Nonablative Facial Skin Tightening

/Home/Cosmetic Laser Treatments/Laser Skin Tightening/Skin Tightening Treatment

Nonablative Facial Skin Tightening

Last Updated: October 31, 2005

Author: A John Vartanian, MD, MS, Assistant Clinical Professor, Division of Head and Neck, Department of Surgery, UCLA David Geffen School of Medicine; Instructor, Department of Otolaryngology-Head and Neck Surgery, University of Southern California Keck School of Medicine

Coauthor(s): Steven H Dayan, MD, Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Illinois


A John Vartanian, MD, MS, is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Editor(s): J David Kriet, MD, FACS, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Director of Facial Plastic and Reconstructive Surgery, University of Kansas School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Dominique Dorion, MD, Program Director and Division Chairman, Professor of Surgery, Division of Otolaryngology, University of Sherbrooke, Canada; Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders; and Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Reduction of rhytids and skin laxity can significantly contribute to improving overall facial appearance. Dermabrasion, chemical peels, and resurfacing lasers (eg, carbon dioxide laser, erbium:yttrium-aluminum-garnet [Er:YAG] laser) are the current mainstays of ablative facial resurfacing. During an ablative facial resurfacing process, the epidermis is denuded to a certain depth by the direct physical, chemical, or thermal injury applied to the skin. The ablative cutaneous injury induces a healing response, resulting in the deposition of a new skin matrix with improved characteristics. During this so-called healing process, skin rejuvenation occurs by a proliferation of fibroblast activity, the action of inflammatory mediators, and a deposition of new collagen and other dermal matrix proteins.

Despite achieving appreciable clinical results, the adverse effects of ablative resurfacing modalities can result in significant edema and erythema that last for several weeks. The potential for impressive clinical improvements must be balanced against well-described morbidities (eg, protracted edema and erythema), long-term sequelae (eg, pigmentary changes), and potential complications (eg, scarring). As such, the typical prolonged recovery times and the potential problems associated with these ablative modalities may also limit their use in patients who desire a rejuvenation procedure with reduced downtime and a minimal risk profile.