Nonsurgical Skin Tightening Guide

The first sign is usually small: a jawline that looks softer in photographs, or neck skin that no longer sits the way it did. Non-invasive skin tightening is the group of options that try to answer that sign without surgery.

The American Society for Dermatologic Surgery describes non-invasive skin tightening procedures as non-surgical devices used to stimulate collagen production in the deeper layers of the skin. The American Society for Dermatologic Surgery also says that most of these devices use laser energy, radiofrequency energy, ultrasound energy or a combination of them to deliver heat to the skin tissue.

The American Academy of Dermatology says a surgical lift, such as a facelift or eyelid surgery, gives the most dramatic results, while the other options offer less downtime and lower cost. The American Academy of Dermatology also says the results from a skin-firming cream will be subtle at best, and that you may not see any results. For a broad view of the choices, read its page on many ways to firm sagging skin.

How slow tightening is

Start with timing, because tightening is slow. The American Society for Dermatologic Surgery says results from procedures that work through collagen stimulation can often take at least 3 to 6 months to appear. The American Society for Dermatologic Surgery adds that the number of treatments depends on the device, the area treated, the energy source and level, the condition, the patient's age and individual characteristics.

The American Academy of Dermatology gives more specific timelines. It says that after one ultrasound treatment, most people see modest lifting and tightening within 2 to 6 months. For radiofrequency, the American Academy of Dermatology says most people have one treatment, feel some tightening right away and see the best results in about 6 months, and that results can last 2 to 3 years with the right skin care. For tightening lasers, the American Academy of Dermatology says you may need 3 to 5 treatments, with results appearing gradually between 2 and 6 months after the last one.

Then look at who each option suits. Cleveland Clinic describes a good candidate for ultrasound skin tightening as someone with mild to moderate extra skin around the face and neck, typically in their 30s or older. Cleveland Clinic also says ultrasound therapy involves no cutting, no stitches and no downtime, which makes it an alternative for people who cannot or do not want a facelift, or who want to put surgery off for a few years.

Expect small after-effects and know where they end. The American Society for Dermatologic Surgery says patients may have mild swelling, bruising or redness, that swelling or bruising can last up to 1 to 2 weeks, and that redness typically resolves within a few hours. Anything beyond that is a question for the clinician.

Threads, ultrasound and the neck

• Thread Lift Benefits and Complications: Sets the benefits of thread lifts next to their complications, so neither is read alone.
• How Ultrasound Facials Tighten Skin: Looks at how ultrasound facials are meant to tighten skin and what to ask before booking one.
• Options for Loose Neck Skin: Covers the choices for neck skin that has started to loosen and the questions to bring to a clinician.

Start with the page that matches the first thing you noticed. If thread lifts are on your list, read the plastic surgery society's page on thread lifts next to the first article and write down every question it raises. Bring that list to a consultation, since the answers there will say more about your own skin than any general guide can.