Tissue tightening technologies: fact or fiction.

Skin laxity is associated with chronological aging and exposure to solar radiation. The authors summarize the advantages and limitations of current laser, light-, and radiofrequency (RF)-based technologies purported to treat skin laxity by effecting heat-induced collagen contraction and subsequent remodeling during the months after treatment. Although penetration of laser or broadband light to the deep dermal layers is limited because of scattering of the light by epidermal melanin, a new device in which broadband infrared light is minimally scattered may overcome these limitations. RF energy offers a treatment alternative that has not only been proven to promote collagen contraction and remodeling but also is not scattered by epidermal constituents. Recently launched devices that use combinations of optical and RF energy achieve clinical benefits at lower and therefore safer levels of energy, with only mild pain and few adverse effects. A combined infrared-RF device takes maximum advantage of both optical and RF technologies to achieve the desired clinical effect. The electrooptical synergy systems have proven to be safe, effective, reliable, and user-friendly. Other more advanced powerful technologies may also be effective in this setting.