Radio-Frequency Skin Tightening: Is it worth it?

Thermage jowls beforeThermage jowls afterRadio-frequency to tighten skin remains a common and popular approach. Many devices exist that treat the skin with radio-frequency. This article will answer the question of whether or not radio-frequency skin tightening is really worth it.

Skin tightening options

When it comes to tightening skin, there are surgical and non-surgical options. Within the non-surgical space, many devices utilize radio-frequency. However, other technologies exist that use other forms of energy including laser and infrared.

The commonality between all non-invasive skin tightening devices is the generation of heat in tissue. I will explain more later why heat is so important.

First, however, surgery deserves mention.

Surgery, in general, tightens skin better than any non-surgical treatment. Procedures such as face lifts, neck lifts, and tummy tucks literally pull skin tighter by cutting out excess tissue and stretching the remaining skin tighter.

Of course, surgery is more invasive than non-surgical skin tightening, so it is not an option for everyone. Some people want to avoid an over-tight look, others find it too invasive, and some are just not candidates for surgery.

Radio-frequency skin tightening

Of the non-surgical treatment devices that exist, many use radio-frequency.

Radio-frequency works by heating the skin. The available devices differ in how they deliver radio-frequency to the skin, but they all strive to deliver enough energy to the skin to heat it to a certain temperature.

Heat is the key.

It turns out that if you heat collagen to a very specific temperature, two things happen. Firstly, the existing collagen fibers tighten. Secondly, the collagen producing cells within the area are triggered to produce more collagen.

The dermis, which is the second layer of skin, is full of collagen.  Collagen also exists deeper in the fat layer within strands that weave between fat providing support for this layer.

Upon heating collagen, skin tightens because of immediate collagen fiber contraction and, also, from delayed new collagen formation.

Thermage and ThermiTight are two pioneering technologies that utilize radio-frequency to tighten skin.


Thermage machineThermage was the first in the category of radio-frequency skin tightening. It works by delivering radio-frequency from the outside of the skin inward.

During treatment, a treatment tip is applied to the skin. When the trigger is fired, a calculated dose of radio-frequency is delivered. By using a sophisticated protocol, Thermage heats skin to a specific temperature and goes to a specific depth. This ultimately leads to collagen tightening and production.

There is no recovery after Thermage because the skin is not broken or damaged.

Further, Thermage is capable of treating many different areas including the face, neck, abdomen, and eyelids.


ThermiTight delivers radiofrequency via a probe inserted below the skin’s surface, and is the first to do so. Placing a probe under the skin allows one to heat both the under-surface of the dermis as well as the deeper collagen fibers that exist between fat.

ThermiTight jawline


Thus, ThermiTight may be more effective at tightening the deeper tissue layers as well as the dermis.

During treatment, both internal and external temperatures are monitored to ensure skin gets to the optimal temperature but is not over-heated.

Other skin tightening devices

There are many other devices that utilize radio-frequency to tighten skin and others that use other energy sources.

Unfortunately, very little data exists comparing one device to another.

Machines that do not use radio-frequency include Ulthera and various other devices that use light or infrared energy. Ulthera uses ultrasound energy. All of these devices use the same concept of generating heat to tighten collagen. What differs is the energy source they use to produce that heat.


While the concept of tightening skin by heating it makes sense, how effective are these treatments?

Most devices have limited scientific data. Thermage is probably the most studied. Most clinical reports, and my own personal experience, find that the average patient sees a mild to modest improvement. One study that tried to quantify results recorded an approximately 20% improvement after one treatment with Thermage.

However, at the time of this study, it was common to only perform one treatment. Now, I often recommend a second treatment at 3 months.

Overall, I find that ThermiTight typically provides more improvement.

Hidden benefit

Whether results are minimal or modest, a major benefit of radio-frequency skin tightening is that treatment induces collagen. Even if not enough collagen is produced to tighten skin, healthy collagen is beneficial. At the very least, it may slow the signs of aging.

In other words, radio-frequency skin tightening treatments may be preventative.

Best candidates

Almost anyone who wants tighter skin, or who is interested in delaying further skin looseness, could benefit from radio-frequency skin tightening. Having said that, older patients who have very loose skin probably won’t see enough improvement to make a non-surgical treatment worthwhile. A face lift is usually the only option for them.

For everyone else, though, radio-frequency skin tightening may be very good option. It is critical, though, to have appropriate expectations about your results.

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