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Nonablative Facial Skin Tightening


Reduction of rhytides 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.

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