What is the most effective non-invasive skin tightening treatment? (Photos)

Question

I’ve been researching nonstop for non evasive skin tightening for my jaw line and neck. I’m 54 and don’t want to be cut yet! I’ve had consults for thermage, zplazty and Fotona 4D .. I just want the most bang for my buck. Under my chin loose skin only, zero fat so I scared a trmt might melt fat as well which wld make it worse. I had CO2 Laser done 8 months ago on jawline but it seemed to make it worse! Instead of tightening the skin seem like it made it loser ..

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Janet Allenby, DO · Answer

Hello,Thank you for your question and photos. Based on what can be seen here, it appears that you would be a great candidate for Ulthera. This treatment combines heat with ultrasound to stimulate collagen growth and tighten the skin. It will give you a more defined jawline. Please consult with a local physician in person to determine if this is the right course of action for you. Good luck!

Kevin Haney, MD · Answer

You would be a perfect candidate for the BTL Exilis Ultra treatment. The Exilis Ultra is a non-invasive, skin tightening device that uses ultrasound AND radiofrequency. We recommend 4-6 treatments to see the best results.

Laura Riehm, MD · Answer

Thanks for your question and posting pictures.  After a complete consultation, we would probably suggest that you stop looking down to look at your phone.  Next, it could be a simple as finding a local provider that offers PCA Skin's Perfecting Neck & Décolleté.  It is a physician grade topical treatment that works really well.  Resurfacing with 755 or 1540 lasers are always an option, but you don't seem to have enough damage to warrant that much treatment.  More than likely, we would recommend a series of Pelleve Radio Frequency skin tightening treatments.  The bulk RF heating stimulates collagen production.  It is a very pleasant treatment that feels like a warm rock massage.  It does take 90 to 120 days to notice a difference in collagen production.  Best of luck and keep your chin up.

Richard E. Moore, MD · Answer

Thank you for your question and posting your photos. There are a number of non-invasive RF devices on the market that may give you temporary improvement including Venus Legacy and Exilis. In addition, you have mentioned Thermage which is non-invasive. After this you can get into some of the micro-needling devices which have RF energy such as Fractora and Viva. Finally, there are the minimally invasive procedure such as FaceTite, ThermiTight and J-Plasma that not only tighten the skin but also the connective tissue beneath the skin. These give the best and longer lasting results.Best to consult with a physician experienced in these newer technologies.I hope this was helpful - Dr. Moore

Robert Whitfield, MD · Answer

It made make sense to have a consult with a provider who has Facetite by InMode.  This technology uses bipolar radio frequency to heat the tissues to tighten them.  Based on your photos and your desires it makes more sense to me as an option for your.  I do the neck treatment under local anesthesia in the office.

Celia Remy, MD - Account Suspended · Answer

Hello - great question!  I agree with Dr Moore's answers below.   Let me go over a quick over view of the types of treatments and their intended outcomes to help you in your decisions.  But please remember- several things changed to create that little spot of laxity over time and usually the most natural outcomes address the different contributing components. Ultimately it is a little like maintenance on your car - you can't just rotate the tires and expect it to run well for 20 years.  Our bodies aging process involved bone loss, fat loss, and laxity of the skin. All of these components contribute to any area where you see a bit of loose skin in the Jowel, or neck line.  So if all of these treatments were free- we would probably look at fillers to "re-inflate" any areas in your midface, lateral face, and jawline that have evidence of bone loss and fat loss.  This acts to support the skin and "resuspend" or lift itt to some degree. Placed properly, fillers are undetectable with you speak and move your face. But fillers in the mid face- actually improve jowel laxity to some degree.  Your provider can evaluate you to see if this is a significant issue in your case. But it is another option for a simpler treatment.  There are long term fillers now - so you have options. So that would be an approach based on lifting or re-suspending the tissue that creates the laxity. Pro's are that it also will improve the midface and lateral face in terms of flat cheeks, and smile lines or "nasal labial folds" if you have shadows there.  
The next general approach would be to shrink or tighten the skin.  This actually has two forms. We generally refer to skin tightening when we discuss treatments such as laser resurfacing, because it tightens the wrinkles. However- as technology has advanced- we can actually get skin contraction- that usually is what patients mean when they think skin tightening.  So - the difference would be like Ironing smooth the surface wrinkles ( resurfacing) and now tightening or tissue contraction is what accomplishes more lift and tightening of the skin over the bone structure to improve jowels, or loose skin of the neck.  It is a difference in texture and surface smoothing- but still having some droop ( resurfacing, fractional, peels etc) .  WHen we use the radio frequency skin tightening, venus freeze, exlipse, etc, or micro invasive  facetite, thermi-tite, j plasma  we are looking to get skin shrinkage, or tissue contraction rather than surface smoothing as a primary intention.  
So think if it this way, if you have a king size sheet on a queen size bed you can iron it to make it smooth when you lay it down ( laser resurfacing, fractional treatments) but to pull it tight around the corners and edges you need to pull it tight and tuck it in ( the looseness we see in our skin over time, jowels, loose skin in the neck - etc.  So "shrinking' the sheet would be like getting a queen size sheet and pulling it over the corners so it "fits". This is what we want around the jawline and to drape the skin smoothly over the neck.  You can also iron the queen size sheet- but that won't make it fit the structure of the bed any better.   Ok- admittedly - that's a bit of a dorky analogy- but hopefully that is helpful. 
SO after all that- I would say this;  See if your provider thinks that some filler/volume in your face could help that small bit of looseness around your jawline if that is your main concern.  If looseness under the jawline is your focus- fillers are not going to be the way to go.  If it is under your jaw line- I would suggest either Venus freeze, or other noninvasive RF treatments - 60 minutes - but 3 treatments every 2 weeks ( rather than 6-10 of the 20-30 minute treatments - you will get much more tightening out of it.), Or if you want the most bang for your buck without surgery, and can tolerate a minimally invasive procedure, Thermi tite or J plasma subdermal  ( not the resurfacing )  would be my recommendation. They give you the most shrinkage of the skin for the longest period of time in my opinion.

Hope that is helpful! 
Dr Remy

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