Loose Skin

Every non-surgical option here works the same way underneath. Collagen contracts when it is heated into a narrow temperature range, and the controlled injury of that heating starts a rebuilding response that lays down new collagen over the months afterward. That is why nothing here looks dramatic the week after, and why the result worth judging is the one you have several months later. What separates the options is whether the heat is delivered through intact skin or placed underneath it, and that division is the one to hold on to.

Three of the non-invasive options work entirely through the surface, with nothing passing beneath it and little to no recovery. Exilis Ultra combines radiofrequency and ultrasound and is the workhorse of that group: comfortable, run as a series of four treatments spaced one to two weeks apart, and used to tighten skin on an abdomen, an inner arm or a thigh. SkinTyte pulses broadband infrared light with sapphire cooling that keeps the surface comfortable while the therapeutic heat reaches the dermis, which makes it easy to tolerate over large areas and a sensible way to treat an abdomen or the thighs. ThermiSmooth warms a smaller area gradually with a handpiece applied to the skin under continuous temperature monitoring, and because the heat builds slowly rather than arriving in a pulse it is gentle enough for thin, crepey skin that a stronger device would not suit: the neck, the area around the eyes, the décolletage.

Two more non-invasive options do a second job alongside the tightening, which is the reason to choose one of them over the three above. Vanquish ME never touches you. A panel hovers above the abdomen and flanks and heats the whole field at once, reducing fat as well as firming the skin over it, so it is worth adding when there is still volume to come down. Morpheus8 goes the other direction, driving radiofrequency through microneedles to a set depth so it tightens and improves surface texture in the same pass. It is used on the upper arms, the abdomen, the thighs, the knees and the skin under the chin, and it costs you a few days of redness.

The minimally invasive options are a genuine step up, and the step is worth being clear about. BodyTite works from underneath: a thin probe passes beneath the skin with an electrode riding on the surface above it, and the tissue between the two is heated directly and held at a controlled temperature, which contracts the fibrous layer far more forcefully than anything applied from outside. It delivers results that approach surgical outcomes without cutting skin out, it is frequently done in the same session as fat removal, and it involves local anesthesia, compression and a real recovery. ThermiTight uses the same subdermal principle in a single temperature-controlled treatment, which suits moderate laxity in someone who would rather come once than commit to a series.

Thermi Breast Lift applies that same controlled heating to the breast through a small number of micro incisions near the areolas, firming the skin envelope and lifting modestly, with no implant.