Sagging & Laxity

Four devices work from the skin surface and differ mainly in what depth they reach and how much of a series they ask for. Ultherapy uses microfocused ultrasound to deposit heat at the level of the SMAS, the same layer a surgeon repositions in a facelift, and it is the only one of the four that lets us see the plane on ultrasound imaging before treating it. Thermage uses monopolar radiofrequency to heat the dermis and the layer just beneath it across broad areas in a single comfortable session. SkinTyte uses broadband infrared light in a series of gentler visits and is described by most patients as comfortable, which makes it a reasonable choice for early laxity across the face and neck. Exilis Ultra pairs radiofrequency with ultrasound and is also run as a series, warming the skin and the tissue just under it a little at a time, which suits laxity that is still mild and someone who would rather have several easy appointments than one long uncomfortable one. All four ask for patience: collagen remodels over roughly two to six months depending on the device, so the result is something you notice in photographs rather than on the drive home.

FaceTite and AccuTite work from the other side. A thin probe is passed under the skin with a matching electrode above it, and radiofrequency energy is delivered directly to the fat and the collagen beneath the skin, contracting the tissue far more forcefully than surface heating can. It is done under local anesthesia, there is swelling and often bruising for several days, and it sits closer to a surgical result than anything non-invasive. AccuTite is the same technology with the smallest applicator, sized for places a larger probe cannot go safely: the brow, the lower lid, the nasolabial area, a small patch of the jawline.

Two options lift mechanically rather than tighten. Thread Lifts use barbed absorbable sutures to reposition tissue upward, and the change is visible the day it is done, which is the appeal. The threads dissolve over the following months, leaving some collagen along their tracks, and the lift is temporary, generally lasting twelve to eighteen months. EasyLift is the surgical option, a direct lift, and it is what we discuss when the anatomy has moved past what energy can meaningfully address.

EMFACE pulls a different lever entirely. It combines radiofrequency with electromagnetic stimulation of the facial muscles, contracting the elevators thousands of times in a twenty minute session. The lift comes from toning the muscle that holds the tissue up rather than from shrinking the skin over it. There are no needles and nothing to recover from, and it is the most reasonable option for someone whose face is starting to soften but who is not ready to have anything done to them.

Dermal Fillers sit in a different column altogether, and it is worth saying plainly why they belong on this page. A face that has deflated is not the same problem as a face that has loosened, though the two look alike in the mirror. Fat pads shrink and bone recedes with age, so the skin over them ends up with more surface than support, and tightening that skin does not restore what has gone from beneath it. Filler puts the support back, and restoring volume in the cheek lifts the sagging skin below it, which is why a heavy fold or a softening jawline is often addressed by treating the midface as well as the fold itself. Past a certain age most people have both problems at once, and filler and an energy treatment then do different halves of the job. Neither substitutes for the other.