Laser Radiofrequency Scarlet-S skin tightening

Non- invasive skin tightening technologies – how do they fare?


Not many people want to go under the knife for a face lift.  The reasons are simple.  Facelift surgery involves significant recovery time.  It costs money and it carries certain risk that is inherent in any open surgery, such as infection, bleeding and poor wound healing. Beside, not everybody needs to have surgery if the sagging of the skin is mild to moderate.

Skin tightening –  the First generation

The first technology which demonstrated great promise is radiofrequency RF . The device that had the first FDA approval is Thermage.  For a number of years,  RF devices stood out to be a great technology for skin tightening ,  and it continues to be so with refinement of the technology and treatment protocols  It never will replace a surgical facelift but it offers a viable options for many. 

The competitor –  Infrared lasers

Many researchers have tried to reproduce the result of RF with laser.  The first such device that had a head to head comparison was the long pulsed millisecond Nd-Yag laser from Candela (now Syneron-Candela)- or GentleYag.  The long wavelength of the laser allows deep dermal penetration to achieve adequate tissue heating to promote collagen remodeling and subsequent skin tightening.  Other similar “IR” laser/light devices from other companies also emerged in the market over the years, competing in the marketplace of skin-tightening.

Skin Tightening –  The Next generation

Ultrasound  (HIFU)  showed up in the medical arena a few years ago and it created a new excitement in the industry.  How is ultrasound so different?  There are two reasons for it.  One is the specificity in the target.  Ultrasound can reach the exact depth of the skin depending on the vibration frequency of the transducers.  The bullseye for skin tightening is the “SMAS”.  This is the skin layer the plastic surgery would tighten during a facelift procedure.  The second reason is the actual visualization of the treated area.  This gives the operator the confidence of where exactly the energy is delivered in the skin. 

So what is the verdict on their efficacy?

At Reviva, we have tried all the technologies mentioned above.  We own or once owned these technologies.  The fact is all these technologies work and it is likely all these devices will co-exist in the marketplace.  Different people will have different result with the technology and it is not fair to say one is always better than all others.  For example, one recent study published in a journal,  Dermatological Surgery,  nicely demonstrates the similar result between RF and ultrasound.   In the study, one half of the face is treated with RF and the other with ultrasound.  Patients are equally satisfied with the outcome on either side.

So, how do I choose?

First find a reputed clinic that have experience with the technology.  You need to get a good medical consultation to see if the technology even is suitable for you.  As mentioned, these technologies all work.  It comes down to what the clinic most proficient and experienced in.

You have to realize that some people need other procedures such as, neurotoxins and /or dermal filler more than skin tightening.  So, do not undergo a treatment that makes no difference to your appearance afterwards.

At the end of the day, you have to consider the cost-effectiveness of the treatment.  If the outcome being equal, why pay more for what you get?  Pain is also a factor as ultrasound can hurt more than RF to many people.  At least it is true in the study subjects in the journal article I mentioned above as well as in our clinical experience at Reviva.  That being said, all skin tightening technologies will hurt to a certain degree. If it does not hurt one bit, it is not working.

You must have a reasonable expectation of what these skin tightening devices can achieve.  It is not surgery and you cannot expect a surgical result from a great plastic surgeon. 

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