Non-ablative Skin Tightening

Non-ablative skin tightening is a newer approach to tissue remodeling and skin rejuvenation employing noninvasive procedures. These procedures produce less dramatic effects in comparison to traditional ablative laser resurfacing, but also significantly less healing time and patient discomfort. A variety of non-ablative procedures have been developed to achieve skin tightening through dermal thermal injury while preserving the epidermis. They include infrared (IR) lasers (Nd:YAG 1064 nm and 1320 nm, diode 1450 nm and Er: glass 1540 nm laser), visible light lasers (pulsed dye laser 585 nm and 595 nm, long pulsed 532 nm laser), intense pulsed light (IPL), photodynamic therapy (PDT), light-emitting diodes (LEDs) and radiofrequency (RF). Visible and IR lasers stimulate the production of type I and type III collagen and elastic fibers, improving skin texture without influencing skin pigmentation and redness. IPL targets both melanin and hemoglobin, resulting not only in improvement of skin texture but also in global improvement of dyspigmentation and vascularity. Photodynamic therapy uses a photosensitizer, light and molecular oxygen to produce improvement of photodamaged skin. Low energy LEDs may improve redness and texture modestly. Radiofrequency is a method using devices that produce electrical energy that heats the dermis at relatively low temperatures, resulting in collagen shrinkage and skin tightening. New technologies combine radiofrequency and IR laser or IPL, with better therapeutic results. Although the results of non-ablative treatments are by far less dramatic than with ablative resurfacing, they have become more popular than traditional methods because the recovery period is shorter, the risks of treatments are minimal, and the improvement is still acceptable.