Nonsurgical skin tightening modalities

Abstract

Dr. Burns: The first patient is a 67-year-old woman who has refused surgical correction (Figure 1). Her priority is to correct the looseness under her neck and jaw line, as well as to improve her general skin condition, which has been compromised by acne damage over her cheeks and forehead. She would also like the redness in her skin addressed. Dr. Dover, how would you approach treating this woman? How would you manage her expectations, and what could you realistically offer? Figure 1 This 67-year-old woman has refused surgical correction but is concerned with looseness under her neck and jowls, as well as the general actinic damage on her cheeks and forehead. She would also like the redness addressed. A. Jay Burns, MD Dr. Dover: I think what she really needs is a face lift, even though I know she is resistant. She has a heavy face with a lot of sagging and extreme neck elasticity. Unless she has a surgical correction, she will never get dramatic improvement in her lower face. You could, however, use skin tightening devices and get some modest improvement. I have actually been pleasantly surprised that people with a significant degree of sagging do sometimes get noticeable tightening, but it is never dramatic. However, in patients such as this, I typically do not recommend nonsurgical skin tightening because the cost and time are not usually worth it. A far less significant issue, the redness, could be improved with a variety of devices, such as pulsed dye laser, a pulsed potassium-titanyl-phosphate (KTP) green light laser, or intense pulsed light (IPL). The latter two would also help with her pigmentation. But her big issue is sagging, which is pronounced. Jeffrey Dover, MD Dr. Burns: Dr. Gregory, what would you suggest for this patient? Dr. Gregory: I agree with Dr. …