Non-Surgical vs. Surgical Skin Tightening – Which Will Work For You?
One of the most significant changes in plastic surgery in the past decade has been the emergence of non-invasive cosmetic procedures. Led by the well recognized use of treatments such as Botox, injectable fillers and laser skin resurfacing, some youthful changes and anti-aging prevention can be realized. Obtaining such results without surgery represents a paradigm shift from historic invasive treatments.
From treating wrinkles to losing wanted body fat, devices using various forms of energy have become popular. (laser, high intensity light, ultrasound, radiofrequency) Their popularity is not just because they are not surgery but because they do produce visible results for most patients. Such hopes of cosmetic improvements by an external device has also been applied to loose or unwanted skin. The concept of non-surgical skin tightening has tremendous appeal, whether it is those sagging jowls, that unwanted roll of belly skin, or that floppy skin on the back of the arms.
Such devices abound and are all over the internet and popular magazines from Thermage, Ulthera or Smartlipo, to name just the most popular. They claim to produce skin tightening as one of their benefits. I regularly see patients who come in to get rid of their turkey neck, bat wings, sagging breasts or roll of skin that bulges over their beltline…with the hope and belief that such devices will avoid the need for surgery.
In reality all of these devices do produce skin tightening, with an occasional dramatic change in a few patients and more modest changes in most patients. Despite their skin tightening abilities, many patients will never be happy with the outcomes of these treatments alone. This has to do with the differences in how patients perceive skin tightening and in how much skin tightening these devices can do.
My observation is that a patient’s perception of skin tightening can be measured by centimeters and inches. Any device’s skin tightening ability can be measured in millimeters or just small fractions of an inch. It is not that these devices can not tighten skin but that most patient’s loose skin problems far exceed what can be done without surgery. No skin tightening device can replace a facelift, armlift or a tummy tuck when truly sagging skin exists. Non-surgical skin tightening works best for very modest amounts of loose skin…that one wouldn’t consider undergoing surgery to remove.
Like trying to lose fat with only taking a pill, wiping the appearance of cellulite and stretch marks clean by a skin massager, or getting rid of those dark undereye circles by just applying a cream, hope is eternal. Getting rid of loose skin, as most patients define extra skin, will almost always defy any current method of device-based skin tightening. It is not always appealing to realize that surgical removal is still the best way to get rid of unwanted loose areas of skin. Having a ‘nip and tuck’ may not be high-tech, but it continues to provide a level of improvement that will satisfy most patient’s expectations.
Dr. Barry Eppley