Can Too Much Nonsurgical Skin-Tightening Be a Bad Thing?

There are a lot of options for tightening mild skin sagging without having to undergo surgery and they typically involve an energy-based treatment. “All energy-based modalities work by delivering various modes of energy into the soft tissues to stimulate collagen production which, in turn, provides tightening effect,” explains Short Hills, NJ facial plastic surgeon Alexander Ovchinsky, MD. 

With more solutions available to turn back the clock, it may be tempting to believe that stacking multiple treatments repeatedly over time can boost results, but is there such a thing as too much tightening? Here, our experts explain what excessive tissue heating can do over time. 

The Main Types of Tighteners

The energy-based treatments used to tighten are either laser-, radio frequency- or ultrasound-based. Lasers use light to target the tissue, while ultrasound and radiofrequency devices heat below the skin’s surface. Laser and radio-frequency treatments focus energy on the skin’s surface, whereas ultrasound reaches 3 mm – 4.5 mm beneath the surface. 

How Much Is Too Much?

Although there is no conclusive data that measures the long-term effects of skin-tightening treatments, there are a few causes for concern to consider before undergoing multiple treatments in the same area in a short period of time. “Repeat laser or radio frequency can induce scarring and skin-texture problems,” explains Eugene, OR plastic surgeon Mark Jewell, MD. “If this occurs, the skin can resemble that of a burn patient. To prevent burns, radio frequency treatments require skin cooling. An ultrasound treatment does not affect the skin like laser or radio frequency.”

Minimal skin-tightening treatments are OK says Chicago plastic surgeon Michael Byun, MD but repeated nonsurgical procedures that heat the tissue may cause a concern over time instead of improvement. “It’s like taking a gift box that has been bent and heating up the cellophane wrapping paper without restoring the shape of the box itself,” he explains. “Yes, the cellophane will shrink and contract, but it will not maintain the appropriate form.”

Not a Surgery Replacement 

According to La Jolla, CA plastic surgeon Robert Singer, MD, one of the biggest mistakes people make with skin-tightening treatments is choosing them instead of surgery when their skin can no longer benefit. “Nonsurgical treatments have a place, but they can be overdone,” he notes. “If they’re done too frequently, they can cause their own problems, like thinning of the skin. Too much of anything, whether it’s laser or radio frequency treatments, whatever it is, can produce its own set of issues. It’s a matter of managing patient expectations and having the treatment done in the right hands in the appropriate patient.” 

“Facial rejuvenation is more than a laser or radio frequency treatment; it involves management of deep layer laxness, volume correction, and skin,” adds Dr. Jewell. “I would say that transcutaneous radio frequency treatments with either contact or microneedles is pretty safe, but it only works on the skin. There are no long-tern studies to substantiate how long results actually last.”

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