Stimulative vs destructive skin tightening treatments: what is best?

Stimulative vs destructive treatments for skin tightening: safety and effectiveness

We are pleased to share our experience and knowledge in radiofrequency and ultrasound, from our clinic in London with everyone in the world. Check all our RF and ultrasound articles here. And if you do live in London, book a treatment with us here.

• Keeping skin firm with exercise and healthy nutrition is great, but sometimes it is not enough

• Skin tightening surgery: only for extremely loose skin

• Non-surgical skin tightening treatments: ideal for most cases of skin looseness

• Which skin tightening treatment?

• Destructive skin tightening treatments: promises of instant miracles, delivery of adverse reactions instead

• With a numbing cream or injection you never know if treatment is too strong, and thereby unsafe, or too light, and thereby ineffective

• Stimulative skin tightening treatments

• Deep-acting, high-power radiofrequency: how to tighten skin on thighs, butt, tummy and entire body naturally

• Nothing else compares: all the second-best treatments

• What about cellulite reduction?

• In summary

• Check our professional consultancy in cellulite, skin tightening, ultrasound cavitation and radiofrequency

Keeping skin firm with exercise and healthy nutrition is great, but usually it is not enough

As mentioned in a previous article, exercise and everyday physical activity are essential for skin firmness, together with a healthy nutrition, rich in protein and polyphenols.

Exercise and physical activity offers the skin’s fibroblasts (collagen- and elastin-producing cells) the necessary mechanical stimulation they need to keep producing collagen and elastin.

Collagen gives skin firmness, while elastin offers elasticity. Together they lead to firm, elastic, healthy, good looking skin.

On the other hand, protein from food is used for the synthesis of collagen and elastin, which themselves are also proteins. Polyphenols and nutrients such as vitamin C favour the synthesis of collagen and elastin and protect against their breakdown.

So indeed exercise and general movement do lead to firmer skin and, as mentioned above, they are absolutely essential to maintain skin tightness and elasticity.

However, exercise and healthy nutrition act very slowly in reversing skin laxity and can only go so far in tightening skin in specific areas or throughout the body. So, indeed you can firm up your skin with exercise and nutrition but usually not enough and definitely not fast enough.

Hence the need for a good, strong skin tightening treatment, for faster, more pronounced results than from just exercise and healthy eating.

Skin tightening surgery: only for extremely loose skin

Even the best non-surgical skin tightening treatment in the world is not a miracle and cannot completely reverse the more serious cases of skin looseness (don’t believe those smooth operators on Instagram who promise miracles with fake ‘before and after’ pictures).

For those extreme skin laxity cases, a surgical thigh lift, breast lift, butt lift, “tummy tuck” etc is the only option, despite their adverse reactions and limitations.

Non-surgical skin tightening treatments: ideal for most cases of skin looseness

However, for the vast majority of skin looseness cases, a good non-surgical skin tightening treatment is the most effective, natural and safe option.

A good skin tightening treatment can act several times faster and much more effectively than exercise and definitely within weeks/months, rather the months/years needed with exercise/nutrition.

Again, collagen and elastin are not built within minutes, hours or days, so if someone promises that, they are simply lying, so turn your back on such lies.

Which skin tightening treatment?

There are plenty of skin tightening treatments but they can be divided in two categories: the ‘stimulative’ and the ‘destructive’ ones.

Destructive skin tightening treatments: promises of instant miracles, delivery of adverse reactions instead

Destructive treatments aim to literally BURN the deeper layers of the skin with the HOPE that the body will repair the damage and build new collagen-rich SCAR TISSUE.

If the intensity used is “just right” for the individual client, we have some new collagen synthesis in the area, in typically 3-6 months.

The result is then baptised as ‘SKIN TIGHTENING’, while in effect it is ‘SCAR TISSUE-ING’:

• The skin burning that occurs is euphemistically called ‘coagulation’ (well, it is actually burning)

• The scar tissue synthesis that occurs is euphemistically called ‘neocollagenesis’ (well, someone forgot to say that the arrangement of the new collagen is that of scar tissue, not of healthy, functional collagen tissue)

• There is no ‘neoelastogenesis’ anywhere in the area, so such treatments lead to a collagen-rich, elastin-poor, and thereby hard-to-the-touch skin

• Within about a year the body gradually gets rid of the scar tissue and people are left with more or less loose skin again

• When the intensity used is too high for the individual client, quite often these treatments lead to excessive scar tissue growth (hard bumps, which do not go away for years) and/or inflammation / hyperpigmentation (which take a lot of time, creams and laser treatments to go away)

• Sometimes the body does not respond to the damage with the synthesis of new collagen (remember the “HOPE” word, above), leading to even looser than before, paper-thin skin

• When intensity used is too low for the individual client, nothing happens and the whole treatment is a waste of time

With a numbing cream or injection you never know if treatment is too strong, and thereby unsafe, or too light, and thereby ineffective

The problem with destructive treatments is that that they require the use of anaesthetic cream or injections, to mask the extreme pain.

However, by losing the skin sensation and the sense of burn/pain, we lose all feedback as to whether treatment is too strong or too light or just right.

It’s just a shot in the dark, based on the mythical “average”. But no single person is an average of 1000 people. Hence all the complications (too high intensity) or no results (too low intensity).

The most popular examples of destructive skin tightening treatments are:

• HIFU / high intensity focused ultrasound, when used at high intensity (at low and medium intensities nothing much happens)

• RF microneedling (due to the needling adverse reaction can occur at any intensity, but especially so at high intensities)

• Static, extreme intensity, radiofrequency

With these treatments you literally play with fire and they are totally unnatural.

Plus with all the above treatments results are hit and miss, despite all the pain and adverse reactions.

You can easily recognise destructive treatments, as:

• They always require the use of anaesthetic cream

• They require downtime

• They are provided in a static, stamp-like manner (as opposed to continuous applicator movement)

• They promise results in one or two miraculous sessions, with results promised to appear in 3-6 months after each session - if they ever appear

• They are reassuringly exorbitantly priced - up to rip-off level - so people think that “if it hurts and it’s very expensive it must work, right”? Well, wrong.

Stimulative skin tightening treatments

Stimulative skin tightening treatments are the natural option, as they are not based on burning the skin with the hope that the body will then rebuild the damage.

Stimulative treatments are based on the STIMULATION - not the damage - of skin’s natural collagen and elastin synthesis processes.

When applied by a well-trained practitioner, stimulative treatments are extremely safe. At our clinic we have better than 99.5% safety record, with the remaining 0.5% (or less) of the cases being mild, very temporary irritation.

Just like resistance exercise, which needs repeated sessions to stimulate muscle building, such treatments need repeated sessions too (typically 6-12 sessions). But as with exercise, results are natural, organic, functional and long-lasting.

You could say that stimulative skin tightening treatments are exercise for your skin:

• With resistance exercise you tighten/lift the muscles, from the inside

• With stimulative skin tightening treatments you tighten/lift the skin, from the outside

The combination creates a nice toned body.

With a good stimulative skin tightening treatment, 80-90% of the results should be seen in about a month after the last session (remember, collagen/elastin synthesis takes weeks, not days to occur). And some 10-20% of the results keep occurring for up to 6 months after the last session.

In most cases anything between 6-12 sessions are needed, with up to 24 sessions for the more severe cases (if a case is so severe that needs more than 24 sessions, surgery is a better option).

The problem with stimulative skin tightening treatments is that most of such treatments on the market are not strong enough (too low power) or deep enough (too superficial).

Deep-acting, high-power radiofrequency: how to tighten skin on thighs, butt, tummy and entire body naturally

According to more than two decades of professional experience and constant research in this field, the most effective stimulative skin tightening treatment is continuous-movement, deep-acting, high-power radiofrequency.

Deep-acting, high-power radiofrequency stimulates:

• Collagen contraction, which materialises within a few minutes to a few days - younger people have a faster response (ideal for cellulite reduction too)

• Collagen and elastin synthesis, which occurs within a few days to a few weeks (ideal for cellulite reduction too)

• Microcirculation (ideal for cellulite reduction too)

• Fat release from fat cells, which occurs within a few minutes to a few days (ideal for cellulite reduction too)

When applied with high-end equipment and by a well-trained practitioner there is nothing more effective or safer.

How about ultrasound cavitation?

Done the right way on the right type of skin, high-power ultrasound cavitation can be almost as effective as deep-acting, high-power radiofrequency for skin tightening. But that requires skill and knowledge.

So, for simplicity, deep-acting, high-power radiofrequency is preferred in most cases.

Nothing else compares: all the second-best treatments

During the last 20+ years I have tried, examined and/or assessed all skin tightening technologies and at the moment of updating this article (November 2023) everything else is just not that effective or safe:

• Infrared treatment is too superficial and/or too weak for the body - perhaps OK for the face if speed of results and number of sessions are not important

• Superficial radiofrequency (such as bipolar RF, tripolar RF etc) is too superficial to reach the dermis and hypodermis, where fibroblasts are located

• Microneedling is just too superficial

• Static, extreme intensity RF is just too painful and too dangerous, as mentioned above

• Static, low intensity RF is just pointless - nothing happens

• High-power HIFU is also too painful and too dangerous, as mentioned above

• Low-power HIFU is just pointless - nothing happens

• Static, extreme intensity RF with microneedling is even more painful and dangerous, yet no more effective

• Low power ultrasound cavitation is a waste of time and money

• Low power RF is also a waste of time and money

• Strong cellulite-specific massage helps a bit with skin firming, but not enough and not fast enough

• Microwave radiofrequency is just too weak

• Electromagnetic muscle stimulation (HIFEM) is not nearly as effective as strong, deep tissue RF for skin tightening. No comparison, regardless of what the marketing blurb says.

• Electrical muscle stimulation (EMS) does not do anything for the skin

• Vibration massage does stimulate collagen but also causes spider veins - no point damaging one thing to fix another

What about cellulite reduction?

Everything I presented above for stimulative and destructive skin tightening treatments applies to cellulite treatments.

The same technologies used for body skin tightening are quite often used for cellulite removal, both the destructive and the stimulative ones. Absolutely nothing changes:

• Deep-acting, high-power radiofrequency is also the best technology for cellulite reduction, as it acts on all major aspects of cellulite

• High-power ultrasound cavitation is a close second for cellulite reduction and, as mentioned above, not so important for skin tightening.

In summary

So my best suggestions for SAFE and effective fast skin tightening in a few weeks (NOT hours and days) are:

• Exercise a lot

• Have enough protein and polyphenols in your diet

• Have 6-12 collagen- and elastin-stimulating sessions of deep-acting, high-power radiofrequency for skin tightening (with deep acting, high-power ultrasound cavitation added to the mix in certain cases or for extra help with cellulite reduction)

And my best suggestion to waste time and money or to have a disaster treatment is:

• Believe in super-expensive, one-session, destructive, lunchtime miracle “procedures”, based on tabloid hype, exaggerated claims and fake Instagram “before and after” photos

I can’t say it more clearly and more honestly than that

Check our professional consultancy in cellulite, skin tightening, ultrasound cavitation and radiofrequency

If you are a therapist or clinic owner and are interested in our professional consultancy/teaching, via Zoom or at our London practice, please contact us here.