Skin tightening

How skin laxity develops

With age, the dermis loses collagen and the elastic fibres become less resilient, partly as a result of sun exposure. The fibrous septa that anchor the skin through the fat to the deeper layers also weaken, and the face loses volume. After major weight loss, stretched skin may not retract on its own. Laxity shows first along the jawline and in the neck, then in the cheeks and around the eyes. Volume loss needs a different approach, such as fillers or biostimulators. Fine lines in the skin itself are covered under wrinkles, and the wider picture of ageing skin under skin rejuvenation.

Skin tightening with radiofrequency

Radiofrequency heats tissue through the tissue's electrical resistance to the current, not through a pigment. Melanin is not a target, which is why RF can also be used on darker skin.

In monopolar RF, the current flows from a single electrode in the handpiece through the body to a return pad placed elsewhere on the skin. This heats a large volume of tissue beneath the electrode: the dermis and, deeper down, the fibrous septa in the subcutaneous fat. Meanwhile, the handpiece cools the skin surface so that the epidermis is spared. Monopolar RF has been used for non-surgical skin tightening for more than twenty years, and recovery is short. Two things matter: full contact between tip and skin, because a blister can leave pigmentation in darker skin; and implants, because the current passes through the body, so a pacemaker or other implanted electronic device is a contraindication.

In RF microneedling, needles deliver the current directly into the dermis. This creates tiny wounds, which also makes the technique suitable for scars and uneven texture. Redness and swelling last a few days. If a patient may later want a facelift, it is worth raising this beforehand: RF microneedling can cause fibrosis and adhesions between tissue layers.

In severe laxity with a lot of excess skin, RF is no substitute for a facelift.

Skin tightening devices

The XERF is our device for needle-free tightening, particularly of the jawline and cheeks. In the deepest of its three modes, a single shot delivers energy at 6.78 MHz and then at 2 MHz. The lower frequency reaches deeper and spreads wider into the subcutaneous tissue, spreading the heat across more layers. The device continuously adjusts the energy to the measured impedance of the skin. The XERF page shows before-and-after photos of the jawline and neck after two sessions. The XERF also fits into a treatment plan alongside fillers: fillers restore volume, the XERF tightens the skin.

Where laxity comes with extensive acne scarring or uneven texture, the Genius treats both. Its insulated needles deliver the energy only at the tip, at a depth you set.

For practices already working with the eCO2 3D, deeper CO₂ resurfacing also produces some tightening through the heat around each column, but with the recovery of an ablative treatment.

If you would like to see the XERF or the Genius in action, we are happy to arrange a demo. After installation, we provide clinical training, treatment protocols and technical support. You can buy a device outright or lease it.