Complete Guide to All Types of Skin Tightening Procedures

Are you at war with the natural signs of aging? Are you discouraged by wrinkled or sagging skin on your face or elsewhere on your body? Maybe you want to take 5 or 10 years off your look. Maybe you lost a significant amount of weight and were left with unsightly loose skin. There are skin tightening procedures available to solve the problem.

We begin to notice sagging skin as we age. This is because the collagen in our body breaks down and diminishes as we get older and our skin loses some of its elasticity. This elasticity is very difficult to restore when it is gone, but skin tightening procedures may improve the look of the skin.

So many things are possible with the broad availability of skin tightening procedures today. You could opt for traditional skin tightening surgery, such as a face lift or tummy tuck. Or choose non surgical skin tightening, such as Thermage or laser skin tightening. The most effective skin tightening procedures for a patient will vary depending on the patient’s health, bone structure and lifestyle, as well as the skill of the doctor. Discuss the various options with your doctor to find a skin rejuvenation solution to suit your needs.

The main objective of skin tightening procedures is to shrink the skin with the least amount of surgery and scarring. While many mild to moderate wrinkles and sags can be tightened with non surgical treatments, your plastic surgeon will recommend surgery if there is too much skin to be removed. Sometimes muscle and bone structure has to be improved or restored and this can only be done with surgery. The non surgical skin tightening procedures are not designed for treating large areas of skin and may not work in your case. The non surgical options also have limitations as to the types of skin they can effectively treat. Yes, you would like to avoid surgery but why waste money on treatments that may have little or no effect?

Surgical skin tightening procedures

Surgical skin tightening procedures may be your best option depending upon what you need to have done. Your doctor will explain which one of the surgical skin tightening procedures may be best for what bothers you most. All surgical procedures carry some risks of complication, so it’s not wise to select a particular procedure only because you believe the risks will be lower. Select a procedure that is right for you and that will accomplish what you need.

Let’s take a brief look at the many different options in the category of surgical skin tightening procedures:

Full Facelift – “Facelift” is a generic term today. The traditional full facelift involves incisions from the hairline, around the ear (front and back), and under the chin. These facelifts are done to rid the entire face and neck of excess fat and skin. Depending on how much skin, muscle and tissue is involved, recovery takes about 10 to 14 days and at least 6 additional months for the swelling and bumps to disappear. Besides this traditional facelift, here are more variations you may have heard about.


    • Subcutaneous (skin only) lift – This was the most common facelift of the old days where the skin was cut and stretched, potentially ending up with a windswept look. It addresses only excess skin and does not deal with tissues or muscles. Those underlying structures will continue to sag without treatment, so this facelift benefits mostly patients who have good muscle structure or who are seeking a touch-up to a previous facelift.


    • SMAS facelift – This category includes several “deep plane” lifts such as mid-face, sub-periosteal and composite facelifts. A deep flap is made in the tissue all the way to the bone, the muscle is tightened, tissue is repositioned and excess skin is removed (if necessary). It is performed mostly for lost fullness in cheeks and areas in the middle of the face or for patients who want facial implants. The composite facelift version includes the lower eyelid muscles. Sometimes the procedure is done using a tiny camera at the end of a probe (endoscope) through tiny incisions when minimal skin removal is necessary. There is usually more swelling involved with this category of skin tightening procedures.


    • “Mini” facelifts – These lifts have different names depending on who is marketing them (“Simoni”, “Lifestyle”, etc). A mini-facelift is appropriate for a patient with minimal loose neck skin or jowls. They are usually best for a younger patient or one who has had a previous facelift and is seeking a touch-up. If you really need a more extensive facelift procedure, you may be disappointed with the partial, short-term results of a “mini” facelift.


    • S-lift – In this procedure, an S-shaped incision is made in the hairline at the temple and in front of the ear. Because the incision is made in front of the ear, this option is best for younger patients who would like a small amount of tightening and who do not have loose neck skin, fat or muscles.


    • Weekend facelift – Small incisions are made under the chin, fat is suctioned out and then a laser is applied to make the skin shrink. This skin tightening procedure is most beneficial for patients who have sagging neck skin. The neck muscle can be tightened or chin implants placed during the procedure and through the same incision. Side effects from the laser may cause burning of the skin.


Abdominoplasty (Tummy Tuck) – The tummy tuck contours and tightens the abdominal muscles, removing loose excess skin above and below the belly button. Essentially the abdominal skin is repositioned and the belly button is moved. Some tummy tucks are done with low incisions and some with higher incisions, depending on what needs to be done. Your surgeon may also offer a hybrid tummy tuck which is performed endoscopically and does not involve alteration of the belly button. Abdominoplasty is one of the most effective skin tightening procedures for difficult areas.

    • Mini tummy tuck – A mini tummy tuck tightens or removes the excess skin below the belly button. It is less invasive than a full (standard) tummy tuck and is well-suited for women with C-section scars and loose skin. It can, however, create a look of a flat lower abdomen and bulging upper abdomen.


Breast Lift (Mastopexy) and Augmentation – A common result of aging, pregnancy and weight loss in women is sagging breasts. Breast lifts rearrange the underlying breast tissue and remove the excess skin to tighten it. There are different types of incisions depending on what needs to be accomplished (“T”, areolar, peri-areolar, lollipop, etc), but your surgeon will try to prevent visible scars as much as possible. When there is a lot of saggy skin, larger breast lifts are required and may require more incisions. To improve the breast’s contour, breast augmentation can be done with an implant.


Body lift (a.k.a., lower body lift or belt lipectomy) – A body lift primarily lifts and reshapes the abdominal area, outer thighs and buttocks. This will leave you with a scar around the waist, but the procedure is particularly beneficial for patients who have had a significant weight loss such as with gastric bypass or lap band surgery. A lower body lift is probably the most dramatic skin tightening procedures in plastic surgery.

Arm lift (a.k.a., brachioplasty) – In this procedure, the excess skin and fat in the upper arm (“bat wings”) is removed to improve the contour of the arms. It is particularly beneficial for patients who have had a significant weight loss.

Buttock lift – Another surgery in the category of skin tightening procedures, a butt lift elevates the buttock area and tightens the skin. This usually results in long incisions and a flattening of the butt unless combined with a fat transfer to enhance the contour of the buttocks. (Also see Brazilian Butt Lift.)

Thigh reduction –Thigh reduction corrects sagging or loose skin in the inner and outer thighs and buttocks, and removes excess fat deposits. It is often done as part of a full body lift or lower body lift. It can leave noticeable scars in the inner or outer thigh area and you can expect 3 to 6 weeks of recovery time.

Liposuction – In addition to reducing fat, all methods of liposuction can also be considered skin tightening procedures because the effect of removing excess fat generally results in tighter skin. Liposuction can be used on all areas of the body including the face, neck, abdomen, thighs and buttocks.  Liposuction of the abdomen would obviously not offer the same results as a surgical tummy tuck, but may be quite effective if there is not too much fat. There are many variations of liposuction (liposculpture, SmartLipo, CoolLipo, etc.) and some include laser treatment to give the body better contour. The skin tightening results vary widely and can depend on which area of the body is being treated. A distinct plus compared to more invasive procedures is that smaller incisions result in minimal scarring.

Non surgical skin tightening procedures

If you want to tighten up your skin without surgery and with minimal downtime compared to drastic face lifts and the like, explore the wide variety of popular choices today in non-invasive, non surgical skin tightening procedures. If you have a significant amount of skin tightening to be done, you may be disappointed with the minimal results of some of these non surgical skin tightening procedures. However, they may be worth a try; they will not preclude you from trying more invasive surgery later. Non-surgical options include:

Thermage – Thermage uses radio frequency technology to deeply heat the tissues underneath your skin to encourage natural collagen growth, tighten skin, and restore your youthful facial contours.  Thermage is safe enough for your chin, neck, or the wrinkles around your eyes.  It can also be used all over the body. Because it heats so deeply, Thermage often only takes one treatment to tighten your loose skin and can be completed in an hour.  You should see tighter, smoother skin immediately and the tightening effects will continue for months after treatment.

Ulthera – Ulthera is the first device to accomplish deep tightening using ultrasound technology. It is best suited for use on the face and stimulates the body’s production of collagen. It also allows the doctor to see the soft tissue layers under the skin so he or she can precisely target the ultrasound waves. Ultherapy skin tightening procedures cannot provide results comparable to surgical face lifts but there is no down-time, no scarring or bruising, and reduced pain. Results are best for patients with mild to moderate loose skin. Many patients and plastic surgeons prefer the results of Ultherapy to those of Thermage.

Laser skin tightening – Laser skin tightening procedures heat the collagen under our skin’s surface, causing the skin to contract or tighten. This process also helps the collagen to regenerate and restores a more youthful, toned look. Laser skin tightening is like having a non-surgical facelift; however, lasers can only accomplish about 20% tightening so you may prefer a surgical procedure if there is major skin tightening or removal to be done. Laser skin tightening is appropriate for men and women of all skin types and skin tones who want good results without painful surgery and lengthy recovery times. A few of the most popular methods are:

  • Titan™ – One of the more popular laser skin tightening procedures today, Titan is used very effectively to tone and tighten skin on the face and neck but is also very successful for tightening loose skin all over the body. Regions such as the stomach, thighs, arms, knees and elbows can all be effectively treated. You should notice tighter skin immediately following Titan treatment and, as new collagen regenerates, the skin tightening will continue over a long period of time.
  • LuxIR™ – LuxIR is faster that other similar lasers because the head of the unit is larger and can cover more area at once. A LuxIR treatment typically lasts 25 minutes. The system also cools the skin so there is very little discomfort for the patient. LuxIR treatments are beneficial for achieving smoother, tighter skin in the face, arms, abdomen and other areas. LuxIR can be done alone or in combination with other skin tightening procedures to enhance the results.
  • ReFirme™ – ReFirme was the first technology to use lower levels of non-ablative laser energy in combination with the power of bi-polar radio frequency energy (ELOS, which stands for electro-optical synergy). ReFirme is said to be excellent for facial skin tightening as well as other areas such as the legs, arms, abdomen and buttocks. ReFirme will firm up loose skin, diminish fine wrinkles and the skin will become more elastic.  Effective on all skin types and all skin colors, ReFirme procedures are typically completed in less than one hour.
  • Affirm™ - Affirm uses two laser wavelengths simultaneously for skin tightening and correction of skin irregularities. It is primarily used to tighten and rejuvenate wrinkles, acne scars, stretch marks, and similar skin problems. Patients report that results from Affirm treatment are superior to other methods. The procedure takes about 15 minutes and there is no downtime aside from some redness of the skin. It can also be used around the eyes to erase crow’s feet.

Dermal fillers – Everyone loses bone, fat, and soft tissue as they age. There may also be shifting of fat pads under your skin. Dermal fillers are injected, primarily in the face, to add volume. The effect is to make the skin look tighter and less saggy. These skin tightening procedures are particularly useful for the jaw line, mouth, cheek and eyebrow areas. Some of the most popular dermal fillers are Restylane, Radiesse, Juvederm, Sculptra and Perlane. Each of them has its preferred uses and its own advantages and disadvantages. This category of skin tightening procedures is also referred to as a “liquid face lift”, but the results are not permanent. You can expect to have treatments every 6 to 12 months to maintain the effects.

Thread Lift (a.k.a., Feather Lift, Ribbon Lift, Aptos Lift, “lunch hour facelift”) – Sutures with little barbs on them (that look like feathers) are threaded through the skin with a very long needle. Then the thread is pulled, causing the barbs to pull and lift the tissue. This procedure requires no incisions and no skin removal so, while it does have the effect of tightening, it does not benefit patients with excess skin. This has been called the “lunch hour facelift” because it can be performed in less than an hour.  Thread lifts have fallen out of favor because the results do not last and there are some unpleasant side effects such as skin puckering or visible blue thread.

Brazilian butt lift – Becoming hugely popular today, this procedure adds fullness and roundness to the buttocks to make them look tighter. Fat is removed via liposuction from selected areas of the body and is then re-injected into the buttocks. The Brazilian butt lift has the benefit of creating a tighter and shapelier waist and abdomen and a fuller, rounder butt.

As you can see, there is a huge variety of skin tightening procedures and only a small selection were described in this article.  Your health, genetics, bone structure, and other factors can affect the outcome. Consult with an experienced plastic surgeon and rely on his or her expertise in selecting the best procedure for you whether surgical or non surgical.

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