Skin tightening: 6 treatments and procedures

Aging is a complex process influenced by factors you can’t control (genetics, hormones, metabolism) and some that you can (hydration, exposure to pollution, sun exposure).

While most of the changes that take place are internal, your skin provides some of the first external signs of aging, such as fine lines, wrinkles, and sagging skin. These changes don’t cause any medical problems, but they can affect the way you see yourself.

There’s no need to undergo procedures to tighten the skin—aging is a natural part of life!—but If the signs of aging are bothering you, there are skin tightening treatments and procedures that can help give you back your younger, firmer skin. 

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The loose skin on the face and body that occurs with age is related to a loss of collagen, breakdown of elastic fibers, and loss of hydration. While these don’t cause any medical concern, they might impact some people’s quality of life, both mentally and socially (Rousseaux, 2017).

Skin tightening procedures are cosmetic treatments intended to change the look of your face and body. There are both surgical and non-surgical options available.

Surgical options for skin tightening include facelifts and tummy tucks. They can produce more dramatic results but are more expensive and have a higher risk of complications.

Non-surgical skin tightening treatment options are much less invasive, and they usually don’t produce results quite as pronounced as surgical options can. The benefits are that they are less expensive, involve fewer risks, and have a shorter recovery time.

Non-invasive skin tightening procedures are some of the most common cosmetic procedures performed today. According to the American Society for Aesthetic Plastic Surgery, Americans spent more than $12 billion on procedures in 2014, and these numbers are growing (Gold, 2015).

Here are six common procedures for tightening the skin. 

Radiofrequency skin tightening uses a device to apply controlled radio waves to restore lost collagen to an area of your skin that you want to be firmer. The procedure is done with topical anesthetics (or often none at all), and you don’t need any downtime for recovery.

The resistance in your tissues changes the radiofrequency energy into thermal energy (heat) in the area being treated. Multiple studies have shown that raising the skin’s temperature and keeping it there for at least three minutes can trigger the release of heat-shock proteins, leading to the formation of new collagen and increased elasticity (Rousseaux, 2017).

Most types of radiofrequency treatment require multiple sessions to see results. The skin tightening effects will only be slightly visible right away. The treatment course typically takes about four months to take full effect. 

Intense pulsed light (IPL) treatment, also called photorejuvenation, is a safe and effective way to treat skin laxity, unwanted hair, and sunspots. IPL treatments use pulses of high-intensity light energy to heat the collagen fibers in your skin and cause them to contract and tighten the skin (Goldberg, 2012).

The thermal stimulation also improves the skin’s texture and encourages new collagen production, which increases volume. This gives your skin a plumper, fuller look (Goldberg, 2012). 

The most common areas to treat with IPL are around the eyes and the mouth. More delicate lines will typically respond better than deeper furrows. Your initial results will be subtle, and an IPL treatment series typically consists of four to six sessions to get the best results. Recent studies have shown that providers can also combine IPL treatments with Botox for smoother skin with fewer wrinkles (Goldberg, 2012).

Ultrasound skin tightening involves using a device to send sound waves deep into your skin to stimulate the production of new collagen. Similar to radiofrequency and IPL, ultrasound relies on generating heat to achieve its effects on your skin. Your existing collagen fibers contract and new collagen is formed (Fabi, 2015). 

Handheld devices are available online and at beauty supply stores to perform ultrasound therapy at home. However, these devices are expensive and need to be used for a more extended period to see results. Without the experience of a trained professional, they may not have any effect at all.

The most commonly reported side effect associated with using ultrasound is brief discomfort during the treatment session. Other, less common side effects include temporary redness, swelling, or bruising. Rare effects include darkened skin and temporary weakness or numbness in the treatment area (Fabi, 2015).

Microneedling is a non-invasive treatment that uses instruments with rows of tiny needles that penetrate the skin, creating a controlled injury. This induces a healing response that stimulates the production of new collagen and elastin fibers (Litchman, 2020).

In addition to skin rejuvenation, microneedling can also help with some kinds of scarring and stretch marks. It is occasionally combined with radiofrequency treatments to increase the effects (Litchman, 2020).

Microneedling is a commonly-used procedure in dermatology. It’s considered a safe, effective, and inexpensive alternative to some other skin tightening treatments. It’s well tolerated by most people and requires very little recovery time (Litchman, 2020).

Some expected side effects from microneedling treatments include (Litchman, 2020):

• Slight pain during the procedure

• Redness

• Mild swelling

• Irritation

These side effects usually disappear in a few hours or a day at most (Litchman, 2020).

Injectable dermal fillers are products injected just beneath the skin to temporarily plump up the skin and improve its appearance. They can be used to treat wrinkles, add volume, and rejuvenate your face.

Injectable fillers can be made from collagen, your fat cells, hyaluronic acid, or synthetic materials. Each type of product has its own risks and benefits. Your dermatologist or injector can help you choose the best filler to smooth and tighten your face.

While other skin-tightening procedures work by stimulating your body’s natural collagen, fillers effectively replace the lost collagen and hyaluronic acid in the skin. Depending on the type of filler you use, your results could last from five or six months up to a year and a half.

When you’re using fillers to tighten loose skin, you may actually achieve a more natural look than other heat-based skin tightening procedures. This is because other treatments, such as lasers, tighten the skin without replacing the lost volume in your skin. Without compensating for this, it can result in a more stretched appearance to the skin’s surface.

A facelift is a surgical procedure that works by tightening your skin and the facial muscles beneath it. A facelift will achieve an overall tightening effect that can help correct sagging skin in the middle part of your face, below your eyes. Your surgeon can also rejuvenate your lower face and address the loss of skin tone that comes with aging.

For those that don’t want or need a complete facelift, you also choose a neck lift to tighten loose, sagging skin near your jawline (sometimes called the “jowls”). You won’t see quite as much effect as a full facelift, but the results are similar (Alexander, 2021).

No matter what type of facelift procedure you choose, the potential complications are similar. These include (del Toro, 2021):

• Bleeding

• Bruising

• Swelling

• Nerve damage

• Wound infections

• Unfavorable scars

• Anesthesia complications

An experienced plastic surgeon can work with you to minimize the chance of any complications while performing your skin tightening procedures.

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Current version

October 20, 2021

Written by

Ellyn Vohnoutka, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.