Non Surgical Anti-Aging Treatments

Non surgical skin tightening involves minimal downtime and risk, unlike surgical facelifts, but how effective are such treatments?

Non-surgical techniques strive to treat skin at greater depths than those achievable using topical creams, and focus on stimulating collagen production.

According to the American Academy of Dermatologists (AAD), currently non surgical alternatives do not deliver the results of a surgical lifting procedure such as a facelift, but they can produce mild to modest tightening by sending heat deep into the skin.

The heat causes some immediate tissue tightening and signals the body to start making new collagen. As the new collagen forms, skin may appear firmer and tighter. There is virtually no downtime.

Some of the popular non-surgical skin-tightening treatments in use and under development are listed below.

In-Use Non-surgical Treatments

Ablative Laser

Laser was first introduced to reduce wrinkles and photo damage in the 1980s.

To begin with, Laser resurfacing was achieved using ablative lasers that vaporize the outermost layer of the skin in a precise and controlled way to a microscopic depth.

The skin then heals over a period of time, as new layers of collagen are produced. The resurfaced skin has a much healthier appearance especially in the case of sun damaged or acne scarred skin.

Ablative laser treatment involves some downtime to allow the skin to heal and also carries minor risks

Fractional Laser

Over the years, the ablative technique was refined through the use of fractional lasers to reduce downtime.

Fractional laser treatment, as the name suggests, exposes only a fraction (20%) of the treated area to pinpoints of laser light, leaving healthy skin in between the ablated areas, which facilitates more rapid healing.

Fractional treatment uses lower energy laser that wounds the skin, without vaporizing it, using microscopic pulses of light. The laser treats the layers of skin under the surface without damaging the surface too much

Radiofrequency (RF) Treatment

According to the AAD, a more effective electrical technique for non-surgical skin lifting is in-office radiofrequency (RF) treatments. RF devices deliver electrical energy deeply into the skin, changing electricity into heat.

Dermatologist Patricia K. Farris, MD, FAAD, clinical assistant professor, Tulane University, New Orleans says that studies show it is the tissues' inherent resistance to the electrical current that generates the heat, which causes contraction of thin membranes running through the fat in the deep layers of the skin, resulting in an immediate tissue tightening.

"RF devices have not replaced traditional surgical face lifting, but significant improvement in neck sagging, jowl and cheek contour, and eyelid and brow drooping have been documented," said Dr. Farris.

Fractional Radiofrequency (FRF)

The latest generation of RF devices deliver energy using the fractionated technology adapted from lasers.

"Studies show that fractionated radiofrequency (FRF) may be more effective than traditional radiofrequency at skin lifting because it induces both collagen and elastin formation," says Farris.


All the treatments listed above require multiple session, but patients may see some improvement after the first treatment.

According to AAD, one study reported that some patients saw a 40% to 60% improvement after the initial treatment, with continued improvement noticeable for up to 1 year after a series of treatments.

Most patients, however, will notice gradual improvement over 4 to 6 months. It also is possible that minimal or no improvement results from non-invasive skin tightening.

Non-surgical Anti-Aging Treatments Under Development

Electroporation (EP)

A new technique to improve aging skin using electricity that is currently being evaluated is Electroporation (EP).

Using the technique high voltage, short duration pulses are applied to the skin to create temporary pores in it.

The pores allow skin nutrients to penetrate deep into the skin, something topical creams are unable to do.

"While research is preliminary, electroporation has been shown to effectively enhance skin penetration of molecules and water-based compounds.

It is possible EP will enable us to deliver compounds such as skin nutrients and growth factors to the skin far more effectively in the future and ultimately help reduce the signs of aging," said Dr. Farris.


Creams that mimic how our body uses bioelectricity to heal wounds are being developed as anti-aging treatments.

For example, a cream with a metal in it is placed on the skin, followed by another cream containing a different metal. The metals applied to the skin have opposite charges, which act like a battery – similar to electric stimulation techniques to reduce muscle or nerve pain.

"Much of what we know about bioelectricity comes from our study of wounds, which appear to generate a low level of electricity that starts the healing process," says Dr. Farris. "Interestingly, it also has been shown that aging skin has lower levels of bioelectricity, resulting in poor wound healing, and reduced collagen and elastin formation. This is an exciting area of research, and more studies on these electrically based cosmeceuticals will help us further understand their capabilities and the duration of aesthetic improvements that can be expected."

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