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Procedure guide
Skin tightening heats the dermis or the tissue under it with ultrasound, radiofrequency or helium plasma, so collagen contracts and new collagen forms. Noninvasive devices work through intact skin; minimally invasive devices place the heat under the skin through a thin tube or needles.
The map
Every practice whose website names skin tightening: medical spas, dermatologists, surgeons, laser clinics and other aesthetic providers. Dot size is Google reviews. Tap a practice for its dossier.
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Providers
Most Google reviews
The treatment
Heat makes collagen fibrils in the dermis contract at once, and the thermal injury starts a healing response that makes new collagen. After Thermage treatment, collagen type I messenger RNA rose in treated human skin. A 2015 review found the main effect of radiofrequency is collagen synthesis, from studies of low methodological quality.
Noninvasive devices leave the skin intact and need little or no downtime. Minimally invasive radiofrequency places heat under the skin through a thin tube or needles, needs sedation and a compression garment for 4 or 5 days, and gives more noticeable results that do not equal a surgical lift.
The FDA clears each device for named uses. Ulthera was granted De Novo classification on September 11, 2009, under regulation 878.4590, focused ultrasound for tissue heat. Thermage, Exilis, TempSure and Renuvion were cleared as electrosurgical devices under regulation 878.4400.
A 2023 systematic review of 16 microfocused ultrasound studies found it tightens mildly to moderately lax facial skin in women. Results declined as laxity and BMI rose, and BMI over 30 was posed as a relative contraindication.
What it changes
What it does not change
The guide
Ultherapy, Thermage, Sofwave, Renuvion, FaceTite, Exilis and TempSure: clearance year, depth and results.
OpenThe skin, dermis, fat and SMAS layers each device heats.
OpenFrom the 2002 Thermage clearance to the 2022 Renuvion warning and clearances.
OpenDay by day after treatment, the risks in numbers and how long results last.
OpenAnswers to the questions patients ask most, with sources.
OpenFlorida skin tightening providers ranked, with their dossiers.
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