What is the best skin tightening procedure?

Question

I'm looking into skin tightening for my thighs, arms, and abdomen. Also, face and neck at some point. I've been reading about Bodytite, Morpheus8, J-plasma/Renuvion, Ultherapy, Body-'skin-/facetite, vaser, thermage, etc etc etc. There are so many! Which is most effective for the body (even if it's something I haven't mentioned)? ?And which is most effective for the face? I do not need much, if any, liposuction.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

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

Vaishali B. Doolabh, MD, FACS · Answer

Hi customframes,
The options for skin tightening address different levels of tightening with different mechanisms.  Body/face tite and Renuvion (subdermal) are inserted under the skin. Body/face tite works on the deeper skin and Renuvion contracts the connective tissue that normally connects the skin to underlying tissues. Body/face tite do not make a change on crepe (skin surface) wrinkling-morpheus8  and Renuvion facial renewal works on the surface to tighten. Once you have an in-person consultation, your plastic surgeon will be able to help figure out which is best for what you need and/or trying to achieve. There are different types of anesthetics for the different treatments and different down times/recovery considerations also. Good luck!

Ryan Rebowe, MD · Answer

In general, if you ask 10 plastic surgeons this question you will get 10 different answers. All of the above mentioned modalities are effective when utilized appropriately. Each one applies extra energy to skin, with or without liposuction, in order to stimulate the elastin fibers to contract and tighten. The most important thing is that you are seeking care from a board certified plastic surgeon who can appropriately manage your pre and postoperative care and can choose the appropriate modality for you that they are also comfortable with.

Giuseppe Fiore, MD · Answer

Hi 
Thanks for your interesting but challenging question. 
without any pictures is not possible to give you a specific answer because it is also important a detailed assessment of the area to be treated, your skin e.g. elasticity, muscle tone, smoking status, age, history of significant weight fluctuations etc. 
I completely agree with you that there are so many devices in the market and every company has a story and in general each device can deliver the energy slightly different than any of the others. 
In addition each device can reach and treat different layers of the skin.  
The most common energy-based devices  for tighter and/or smooth the skin are Radiofrequency, Laser, Ultrasound, Microneedling. 
To achieve optimal results, it would be better to uses devices in combination.
Current literature suggests that radiofrequency (RF) energy shows objective skin tightening / tissue contraction. 
However non-surgical skin tightening is for patients with mild to moderate skin laxity. For patients with severe skin laxity then surgical skin removal is a more suitable option. 
it is important that the doctors  that offer these energy based devices are very clear with patients about what the devices can and can not achieve.
in my clinical practice I have experience in Vaser, Renuvion, Face/Neck/bodytite and Morpheus 8. I usually combine 2 devices to have better results. 
Vaser Liposuction is for fat removal and body contouring. The combination with J plasma- Renuvion or Bodytite will allow to increase the probability of skin tightening. 
1) Renuvion requires only 1 session. 2) Bodytite requires 1 session in combination with Morpheus 8 (3 sessions 4 to 6 weeks apart). Morpheus 8 involves microneedling and Radiofrequency and could be quite discomfort at high level of energy for better results. For this reason, in my clinic , Morpheus 8 is performed by a surgeon with experience in local anesthetic infiltration to reduce the discomfort.
Before to consider any surgical option I would recommend first to start with non surgical/ less invasive option however the results are never guarantee because each patient is different and the results varies patient to patient. 
I would recommend to make an appointment with amsurgeon expert in body contouring and skin tightening for a medical assessment in order to make a bespoke treatment plan. 
Hope this helps, 
Best Wishes, 
Dr Giuseppe Fiore

Randal Haworth, MD, FACS · Answer

Hello !

BodyTite is one of the most effective and modern liposuction methods for intraoperative skin tightening (skin becomes around 40% firmer and more toned compared to traditional liposuction).

FaceTite is a new procedure that is comperable to a surgical facelift, without the scars. FaceTite provides dramatic improvement in skin laxity on the face and neck, which was previously only attainable through a surgical procedure such as a facelift.

I hope this helps,

Best of luck !

Randal Haworth

Yixiu Zheng, MD · Answer

Best is subjective, different for different people and dependent on the areas of concern. In my experience with my patients, the best skin tightening for eyebrow and jowl is Agnes precision microneedling. 
General face and body skin tightening is RF frequency microneedling with or without Agnes precision microneedling. 
The best painless skin tightening is BBL forever young with or without skintyte.

Camille Cash, MD · Answer

Each of the options you mentioned helps with skin tightening.  The correct one for you would depend on how much laxity you have and your goals for treatment.  BodyTite/FaceTite and Morpheus8 are options that do not require general anesthesia.  J Plasma is often performed in conjunction with liposuction optimize results. The best place to begin is a consultation with a board certified plastic surgeon to learn more.

Leita Harris, MD · Answer

RF Micro-needling is a great head to toe treatment option. Any place (just about :)) there is loose skin, the procedure is able to tighten the skin by delivering radio frequency energy into varying levels of the skin including the deeper layers. With each session (4-6 weeks apart) the settings can be modified to continue to achieve gradual improvement for enhanced results. I LOVE it for the face and of course, I never do the face without the neck and décolleté... can't have a rejuvenated face with a loose neck! All skin types approved.