What is the Best Laser for Skin Tightening?

I am 47 and would like to have laser treatment to firm my skin and achieve a natural look. What is the best brand of laser for skin tightening - I have heard of Alluma and Accent?

Doctor Answers 11

Deep Skin Tightening and non-ablative Fractional Laser Resurfacing is best

Dear lfurnari,

There are many skin tigthtening machines, the best are Thermage, LuxIR Deep, Titan, and Refirme in my opinion.

They all achieve at best 20% tightening of the skin, and in my experience (4 years) I have to show patients before and after pictures for them to see the results-most are disappointed.

A face lift will give you a much better and immediately visible result.

However if you are adamant about trying non-surgical skin tightening, newer data suggest that results are improved by combination therapy with non-ablative fractional laser skin resurfacing.

The skin tightening machines work deeply, at 1000 to 2000 microns deep in the skin and cause the skin to tighten. The non-ablative laser resurfacing works from 200 to 1000 microns deep and adds both a skin plumping and skin tightening component.

I use a combination of the LuxIR Deep and the Lux1540 non-ablative laser and have been very happy with the results of the combined technique.

Laser Skin Tightening

Laser Skin Tightening: Over the last several years, one focus of aesthetic medical technology has been on a means for improving fine wrinkles and lines on the face without prolonged 'downtime'. This is often referred to as non-invasive collagen remodeling.

This has traditionally been accomplished with laser peels (carbon dioxide, erbium) or deep chemical peels (phenol, high-concentration TCA), which resurface the skin by creating a second-degree burn. The epidermis is essentially burned through and the dermis is injured, stimulating new collagen production. The problems with these aggressive peels are the following:

  • an open, weeping facial wound (like a burn which has blistered) for several days, followed by crusting/scabbing
  • a great deal of discomfort and itching
  • a prolonged period (frequently several months) of erythema (facial redness) which must be concealed with make-up
  • the possibility of hypo- or hyperpigmentation due to melanocyte injury or overstimulation
  • a line of 'demarcation' between peeled and non-peeled skin
  • the risk of scarring if the level of the peel is too deep
  • the possibility of a 'waxy' or 'shiny' skin appearance with deep or repeated peels

The ideal method for improvement of facial wrinkles and lines, therefore, should stimulate new collagen production in the dermis without injuring the epidermis (which results in long downtimes and the possibility of pigmentation changes and scarring). Our goal is to improve the quality and tone of facial skin without (or with as little as possible) downtime.

Laser Skin Tightening can provide extremely dramatic facial and body skin tightening results without surgery.

Laser Skin Tightening is a series of laser treatments, using the Candela GentleYAG laser, designed to stimulate dermal collagen production and regeneration of damaged skin cells. The single-wavelength light energy produced by the GentleYAG targets fibroblasts in the dermis, which produce new collagen in response to laser energy. Increased turnover of skin cells is also stimulated, helping to regenerate and replace damaged cells.

There is no downtime or external injury to the skin. A person can return to work or reapply makeup immediately following the procedure. The full face and neck can be treated in just one hour.

The new dermal collagen that is produced becomes part of the structure of the treated skin, and thus Laser Skin Tightening can produce improvements in skin which lasts for years. GentleYAG skin tightening is so powerful that new collagen production can continue several months after the treatment. Most people report improvement immediately, with even more dramatic results weeks later. New collagen growth results in continued skin tightening and the development of a more youthful complexion with fewer lines, folds, and looseness of the skin. Continued exposure to the damaging ultraviolet rays of the sun will result in breakdown of both existing and new collagen over time, so it is very important to protect your results by limiting sun exposure, using a high-SPF sunblock, and maintaining a healthy and scientifically sound skin care regimen.

Another unique feature of the GentleYAG is the Dynamic Cooling Device (DCDT) which sprays a cooling agent on the skin before every laser pulse. The DCDT protects the outer skin layers during laser treatment and reduces discomfort. No topical numbing agents are required.

LST can be used to treat any part of the body that may benefit from softer, smoother skin quality, wrinkle reduction, improvement of pore size and texture, or elimination of acne scars. The GentleYAG can provide beautiful firm skin on the face, neck, chest, upper arms, legs and other body areas with no downtime and without the need for potentially dangerous numbing creams.

Clinical studies suggest that 4-6 treatments spaced 2 to 4 weeks apart in most cases will produce a significant increase in dermal collagen, remodeling of dermal matrix components, and a resulting improvement in overall skin tone and vitality.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Skin tightening procedures

The two devices that you mention are both radiofrequency devices. Lasers use light to target the tissue, and radiofrequency devices use energy to heat the skin below the surface. This results in skin tightening. In my office, I use the radiofrequency device Thermage.

The best results are achieved in patients who have mildly loose skin but do not have significant sun damage skin and who do not smoke. The treatment can take up to an hour or longer, depending on whether you are treating the eye area, the face, the neck, or some combination of all three areas.

During the treatment you will feel warmth or heat but it is not painful. The results of one treatment can last several years, but because the aging process continues, you may want to have additional treatments.

Jordana S. Gilman, MD
Washington Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

3-D Collagen Firming Laser

One of our newest lasers for skin tightening is the 3-D Collagen Firming Laser for face and neck. It firms, lifts and tightens your skin by stimulating collagen. This is the most effective rejuvenating laser treatment that is non- invasive!

Dennis Gross, MD
New York Dermatologist
4.4 out of 5 stars 5 reviews

Achieving a Natural Look with Laser Devices

Skin Tightening is known to be effective with several types of devices, TITAN by Cutera, being the first in the industry with infrared delivery. There are very few risks associated with laser skin tightening. The TITAN  technology gently heats deeper layers of collagen while cooling the skin’s outer layers. It has been our experience, that the right candidate will achieve better than 50% improvement if an aggressive treatment is done. We suggest 2 or 3 treatments scheduled 4 weeks apart. The results are long-lasting and especially good for sagging jowls!

Ronald Moser, MD
San Juan Capistrano Physician
5.0 out of 5 stars 1 review

Its not the brand but the Specialist and the technique

Skin tightening can be done either with a fractional or fully ablative laser, this give the best results. Phenol peels and deep peels are getting more out dated due to the greater safety of lasers. 

I would recommend that you see a Specialist Plastics or Dermatologist who is comfortable with fully ablative lasers- CO2 would give the best outcome. 

I personally use BOTH CO2 and Erbium to achieve the desired outcome. For the eye area, I use erbium fully ablative followed by fractional CO2 at the highest setting. 

Dr Davin Lim
Laser and Cosmetic Dermatologist
Brisbane and Gold Coast

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Noninvasive Skin Tightening Works! ..or Does It? Claims, Fact and Fiction


The problem with noninvasive skin tightening is that everyone wants it and everyone wants to believe it works.  The result is practitioners of all sorts capitalizing on this demand.  The truth about skin tightening interventions is that almost all of them work AND NONE OF THEM WORK.  What I mean by this is that there are many ways to convert energy into heat inside or below the skin causing contraction.  The problem is that to deliver clinically effective results the tissue needs to reach at a minimum 43 C which is uncomfortable and can be scary for the patient and the practitioner.  This often results in ineffective treatment and wasted time and money.  I have developed extensive experience with noninvasive technologies mot because I'm a fan but because my patients demand it.  After using several "best in class" technologies to deliver definitive results, my patients were relatively pleased but I was underwhelmed.  THis is why I started using  a treatment that we call Maerckks Multimodal Therapy(MMT) in my practice.  All this is is an intelligently designed multitechnology treatment customized for the individual patient.  I use multiple diffferent frequencies and administration systems for radiofrequency delivery, three different ultrasound frequencies, infrared pulsed light, two different laser systems in concert to deliver immediate significant results that are hard to argue with and continue improving for weeks.  I think the only way to get real results is to combine technologies under the direction of a plastic surgeon that understands the capabilities and limitations of noninvasive skin tightening.  No one technology really delivers anything significant.  Also realiize that even my MMT results that I am very proud of do not remotely compare to what I can achieve with surgery and the cost can approach or exceed that of surgery depending on location and individual patient findings

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 73 reviews

Skin Tightening Laser

Hello, and thank you for your question. There are many lasers on the market today, however, in my practice, I generally use a Fractional Co2 laser. This treatment reduces the furrows of deep wrinkles and eliminates the shallow ones. This laser skin tightening treatment allows the dermis to produce new cells and new collagen, thereby giving your skin a smoother and younger appearance. It is also not as damaging as its older brother the non-fractionated Co2.

As always, be sure to consult with a board-certified plastic surgeon to ensure that this procedure is right for you. 

Jonathan Berman, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

ReFirme is an option

We offer ReFirme, which uses a synergistic combination of optical and bi-polar radio frequency energies. It has helped our patients achieve the firmer skin they desire without surgery.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Facial Skin Tightening

Thank you for your question. I would suggest Ultherapy for facial skin tightening. Ultherapy deposits focused ultrasound energy below the surface of the skin to stimulate the body’s creation of new collagen. As a result, skin will actually begin to lift and tone over time. Collagen is a natural protein that gives skin its youthfulness by keeping it firmed, toned and elastic. Plus, the treatment is completely non-invasive and does not require downtime. I have seen excellent results with the treatment.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

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.