With ongoing technological advances, multiple new treatments for skin tightening are continually be developed. These devices generally are based on the principle of sending heat to the deeper levels of the skin while protecting and bypassing the epidermis (the top and outermost layer of the skin) . This will minimize complications such as crusting, scabbing, and pigmentation alteration and will heat and tighten loose skin by inducing deeper skin retraction. These devices may utilize a variety of energy types including radiofrequency, broad based light, or ultrasound to deliver heat. Areas that may be treated include the forehead, lower face/jowls, and neck. Treatments generally involve some discomfort during the treatment but otherwise have no long term downtime.
Radiofrequency Devices – A number of radiofrequency devices are currently available for skin tightening. Some of these devices utilize radiofrequency alone (e.g., Thermage) while others use a combination of radiofrequency and lasers or light. The radiofrequency energy passes through the epidermis (which is cooled to provide protection) and provides diffuse bulk heating deeper in the skin thereby inducing skin retraction.
Titan (Cutera) – conceptually similar the radiofrequency devices, the Titan uses broad based light to induce deep tissue bulk heating. The epidermis is protected by a contact cooling mechanism.
Ulthera – The newest and perhaps most promising of the skin devices, Ulthera uses ultrasound energy which is focused (rather than diffuse bulk heating like the above devices) to heat columns of the deep skin right above the muscular layer. This allows deep skin tightening to achieve a nonsurgical face lift. Often, only one treatment is all that is required and visible results are apparent immediately although ongoing improvement should be observed over the following weeks. The ultrasound beam completely bypasses the epidermis so the safety profile for ethnic skin is the best of all the devices.
The results from these devices can vary from person to person and range from modest to prominent improvement. They are generally considered safe for all skin types including darker skin tones. However, any time heat is delivered to the skin there is always a risk of blistering, crusting, and hyper or hypopigmentation so it is always best to confirm that the device being used is in fact safe for darker skin tones and that the operator has significant experience with ethnic skin to know the appropriate settings to use.