Which Noninvasive Skin Tightening Procedures are Safe for hEDS Patients? (Photos)

That’s a very thoughtful and well-informed question — and I truly appreciate the care you’re taking in understanding how your Ehlers-Danlos Syndrome (hEDS) may affect treatment options. You’re absolutely right that hEDS impacts collagen structure, skin elasticity, and wound healing, so extra caution is needed when considering any skin-tightening or energy-based procedures.

Because of the fragility of your connective tissue and blood vessels, treatments like Ultherapy or HIFU (which use focused ultrasound energy to penetrate deep layers such as the SMAS) can carry increased risks — including bruising, vascular injury, or delayed healing. The case you mentioned of carotid artery dissection is rare, but it’s understandable to be cautious, especially for areas like the neck.

That said, not all noninvasive treatments are completely off-limits. Options such as radiofrequency-based tightening (e.g., Thermage or RF microneedling at low settings) may sometimes be performed more safely when done by an experienced dermatologist or plastic surgeon familiar with hEDS. These devices can be adjusted for gentler parameters and applied more superficially, avoiding deep vascular structures.

Other supportive options include topical firming treatments, gentle laser resurfacing, or collagen-stimulating injectables (like dilute biostimulatory fillers), but again, these should be carefully tailored to your skin’s sensitivity and healing tendencies.

In general, the most important step is ensuring that any treatment plan is highly conservative, avoids aggressive settings, and is performed by a clinician with experience in connective tissue disorders. A patch test or small trial area can also help assess how your skin responds before treating larger areas.

You’ve already achieved an incredible milestone with your weight loss — and with the right guidance, there are safe and effective ways to support your skin health while protecting your tissues.