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In the first part of our “Which treatment?” series, we unpacked FAQs about skin resurfacing. In round two, we explore the growing number of minimally-invasive options to tighten sagging skin, restore youthful volume, and enhance facial features.

As we age, tissues deep below the skin’s surface begins to lose collagen, elastin, and fat, leading to issues such as jowling, hollowing cheeks and temples, and deep creases. And, regardless of age, sometimes our features just don’t look quite the way we want, whether it be a double chin, sagging tummy, sagging “down there,” or a jawline that lacks definition.

Here at the La Jolla Cosmetic Medical Spa, we’ve got the goods to help you address many concerns without surgery—and the technology just keeps getting better. The Q&A below will help you get to know what’s what in the world of San Diego skin tightening, non-surgical facial contouring, and more.


How does non-surgical skin tightening work?

This is a great one to start with, as it’ll help you better understand all the Q&A that follows. First, let’s talk about why skin sags. Young, healthy skin has a great supply of collagen, elastin, and hyaluronic acid—proteins that give the skin structure and suppleness. Skin cells also turn over at a high rate, so we’ve always got a fresh supply of smooth, healthy skin cells.

As we age, sun damage, lifestyle factors, and unavoidable wear and tear damages skin DNA, slowing cell turnover and collagen production and causing skin to become thinner, drier and less elastic. At the same time, the youthful facial fat layer dwindles (of all places!). Because aging skin can’t contract as well, it succumbs to gravity and sags over its thinning foundation.

Non-surgical skin tightening treatments work by applying controlled heat to the skin’s deeper layers. This heat triggers new collagen and elastin production and accelerates cell turnover, helping skin gradually become firmer and smoother. Different treatments will use different technologies to deliver the heat: radiofrequency (Thermi treatments), light (laser treatments), and ultrasound (Ultherapy) are common examples.

What can be done for droopy face skin?

Sagging skin around the eyes, cheeks and jawline are among the most common complaints we address at La Jolla Cosmetic Medical Spa—no one likes to see those dreaded jowls! Fortunately, there are many great options to lift sagging skin, reduce jowling and soften creases:

  • ThermiSmooth Face is a non-invasive radiofrequency treatment and an excellent option to firm and smooth crepey skin on the face, particularly around sensitive areas such as the mouth, lips and eyes.
  • ThermiTight also uses radiofrequency, but is applied sub-dermally using a small probe to target moderate sagging around the cheeks, neck and jawline to achieve a mild face “lift” with minimal downtime.
  • Ultherapy is another option that uses ultrasound energy to prompt new collagen production and tighten lax skin. It’s great for the brow and eye area, lower face, neck, and decolletage too!

Keep in mind that non-surgical skin tightening is best for addressing mild to moderate skin laxity and best suited to patients in the earlier stages of facial aging. A surgical facelift is still the best option for treating extensive jowling, loose neck skin, or deep facial folds.

What are my options to get rid of a double chin?

Excess fat under the chin, or “submental fullness” in clinical speak, is typically an inherited trait—patients are often at a healthy body weight and frustrated that diet and exercise have no effect on their double chin. While liposuction once was the only effective option to treat a double chin, you’ve now got several non-surgical alternatives to choose from:

  • Kybella is an injectable medication that effectively dissolves fat cells beneath the chin, which your body will then process and eliminate naturally. Patients undergo a series of 2 to 4 treatments, with final results apparent in 3 to 6 months. A plus of Kybella is that we can inject specific points in the chin to improve contouring.
  • CooMini is CoolSculpting specifically for reducing chin fat. A vacuum-assisted cooling device is placed under the chin, which delivers intense cold that causes fat cells to break down. Results appear gradually as your body metabolizes the fat, over about 2 to 3 months. CoolMini requires no needles or anesthetic.

Which is best for you? That takes a one-on-one consultation with a provider who’s experienced with both treatments—she’ll be able to tell you with an unbiased eye which one is likely to achieve better results for you.

What is the best way to treat hollow cheeks?

Remember that facial fat loss we discussed above? One area where this becomes most apparent is in the cheeks, which can appear hollow, sunken or droopy with volume loss.

To rejuvenate hollow cheeks, we love the tried-and-true plumping prowess of injectable fillers. Juvéderm VOLUMA XC and Restylane Lyft are both high-quality, FDA approved fillers specifically formulated for cheek enhancement. They have a thicker, more durable gel than other fillers, which we can inject more deeply beneath the skin’s surface to achieve a subtle lift as well as round out hollowing or flat cheeks.

Both are excellent products that can achieve similar results. Ultimately, provider skill matters the most with filler injections—a highly skilled, experienced injector with a honed eye for aesthetic detail will be able to achieve a gorgeous result with either product.

What’s the best non-surgical skin tightening option for my tummy?

Lax skin on the belly is one of the most common (and frustrating) badges of motherhood. You work hard to get back to your pre-pregnancy weight, but despite all those ab workouts and weeks of clean eating, that loose skin is still there. And while a tummy tuck can certainly get rid of sagging skin on your belly and tighten stretched muscles to boot, not everyone is ready for surgery.

If you’re bothered by a modest area of crinkled, loose skin, there are a few things we can do:

  • ThermiTight can work wonders to firm mild to moderately loose skin on the body and reduce a little fat in the process. Using a small subdermal probe, ThermiTight delivers radiofrequency beneath the skin, increasing collagen and elastin production and melting fat cells. Most patients need only 1 to 3 days of downtime and experience noticeably firmer skin within a few weeks, with continued improvement for up to 6 months.
  • If fat reduction is your main goal—but a little skin tightening would be a bonus—CoolSculpting is right up your alley. Our most popular non-surgical fat reduction option, CoolSculpting can spot-reduce fat nearly anywhere from neck to knees, and many patients experience a mild skin tightening benefit as well.

Psst! We have a secret weapon for boosting skin tightening results at LJCSC: the Zimmer ZWave. This non-invasive radial pulse therapy treatment has been clinically proven to enhance skin smoothing and fat reduction following Thermi or CoolSculpting treatments. It takes just 15 minutes, and we include it with CoolSculpting for our patients.

Does ThermiVa really work to tighten vaginal tissues?

Why, yes it does! Like other Thermi treatments, ThermiVa uses radiofrequency, delivered via a thin wand, to tighten and thicken internal (vagina) and external (labia) tissues that have loosened due to aging or childbearing.

ThermiVa not only achieves a cosmetic benefit, but tightening things up “down there” can have therapeutic benefits for many patients: increased natural lubrication, reduced urinary stress incontinence, and more satisfying sex for you and your partner are just a few. Treatment is a breeze, too—ThermiVa is not painful, takes about 30 minutes to perform, and many patients notice a difference immediately, with tightness and tone improving progressively with optional follow-up treatments.

Want firm answers about your skin tightening options? Get in touch with us!

We hope this Q&A has plumped up your knowledge on the many non-surgical options for tightening, smoothing and rejuvenating your face and body. If you’re ready to take the next step and try one of these treatments, contact us at La Jolla Cosmetic Medical Spa for a free personal consultation with one of our experienced aesthetic providers.

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