By Natalie Ledbetter CRNA, DAcOM
We are all so busy these days that the thought of a couple weeks or more of downtime after a face, neck, or brow lift is enough to steer many of us into looking at non-surgical skin tightening and lifting. There are a confusing number of devices on the market designed to increase collagen production and thus tighten skin. I have many clients and friends ask me what the best no-downtime skin tightening procedure is.
Radio Frequency
The most widely used technologies currently use radio frequency (RF) either with microneedling or by an applicator that emits RF when massaged across the skin. Procedures involving needles have some degree of downtime due to the poke holes from the needle sticks and swelling that can usually occur for anywhere from a day up to 2 weeks. The devices that use a massaging wand usually only cause some redness and maybe a little swelling that are both short lived. These non-needle techniques are not as aggressive as the RF microneedling procedures and so many more treatments are needed to achieve results, often up to 10 sessions.
Ultrasound/ Ultherapy
Another method used to tighten skin is ultrasound. Ultherapy is the most widely known device of this type and it uses high frequency ultrasound waves to heat the skin and muscle causing collagen production resulting in skin tightening. Ultherapy sends the waves deep into the tissue often resulting in pain and can cause shrinkage of the fat pads present under the skin that is treated. Fat pad shrinkage is not usually wanted because this can lead to more sagging of the skin once it loses the underlying support the fat pad offered. Results are usually seen in 3 to 6 months.
Ultherapy has a 65% “worth-it” rating on Real Self which means that 35% of the people who had Ultherapy did not think it was worth it. Most who felt this way said it was either the amount of pain, the expensive price, or a lack of perceived results that caused the “No” vote.
Ultrasound/ Sofwave
There is a new player on the Ultrasound scene called Sofwave that uses different ultrasound technology than that of Ultherapy. The waves enter the skin in a wide pattern and do not go deeper than the dermis. This leads to less pain and avoids melting the fat pads. There is no downtime with Sofwave and most patients say they think they look a little better already in the first few days. Final results are usually seen in 2 to 3 months.
Because this system targets the skin instead of deeper tissues, it treats crepey or thin skin, and lines and wrinkles as well as lifting and tightening. It has been used on the brow area, nasolabial folds, abdomen, to treat jowls, and on the neck as well as full face and neck. I recommend treating the full face and neck because collagen loss does not occur in only one area. This treatment stimulates collagen production in all the areas treated and can help counteract the collagen loss and skin sagging that will come with time.
Many of my patients need less filler after a Sofwave treatment than they would have if they only had filler alone. We are also noticing that the increased collagen production is helping acne scars and improving the texture of the treated skin.
This procedure has a 100% “worth-it” rating on Real Self at the time of the writing of this article. Most people are saying that it is tolerable, and all of our clients have said they would definitely do it again. They love the fact that there is no downtime and that some results can be seen within a few days with full results occurring within 2 to 3 months.
I had this done to my brow, jawline, and abdomen recently and will be writing more about this amazing new treatment soon after I have given it 2 to 3 months to develop results.
Want information on non-needle RF skin tightening? Click here. https://lalongevity.com/forma-skin-tightening-treatment-2/
Here is information on 
more skin tightening and resurfacing treatments such as Halo and Morpheus.