Skin Tightening Q&A: Do “Non-Surgical” Lasers and Ultrasound Work?

Question – Can you offer some insight into all the non-surgical procedures that are inundating the market for skin tightening, for instance, lasers and soundwave technologies? Many are saying they were featured on shows like Dr. Oz to lend credibility to their claims…. I suspect it is just another “too good to be true” story, but your thoughts on the subject would be most welcome. – Debra

Answer – Excellent questions, Debra. Regarding the latest generation of “non-ablative” lasers for skin tightening and sound-wave technologies, the short answer is that, as with most things in life, “there are no shortcuts” and “if it’s too good to be true, it usually is” (for more on the high cost of smartly marketed, less invasive and/or expensive treatments and technologies, please see slides 14-17 from my ‘What to Look For in a Plastic Surgeon‘ presentation.

That said, if a new product, technique or technology is shown to be both safe and superior to the current treatment standard (through peer-reviewed, double blind studies by other plastic surgeons), my approach has always been to assimilate/incorporate it into my practice. Even then, however, I try to never be among the first wave of users. This helps ensure not only the safety of my patients, but also their satisfaction with the results as well.

Case in point, for years, laser liposuction companies and MDs claimed that the machines not only suctioned fat, but were also a method of non-surgical skin tightening. The technology was promoted featured on promoted featured on Oprah, GMA, The Today Show, People Magazine (‘The New Lipo: Has Fat Met Its Match?‘) and hundreds of other publications. But since its introduction, no studies have confirmed its superiority to traditional tumescent liposuction methods. What has been confirmed, though, is laser liposuction’s potential to burn skin. More on that here.

The other issue to keep in mind with many methods of non-surgical skin tightening is that the patients who typically respond best to non-invasive treatment modalities are usually the patients who need them the least (re: patients with minimal laxity that are only looking to gently improve skin tone and appearance). For everyone else, the potential for complications aren’t worth the modest amount of tightening these devices potentially provide.This was confirmed at the recent Cutting Edge Plastic Surgery Symposium in New York City.

Regarding Dr. Oz, while I don’t watch his show, the little bit I’ve seen suggests that the good (educational programming) outweighs the not-so-good (promotional programming) insomuch that it—hopefully—leads to further investigation into the ideas and products explored in each episode. The recent profile of him by New Yorker Magazine isn’t quite as kind, but before Oz, any new cosmetic device featured by Oprah, a morning show or a celebrity magazine resulted in a wave of phone calls and questions from patients interested in the product or procedure.

That said, while there will always be people willing to promote, sell or purchase “less expensive and invasive yet equally effective” cosmetic treatments, I think the chances of another “SmartLipo” are fairly limited, thanks to the emergence of websites like RealSelf.com, which enable both patients (through reviews) and surgeons (through Q&A) to bypass the media/marketers and openly discuss/vet the safety, efficacy and legitimacy of not only most every cosmetic procedure and product on the market but also many of the “salesman” surgeons who promote them to their patients (e.g. Dr. Rand’s comments on the “vampire facelifts”; all 12 responses to this question about “Teardrop Augmentation Mastopexy”). Just remember that no matter how much you hear about a new product—whether it’s lasers for skin tightening or anything else—it’s always important to do your research.