An Introduction to Non-Invasive Tissue Tightening:
Of the new crop of skin tightening procedures, the two that are best known are the proprietary procedures Thermage and Titan. While these two treatments utilize different proprietary technology, the idea is essentially the same, in that they both aim to heat the deeper layer of the skin (the dermis) in order to effect a “healing response”. This healing response encourages increased collagen production and remodeling of existing collagen. Supportive underlying tissues of the skin contract, resulting in a tighter, more uplifted appearance to the skin.
How These Treatments Can Help You:
Although it is too soon to have evidence of what the long term effects may be, both treatments have been used with success on the face and areas of the body. Some of the most dramatic results have been seen in the area of the neck and jaw line. However, these treatments are also showing some promising results on sagging skin on the abdomen, upper arms, butt, and thighs, and seem to offer some help with diminishing the appearance of cellulite as well.
Unlike with ablative lasers or chemical peels, there is no peeling of the top layer of skin, and therefore the procedures are more suitable for patients with darker skin tones, because of the significantly lowered risk of pigmentation changes. The cost is also considerably less than surgical facelift, and because the procedure is non-invasive (no cutting) there is usually no need to take time off from work.
Risks, Recovery, & Downtime:
Pain management is hardly an issue, as some of these procedures require the use of local anesthetic and / or over-the-counter pain killers, while some use nothing at all. All incorporate some sort of means of cooling the skin during the treatment.
For most patients, there is no downtime, although a few people may have excessive swelling or redness, or even temporary skin blanching (whiteness) immediately following a treatment. More serious risks include bumps, blistering, permanent pigmentation changes, or skin depressions, although these are rare. Extremely rare incidents of scarring or infection have been reported.
Costs vary between $500-$5000, depending mostly on the size of the area being treated. Cost per treatment is generally higher with Thermage, although generally only one treatment is required. Titan requires 1-3 treatments, as recommended by your doctor to treat your specific concerns.
Differences Between the Top Contenders:
The basic difference between Thermage and Titan is the mechanism by which the dermis is heated. Thermage employs radiofrequency energy, while Titan uses infrared. Other lesser-known systems include a machine called Lux-IR, which uses infrared, and Aluma, which uses radiofrequency. Because they are relatively new technologies, there have been no long-term studies completed on their safety and effectiveness. However, there are many who believe the infrared technology is superior because it provides a more even, controlled heating of the tissue with less risk of post-procedure contour irregularities.
Keep in mind that these procedures are not meant to deliver the same results as a surgical face lift. You cannot expect to erase 15-20 years with non-invasive tissue tightening. Also important to remember is that results vary from patient to patient due to differences in skin thickness and texture, healing response, and lifestyle variables. These procedures are probably best looked at as a way for younger patients to stave off more invasive procedures, or for those patients for whom surgery is not an option.
Who is a Good Candidate?:
Skin-tightening procedures seem to work best in patients who have thin faces who don’t quite yet need a facelift and want to put it off for a few years. In some cases, these procedures may have little or no discernible effect on those who are really ready for a facelift due to having very loose skin and, or those with a lot of excess facial fat. Although many patients do experience dramatic differences, there is no guarantee of a noticeable improvement.
How to Ensure the Best Result:
Operator technique is of paramount importance to obtaining a good result with these procedures, so make sure to do your research regarding the experience and training of the person who will be performing your procedure. And don’t forget to get and check references!
Keep in mind that since dermal collagen remodeling takes place over time, you cannot expect to see the final result until up to six months following your final session. This means that patients may be able to expect to see some immediate results, with improvements continuing for up to six months following the procedure.
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