remains the best options to lifts "sags and bags," which may be misinterpreted as loose skin. Some patients are candidates for laser skin resurfacing. The erbium laser with Profractional technology or the CO2 laser... more

James C. Grotting, MD

Birmingham Plastic Surgeon

ASAPS ASPS

Some surgical alternatives for skin tightening

If you hae really prominent jowls, you will be better going under the knife. If the jowls aren't too bad, facial fillers can help. This can include Radiesse, Restylane, or Juvederm. Some lasers promote skin tightening. I have one and tell my patients that it can probably improve it by about 20-30% at most.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

First of all, you should go to an American Board of...

First of all, you should go to an American Board of Plastic Surgery certified surgeon who can offer all of the surgical and non-surgical treatments that are available. Only this person is uniquely qualified to help you sort this process out and find a treatment option that will meet your expectations. Other people who offer cosmetic services but are not ABPS certifed surgeons will tend to offer whatever it is that they do regardless of whether it will meet your expectations. "When... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Skin tightening without surgery

As my grandfather used to tell me, there are no free lunches. Although there are other ways to tighten the skin without surgery, they can't compete with taking out skin. Sure there is some contraction of the dermal elements with radiofrequency (like Aluma, Thermage, or Titan) and with resurfacing of the skin (chemical peel, or laser such as Active FX), but I tell my patients that these other treatments will only tighten the skin about 5-15% depending on the treatment, and the... more

Dan Mills, MD

Orange County Plastic Surgeon

ASAPS ASPS

There are many non-surgical ways to tighten skin. The...

There are many non-surgical ways to tighten skin. The recommended procedure depends on the extent of loose skin as well as the location. It is important to remember that any non-surgical skin tightening procedure will not be as effective as surgery, and all non-surgical skin tightening procedures require multiple treatments given every 3-4 weeks to reach maximal effectiveness. My favorite skin tightening procedures are: Aluma which is used for the neck and body areas. (Usually requires 6... more

Mitchel Goldman, MD

San Diego Dermatologic Surgeon

Unfortunately, thread lifts are no longer available...

Unfortunately, thread lifts are no longer available because the manufacturer has stopped making the threads. However, there are two good alternatives for patients seeking non-invasive ways to tighten skin: Thermage ThermaCool Non-Surgical Facelifts and Titan Non-Surgical Tummy Tucks can tighten skin all over the body and provide a non-invasive alternative to procedures such as face lifts and tummy tucks. These treatments can be combined with fillers and Botox injections, as well as other... more

David Goldberg, MD

New York Dermatologic Surgeon

Combine Sculptra, Dermal Fillers and Fractional CO2 Laser for Best Results

I often see patients who wish to undergo facial rejuvenation. Sometimes they have fears about actual cutting procedures or for medical reasons (ie: blood thinners) can't have them. My first answer is: You can't! In reality you can't tighten the skin of the face effectively without removing part of it surgically. The good news is these are usually medium sized procedures that you get well from in about 10 days with draumatic improvements. They are often being portrayed as big and bad by... more

David L. Mobley, MD

Sarasota Plastic Surgeon

ASAPS ASPS

Fillers are an option for sagging skin

The most reliable way to tighten sagging skin without surgery is by using injectable fillers like Juvederm, Restylane, Radiesse, etc. This is a little like inflating a beach ball to address the pockets and bulges. For example, by using a filler to restore volume to the cheeks, you can lessen the appearance of the jowls to some extent. Another appraoch involves injecting filler into the area just in front of the jowls (call the pre-jowl sulcus) which can reduce the appearance of the jowl.... more

Paul L. Leong, MD

Pittsburgh Facial Plastic Surgeon

Lasers, chemical treatment, and fillers can address sagging skin

Although a facelift would provide the definitive solution, there are other modalities if used for the right indications that can provide marked improvements. Lasers such as Thermage (radiofrequency) and Titan (infrared) can provide some dermal tightening with stimulation of callagen synthesis. Yet, one can not expect results similar to a facelift. At best, they provide some minor improvements in skin elasticity and minor skin tightening. Fillers such as Restylane, Juvederm, and Radiesse... more

Steve S. Kim, MD, PhD

Los Angeles Plastic Surgeon

ASPS

Realself survey: facelift satisfaction is 78% vs Fraxel is 51%. What do you think?

If we could we wouldn't have to perform neck lifts, eye lifts, breast lifts, tummy tucks, or any other post-bariatric (massive weight loss) contouring procedures. That is one of the "holy grails" of plastic surgery. How do we make the skin shrink with the least amount of surgery and scarring. Unfortunately, it comes down to the elasticity of the skin which is hard to restore once it is gone. Instead we remove skin to make the remaining skin tight.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

The combination of Silhouette Threads and Ribbon Lifts give the most improvement!

Every one talks about various fillers and laser treatments but these are very disappointing by themselves. I do think they are helpful as an adjuctive treatment to help improve the results but they can't replace a good Silhouette lift combined with a ribbon lift procedure. The procedure is done under only local anesthesia and can be done in about 1 1/2 hrs. I use the combination since the ribbon lift gives the greatest pull up and stabilization of the tissue while the silhouette threadlift... more

David Hansen, MD

Beverly Hills Dermatologic Surgeon

Surgical vs. Nonsurgical Facial Rejuvenation: Good Options for Both

Your question is very good one, as cosmetic surgery has more and more options for nonsurgical rejuvenation. The key in to consult with a Plastic Surgeon who is familiar with, comfortable with, and trained in all aspect of facial rejuvenation, from nonsurgical options such as fillers, lasers, and Botox, as well as surgical options. This is really the best way to have all of your options laid out in front of you, with the pros and cons of each, so that you can make the best decision for... more

Shahram Salemy, MD

Seattle Plastic Surgeon

ASPS

Thermage: Tightening Sagging Skin Without Surgery.

We have had very good results tightening sagging skin without surgery using Thermage which relies on radiowaves to contract the collagen of the deep layers of the skin. I have discussed Thermage in answering other related questions. Thermage has received mixed reviews, but the inconsistent results are primarily due to inappropriate patient selection and incorrect use of the technique. Thermage is particularly valuable in areas like the arms and the thighs where there is no great surgical... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Ultherapy - noninvasive method of lifting jowls

You may want to consider ultherapy if your jawline is starting to show signs of age. It is clinically proven to incite collagen production. Increased collagen means increased firmness. The upside is that it is completely noninvasive. It takes about an hour, and you can go back to work. The downside is that results are gradual. You will see most of the results by 3-6 months, though collagen production continues for as long as 12 months, and perhaps longer.... more

Melissa Chiang, MD

Houston Dermatologist

Sciton SkinTyte can improve loose skin

SkinTyte uses infrared light to heat the skin. After several treatments done days apart, the heat treatment will encourage tightening of the skin which then continues to improve over the next several months. This process is not permanent, but appears to last for up to six months, then a single touch up will reinforce the correction. As with all of the skin tightening processes, the results do not compare to the results of facelift surgery. However, this remains a... more

Elizabeth Lee, MD

Bay Area Plastic Surgeon

ASAPS ASPS

Ultherapy is a new non-invasive option for skin tightening

Ultherapy™ is a new non-invasive ultrasound procedure that has recently been approved by the FDA for use in the US. It has, however, been available in Asia and in Europe for several years, and preliminary results have been impressive. Ulthera™ is currently only being offered to select physicians within the US who have significant facial aesthetic practices, many of whom are involved in research and clinical studies as well. Ulthera is the first device that uses ultrasound... more

Steven L. Ringler, MD

Grand Rapids Plastic Surgeon

ASAPS ASPS

Limited options for skin tightening

It sounds like your tissues are responding to time, gravity, oxidants, and other things your body is going through, as it ages. From your description, lasers, chemical peels, IPL, etc won't work, and duct tape is tacky.