The non-surgical skin tightening has been a goal that has been sought after for many years. It as been well demonstrated that adding energy to the skin results in collagen regeneration and tissue remodelling. However, the devil has been in the details. The problem has been to get adequate energy input without causing damage and hopefully get noticeable results without producing significant pain.
Perhaps the most well known of these devices is the Thermage, which uses a radiofrequency current to cause the skin molecules to vibrate, heating the skin. The Thermage was first released in 2002, and was quite painful and produced results that frequently were difficult to appreciate. Over the years, the Thermage has been gradually refined, so it is somewhat less painful although it still hurts. The results are a bit better, but still variable. We have a Thermage unit in our office, and we found that the results were better off the face than on the face. We ended up using it on the arms and body but did not recommended it for the face and neck, because we did not feel comfortable recommending a procedure with a high failure rate.
Lasers and light sources have also been used in an attempt to achieve skin tightening. There have been units such as the Titan & SkinTyte which did not produce noticeably better results than Thermage. The more recent entry into the field is the ultrasound devices, most notably Ulthera. Ulthera is able to focus the energy deeper in the skin, but appears to be more painful even than Thermage without producing, in my opinion, significantly better results.