Every patient is different! That is why non surgical tightening procedures are not magical and deserve a physician consultation to determine what is the best treatment, even if that physician does not perform that treatment!Some patients refuse to have surgery and want to reverse the effects of aging. We have to have realistic expectations. Non-invasive energy sources, whether radiofrequency, such as: ThermiRF, Pelleve, Thermage and Exelis, lasers such as Fraxel Repair, plasma such as the former Rhytec Portrait which is now an Energist device, can help tighten facial and non facial tissues but not to the extent of surgery. I tell those patients that see me in consultation, who can benefit with a greater result from surgery than the non-invasive energy sources. Many of those patients don't want surgery knowing that the result will remove more fat or more sagging skin. They are more than happy to have some result of facial rejuvenation, knowing that unlike with surgery, there is no way to know how much skin will be lifted, as this is a result of their individualistic body response.ThermiRF has produced a treatment called ThermiSmooth. This is a series of non-invasive, non painful, treatments, often done 10 to 14 days or more part, for 5 or 6 treatments. This is compared to having one ThermiTight procedure but this is more of a minimally invasive procedure involving more post operative swelling and possibly bruising. Local anesthetic has to be injected prior to ThermiTight, not ThermiSmooth.I have found significant reversal of photoaging with lifting from ThermiSmooth on my patients. Some have dramatic improvement but none obtain this immediately after the procedure. It always takes a minimum of six months to more than a year after the procedure to obtain the maximal improvement.ThemiTight has a high patient satisfaction rating. I have found though, that all procedures that produce results over time, in contrast to plastic surgery, require the patient to view their before photos to see the difference as none of us can remember exactly how we looked and when changes for the better occur slowly day after day, it's difficult for anyone to judge how they're doing. Comparing the final post operative photograph to the before often shows a dramatic improvement.