Which Non-invasive Treatment is Most Effective for Mild/moderate Skin Laxity and Crepiness on Thighs, Hips and Buttocks?

I accept that results may be small & will require ongoing management, but I don't want thigh lift scars. I'm 35. Have lost 40 lbs and been @ my goal weight for 4 months (BMI of 21). Am active. Which of Thermage, VelaShape and similar machines is best to tighten & smooth skin? (Also, how important is it that a Dr administer the treatment? It seems even at Dr's offices, technicians do the work. How can I know whether a Dr will perform the tx?) And who is the ideal candidate for this kind of work?

Doctor Answers 5

Non-invasive skin tightening could be the Emperor's clothes!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You seem to have pretty realistic expectations, and the three classes of devices are RF (radio-frequency) like Thermage, Velasmooth (Velashape), Accent, Exilis, and perhaps others; external ultrasound like Ultrashape, Ultherapy, and others; and light-based (could be laser, LED, or infrared) such as Zerona, Titan, Smoothshapes, and others.

A fourth class could be considered combination devices, such as Velasmooth and Velashape which combine massage, RF, and infrared; Ultrashape (newest version 3) which combines RF and external ultrasound; ReFirme, which is IR and RF; etc.

Sometimes I consider these multiple-modality devices to be a sign of single-method ineffectiveness, so why not add another method? (Also good for marketing, which ALL of these devices have in common!).

Other times I consider combination devices to be evidence of combination therapy perhaps being better than individual, but you can look up each of these devices/treatments/methods here on RealSelf and see the "Worth-It" ratings. You will see that the best of these is Ultherapy at 89% "worth-it" and $2600 average cost, Exilis at 80% and $1300 average cost, Accent at 54% "worth-it" with an average cost of $2300, and the worst, Velashape at 31% and $1600 average cost, and Ultrashape at 36% and $2800 average cost. Most of the rest have a "worth-it" rating in the 30 and 40% range. ReFirme is at 50% and $900 cost. Thermage is at 40% "worth-it" and $2700 average cost, and Zerona 37% "worth-it" at $2100 cost.

Even Endermologie, an FDA-approved massage, diet, and exercise program for treatment of cellulite that has been available for years (we offer it in our skin and body clinics) has a worth-it rating of 48% at $1600 average cost!

You can also see that cost has virtually NO CORRELATION with effectiveness (if "worth-it" reviews are accurate, and the more of them there are, the more accurate they should be)!

Doctors don't typically administer any of these non-surgical treatments--this is obviously important when choosing a surgeon, but not for these non-surgical treatments where a technician will spend the proper amount of time (hopefully) with you. Experience of the technician and how long a clinic or spa has used  the device should guide you here. Don't fall for the "latest and greatest and up-to-datest" ploy of marketing by those who seek to sell you the Emperor's clothes!

Please read the "Not worth-it" reviews. Your eyes may be opened to the fact that there is a sucker in every crowd, and that even totally bogus treatments (placebos) can have positive results. Balance the risks and costs with your admittedly-realistic goals, and you may come to the conclusion that a nice new dress, (faux) fur coat, or cruise is a more rewarding expenditure of your money. Best wishes.

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Devices for Non-Invasive Tightening

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are a pretty good candidate for non-invasive tightening as you are young and loose skin is mild to moderate. The devices currently used for tightening are either radiofrequency like velashape and thermage or light based like sciton st. These devices work by heating skin to a certain temperature and maintaining that temperature for a designated time period. We definitely don't have all the answers to who will be better responder or which machine is better. Typically the doctors don't do the procedure and in fact a good technician with interest and time to do the procedure will probably get the best results. Look for experienced offices and technicians.

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 46 reviews

Thermage may help tighten and smoothen some cellulite and skin laxity

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Some patients have seen improvement with Thermage for crepiness of the skin and occasionally cellulite appears to improve, but for long term improvement all the non invasive body treatments may fall short. You may have to consider maintenance treatment if you do see results you like from a treatment.  In NYC, many practices, assistants, not the doctors, do body firming procedures. The doctor would supervise and set the parameters.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Skin tightening devices

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In most cases the skin devices only improve the quality of the skin about 20%.  They do not lift the skin and are certainly not a substitute for surgical excisions.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best Non Invasive Machine for Skin Tightening

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
In my experience in research, the Velashape 3 it is most effective at tightening skin in making it more smooth (cellulite correction). In California as necessary for a good faith examination by an M.D., nurse practitioner or physician assistant however the treatment can also be performed by registered nurse. I would verify at your treatment center if in California that this is the case.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.