Skin tightening unfortunately is one of the most misunderstood aesthetic concerns out there. It's mostly because of industry marketing. Unfortunately there are a lot of different techniques and technologies that offer skin tightening. The sad truth is none of them work very well, and the ones that work usually do more damage than good.

When I perform skin tightening in my office, I have this custom tailored blend of technologies that I feel very comfortable with. I call it Maercks Multi-Modal Therapy. All that means is I'm using several modes all at the same time to get the maximum tightening I can by tightening deep tissue, dermal and then superficial dermal tissue using different radio frequencies: bipolar, monopolar and multipolar. Using different frequencies in each modality, infrared light and technology called SkinTyte by Sciton and some ultrasound for the deep fat tightening. I get, what I think, are the best skin tightening results you can get, but I always tell patients before we start that I know I'm going to be underwhelmed with the results and they might be as well. The response is mixed. Some patients are really happy with it, come back and want to repeat it. Some patients are very disappointed.

Like most things in non-invasive surgery, the people that need it the least get the most benefit. Now when you take these heavily marketed technologies like Ulthera, Thermage - they're all kind of similar. They want to create some intense heat and some controllable pattern that takes doctor decision out of the procedure. Ulthera is a triumph of technology which focuses ultrasound underneath the skin and makes these pea-shaped burns. Unfortunately there's no aesthetic benefit to having these little dots.

In the end, people get burned; have irregular contractures, [inaudible 00:01:55] irregularities just like we saw over the years with Thermage. I have patients from just about every skin tightening technology that come to me for revisional surgery and fat grafting to actually correct the defects they gained by trying to avoid surgery. My advice is go to a surgeon that understands invasive and non-invasive and can guide you through that decision making process so you don't fall prey to a moneymaking technique or technology.

How to Treat Loose Skin Around the Face and Neck

Dr. Rian Maercks discusses how to treat loose skin around the face and neck.