Laser Skin Tightening: How It Works, Results, Risks and Cost

• Laser skin tightening can decrease skin laxity (looseness) and smooth wrinkles from any part of the body.
• Nonablative laser skin tightening heats the tissue beneath the skin to stimulate the production of collagen, the protein that gives your skin its elasticity.
• Ablative laser resurfacing removes the top layer of the skin to encourage new, tighter skin to grow as a result of the wound healing process.
• Laser skin tightening is safe and effective for every skin type and color.

Aging, genetics and exposure to the sun slow down the production of collagen and elastin, two components that give your skin its elasticity. Over time, sagging skin, wrinkles and fine lines  become more pronounced.

Laser skin tightening is a treatment whereby lasers are used to decrease skin laxity, or loose skin, by increasing skin’s collagen production through heat and the wound healing process.

Different laser treatments are available to improve skin laxity on different parts of the body based on specific needs and preferences.

How Does Laser Skin Tightening Work?

During laser skin tightening, a laser heats the water molecules present within the tissue. As the water is heated, it turns into gas and vaporizes the surrounding skin cells, triggering fibroplasia, or the wound healing process, stimulating the production of new collagen and contracting existing collagen fibers.

Dermatologists use lasers that generate different wavelengths to control how much laser energy is absorbed by the water in your skin, which, in turn, controls how invasive a given treatment is.

Nonablative laser treatments are noninvasive and cause no damage to the outer layer of skin (the epidermis).

Ablative (a type of treatment in which tissue is removed) laser resurfacing treatments are minimally invasive. During ablative skin treatment, your epidermis is removed by the laser while the tissues beneath are heated to trigger fibroplasia. After your skin heals, it will become tighter and more firm.

One of two types of lasers can be used for either treatment:

• Nonfractionated lasers treat the entire targeted surface area.
• Fractionated lasers treat an equally distributed portion of the surface area.

What to expect during the procedure

Both nonablative and ablative treatments are nonsurgical outpatient procedures. Provided you don’t experience any unexpected reactions or side effects, you’ll be able to go home shortly after your procedure.

Before a nonablative procedure, your dermatologist may apply gel or cream to your skin to better control its temperature. Depending on the laser, a special functionality will keep your epidermis cool during the procedure.

Next, a doctor or dermatologist will apply topical anesthesia to the treatment area. Some procedures—particularly fractional ablative treatments using a carbon dioxide laser—may require local or general anesthesia or sedation.

The length of the procedure depends on which part of your body is being treated. In general, you can expect a nonablative procedure to last between half an hour to two hours. Ablative treatments may last between half an hour if only part of your face is being treated, or up to four hours for a more extensive area of the body.

Is Laser Skin Tightening Right for You?

You are a good candidate for laser skin tightening if you would like to treat:

• Loose or sagging skin
• Wrinkles
• Crepey skin
• Acne
• Scarring

Those with darker skin (Fitzpatrick skin types III–VI) are more predisposed to scarring and other side effects following treatment by ablative fractional lasers, as the melanin present in their skin absorbs the energy. Patients with skin types III–VI should be treated with a nonablative fractional laser.

The Fitzpatrick scale

The Fitzpatrick scale classifies skin types by how much pigmentation is present in the skin and how the skin responds to ultraviolet light. Dermatologists and medical professionals use the scale to predict one’s susceptibility to skin cancer based on type.

Type I	Type II	Type III	Type IV	Type V	Type VI
Ivory white skin	Fair skin	Average skin	Light brown skin	Brown skin	Black skin
Always burns; never tans	Always burns; tans with difficulty	Sometimes mild burns; average tan	Rarely burns; tans easily	Never burns; tans very easily	Never burns; tans very easily

Treatment options

Your specific skin conditions dictate which laser is used during your laser skin tightening procedure.

Though ablative laser procedures provide the most effective results to encourage collagen production and tighten skin, they also have the highest risk of side effects and complications.

Nonablative laser procedures are more gentle to your skin and minimize risk, but you’ll likely require multiple procedures to experience the same results as you would after an ablative treatment.

Ablative nonfractionated lasers

• Ablative nonfractionated carbon dioxide (CO₂) lasers are theorized to cause immediate skin tightening and continued collagen production. CO₂ lasers work best when removing fine lines, wrinkles and scars, though they are less effective at removing deep wrinkles.
• Erbium-doped yttrium aluminum garnet (Er:YAG) lasers are better absorbed by the water in your skin. Er:YAG lasers don’t penetrate as deeply into your epidermis, making them more precise than CO₂ lasers while causing less damage to your tissue.

Nonablative nonfractionated lasers

• Pulsed energy lasers target the dermis (the layer of skin beneath the epidermis) to stimulate collagen production. Pulsed energy lasers are effective at increasing skin tone and texture and reducing wrinkles, acne and scars.
• Neodymium-doped yttrium aluminum garnet (or Nd:YAG) lasers generate energy that is absorbed by the water in the dermis, stimulating collagen and elastin production without causing damage to the epidermis. Nd:YAG lasers produce effective anti-aging and anti-wrinkle effects in all skin types.

Ablative fractionated lasers

• CO₂ fractionated lasers can penetrate deeper into the skin to tighten sagging skin, treat fine lines and reduce both superficial and deep wrinkles.
• Er: YAG fractionated lasers function in much the same way as CO₂ ablative fractionated lasers, with similar efficacy, side effects and downtime.

Nonablative fractionated lasers

• Fraxel repair lasers are effective for treating superficial wrinkles in all skin types by penetrating deep into the tissues beneath the epidermis without causing any damage to the epidermis.
• Nonablative fractionated Nd:YAG lasers apply heat to microscopic zones to treat wrinkles and tighten skin.
• Erbium fiber lasers and thulium fiber lasers possess both ablative and nonablative functionality to tighten skin and treat wrinkles, photoaging and other skin conditions, such as acne and scarring.

Treatment Areas

Laser skin tightening procedures can be done on nearly any part of your body. However, the efficacy of a given laser skin treatment depends on the part of the body it’s used on.

Face and neck

Patients without excessive skin are candidates for face and neck laser treatment. Dermatologists and doctors will adjust the energy of a laser to account for the thickness or thinness of the skin in these (and other) areas.

Other body areas

Skin laxity in the arms, stomach, hips, thighs, knees, calves and ankles can also be improved following laser skin tightening.

Some dermatologists may recommend additional areas of the body be treated for optimal body contouring prior to treatment.

Laser Skin Tightening Before and Afters

Laser Skin Tightening Recovery and Results

Downtime following a laser skin tightening procedure depends on the type of laser used during treatment.

Little to no downtime can be expected following a nonablative laser skin tightening procedure. Patients who undergo ablative laser treatment can expect 2–3 weeks of downtime before the skin has fully healed.

Nonablative laser treatments generally require multiple treatments for the procedure to be effective. While some degree of visible skin tightening may be noticed immediately after treatment, results become most apparent at least six months later.

Ablative treatments deliver improvements in skin laxity of the neck after 1–3 sessions, with continued improvement after 2 months. CO₂ lasers result in a 45% improvement in wrinkles, and an improvement in skin laxity and collagen depth.

Skin tightening after ablative laser skin treatment is still observable up to 3 months after a procedure.

Reviews

Patients who undergo nonablative laser skin tightening commonly report high satisfaction with the procedure. The short length of the procedure itself, visible results of skin tightening and the ability to be treated in the office—not an operating room—contribute to their satisfaction.

Patients with darker skin who elect for nonablative fractional laser treatments also report high satisfaction with the procedure, owing to its lack of downtime.

Post-treatment care plays a large role in patient satisfaction after an ablative fractional laser treatment session. While patients are still satisfied 3 months after such treatments, their satisfaction gradually drops as improvement to their skin laxity wanes.

How Much Does Laser Skin Tightening Cost?

Insurance does not generally cover cosmetic surgery such as laser skin tightening.

The cost of laser skin tightening depends on:

• Type of procedure
• Treatment area
• Number of treatments required
• Location where you live or where the office is located

In 2018, the average cost for ablative laser skin tightening was approximately $2,000 and $1,100 for nonablative procedures. In general, treatments can range anywhere from $750 to $7,500.

You may also have to pay additional costs, such as fees for using the facility or anesthesia and the cost for any medication or aftercare that you are prescribed.

Laser Skin Tightening Risks

The typical laser skin tightening procedure is safe and only rarely results in long-lasting side effects or complications.

Fractionated lasers (both ablative and nonablative) lead to higher safety and fewer side effects than nonfractionated lasers as they reduce the total surface area being treated while leaving “untreated islands” of surrounding skin. The wounded skin then draws proteins out from the intact skin to rapidly heal the affected area.

Additionally, ablative fractionated CO₂ laser energy is well-absorbed by high amounts of water in your skin.

The greatest risk posed to patients following laser treatment is caused by poor technique or a mistake on behalf of the doctor.

Severe risks and complications, such as scarring, infection, hyperpigmentation and hypopigmentation (darkening or lightening of skin color, respectively) have led dermatologists to largely avoid ablative nonfractionated lasers.

Common side effects

While prolonged side effects are rare following laser skin tightening, patients may experience some short-term side effects after treatment.

Nonablative skin tightening side effects

• Mild pain, discomfort and stinging during the procedure
• Some swelling, redness or superficial blistering after the procedure

Ablative skin tightening side effects

• Acne
• Oozing
• Bleeding
• Crusting
• Postinflammatory hyperpigmentation
• Redness
• Scarring
• Infection (herpes outbreak)

In most cases, side effects experienced after an ablative treatment clear up within weeks.

Are At-Home Laser Skin Tightening Machines Worth It?

At-home laser skin tightening machines are an alternative to in-office procedures. The downside of at-home devices, however, is the reduced energy generated by the device compared to the machine used by your dermatologist.

Still, those that have used an at-home device have reported a more youthful appearance and fewer wrinkles after using the device for at least 4 weeks.

Alternatives to Laser Skin Tightening

Skin rejuvenation can be achieved through ways other than laser skin tightening. A number of cosmetic products, procedures or forms of plastic surgery are available to fulfill your specific needs.

Topical alternatives

Topical alternatives, available both over-the-counter (OTC) and via prescription, have proven anti-aging and skin tightening properties. Skin tightening creams and lotions with these ingredients stimulate collagen production and protect your skin from sun damage:

• Vitamin B3, or niacinamide
• Vitamin C, or L-ascorbic acid
• Vitamin E, or alpha-tocopherol
• Retinol
• Tretinoin
• Peptides
• Hyaluronic acid (HA)
• Salicylic acid, or beta hydroxy acid (BHA)
• Glycolic acid, or alpha hydroxy acid (AHA)

OTC chemical peels are effective in exfoliating your skin. For a stronger chemical peel treatment, visit your dermatologist.

Adding a topical cream to your skin care routine or using a chemical peel won’t give you the same skin tightening effect as a laser skin treatment or plastic surgery, but continued use can give you visible results.

Other alternatives

Skin tightening can be achieved through methods other than laser rejuvenation or topical creams and lotions. These procedures may be:

• Noninvasive: nonsurgical and without causing damage to the skin
• Minimally invasive: possibly requiring sedation and causing some damage to the skin
• Surgical: requiring sedation and anesthesia

Noninvasive alternatives to laser skin tightening are:

• Radio frequency (RF) skin tightening, which uses heat to stimulate the production of new collagen and tighten collagen fibers.
• Ultrasound skin tightening (ultherapy), which sends ultrasound energy deep into the skin to stimulate collagen production.

Minimally invasive procedures for skin tightening include:

• Microneedling, or collagen induction therapy, in which your skin is punctured by small needles to trigger the healing process and stimulate collagen production.
• Dermal filling, in which a substance is injected beneath your skin in order to plump it up and soften wrinkles.
• Neurotoxins, injected into a muscle paralyze or freeze it, thus reducing or removing wrinkles caused by muscle movement.

Surgical treatments for skin tightening are:

• Eyelifts, or blepharoplasty, a form of plastic surgery that lifts your upper and lower eyelids and removes loose skin and fat from the eye area.
• Necklifts, including cervicoplasty, which removes excess skin from around your neck, and platysmaplasty, which tightens and realigns the muscles in your neck.
• Facelifts, or rhytidectomy, a form of cosmetic surgery in which skin is pulled away from the underlying muscles and tightened, and sagging skin is removed from the face and jowls.

Choosing an alternative option over laser skin tightening depends on the type of procedure you prefer (if any at all), how long you would like improvements to last and the efficacy of a given alternative.

Takeaway

Laser skin tightening is a safe and effective treatment for patients of all skin colors. Patients can expect to experience few side effects, but with a low likelihood of prolonged complications after a procedure. It provides better efficacy than noninvasive options without the extensive downtime and side effects of plastic surgery.