Dear Dr. Seckel. I’m 55 and have some moderate sagging on my lower face and jowls. About 3 years ago I had one Thermage treatment in the hope of tightening that area. If there were results, they’re too subtle for me to discern. In the past 9 months, I had 2 Fraxel treatments seeking a tightening of that area. Again, no visible results. I just contacted a physician about having a Titan treatment for the same area because I’ve read that the down time (with redness and swelling) is less than Fraxel. The doctor is dubious about getting results since the two other similar treatments seemed to have little effect. While in his office, however, I was told about Sculptra and shown photos (from the manufacturer and one in-house patient) that would indicate that several Sculptra treatments might achieve the visible tightening I’m looking for. Would you please discuss Sculptra on your site in relation to skin-tightening? Also, if I decide to do it, how can I prevent or minimize bruising from the injections? I bruise very easily and being a workingwoman, I need to minimize “down time”. Thank you, Anita, Salt Lake City, UT
Dear Anita,
Only a face lift will significantly tighten lax facial skin. Sculptra or any of the other soft tissue fillers such as Restylane, Radiesse, and Cosmoplast etc WILL NOT tighten skin. They work by filling depressions such as the nasal-labial fold and marionette lines, thus lessening the shadow created by the loose skin. They can produce pleasing results but DO NOT tighten skin. Thus I do not think Sculptra is the answer for your concern about the loose or lax skin of your lower face. The bruising as a result of multiple cris-crossing injections of Sculptra or any filler to treat multiple facial areas can be very significant, and the results are of course temporary.
Fraxel has not been shown to produce significant skin tightening and I would not recommend it for that purpose.
The most effective skin tightening technologies are LuxIR by Palomar , which I use, and Thermage, Titan, and Aluma with Faces by Lumenis.
These technologies will tighten skin but you must be aware that the skin tightening is only about 30% which is subtle-you have to look carefully for it in the mirror and compare to a pre treatment photo.
Also most experts agree that it takes MULTIPLE treatments-at least 3-4 and a waiting period of 6 months to see the full result of skin tightening using these methods. Skin tightening is not a non-surgical face lift. Results of skin tightening are 10 to 20 % of the faciual tightening seen with a face lift in my experience.
I am not surprised that you saw no improvement after only one treatment with Thermage. Most skin tightening machjines require at least 4 treatments to achieve maximum skin tightening.
Some people do not respond to skin tightening-usually older patients with a lot of sun damage and aging changes but this does not sound like your case.
If you are going to proceed with the Titan expect that you will need 3-4 sessions and a wait of 6 months to see your final result. Be aware however that 30% improvement is most likely all that you will experience.
A =mini face lift will give you a much better result than skin tightening if done by an experienced board certified plastic surgeon with minimal down time of about a week. I know you don’t want surgery but in the long run you may save money and get the result you desire. You have tried the non-surgical facial rejuvenation options and have been disappointed so I think it is unlikely you will get the result you desire after spending a lot more money and time. Certainly filler such as Sculptra is not the answer for tightening skin.
For more information on fillers, nasal-labial folds and non-surgical facial rejuvenation read Save Your Face or contact me.
Thank you,
Boston, Massachusetts