The following was written by Fritz E. Barton, Jr., M.D. He originally posted this on his website 4/11, but it is still very pertinent. Patients ask me all the time about laser skin tightening so this is Dr. Barton's view.
NON-SURGICAL
SKIN TIGHTENING….REALLY?
The
American Society for Laser Medicine & Surgery (ASLMS) just concluded its
annual meeting in Grapevine, Texas. The ASLMS is the nation’s largest
organization of clinicians and scientists who perform laser procedures.
Here are
highlights from the meeting…
The
concept of non-surgical skin tightening, particularly in
the face, neck, and abdomen is always a hot topic. The principle is heating
dermal layer of the skin to 55-65 degrees centigrade creating contraction of
collagen.The exhibit hall was bursting with technology claiming to tighten
skin. The media is excited with testimonials. Good business for doctors, but is
does it really work?
Thermage TM attempts to
tighten skin by using focused radiofrequency waves to heat the dermis. The
technology has been around for nearly ten years. It never really caught on
because the treatments were very painful, and the benefits were limited. Solta,
the company who bought Thermage, has modified the machine so that treatments
are less painful. However, the results are minimal and inconsistent.
UltheraTM attempts to heat
the dermis to create tightening using focused ultrasound waves. The technology
is elegant and interesting. However, the treatment parameters of depth and
density, have not been established. As with many new technologies, they are
marketed before the exact effective guidelines have been established. No doubt,
a few patients have shown noticeable, though modest benefits – main in the
neck. I would say Ulthera is worth watching in development, but not ready for
routine use.
The
problem with all this skin tightening technology is that basic studies of
effect have not been completed. How much can you burn dermis without scarring?
How little can you burn dermis and still get benefit? How long does initial
dermal contraction last? How consistently do you get a result worth the cost?
Until
these technologies have been in use long enough to either become standardized
or discarded for the next “new treatment”, I would say watch and wait. There still is no minimal
procedure with maximum
result in skin tightening!
