Energy Driven Devices to Soften Wrinkles and Resurface the Skin<title> <HEAD> <TITLE>Energy Driven Devices to Soften Wrinkles and Resurface the Skin

Energy Driven Devices

Intense Pulsed Light, Titan and Thermage

Lois W. Stern

With grateful appreciation to:
Dr. Vic Narurkar, Dr. Lawrence Bass, and Michelle Martel for their invaluable input in developing this article.

A number of devices are on the market in the United States for skin tightening and smoothing on both the face and body. In fact, skin tightening and wrinkle reducing treatments with lasers and other energy delivery devices in combination with volume restoration can postpone the need for a facelift or other surgical skin removal procedures for some time. While such treatments will not totally eliminate the need for surgical procedures for facial rejuvenation, these approaches are the mainstay of modern strategies to maintain and restore a youthful facial appearance in the least invasive manner possible.

Energy driven devices are designed to soften wrinkles and resurface the skin, tighten skin laxity and improve a variety of other skin conditions, including pigment and vascular skin changes, age spots, rosacea, acne scars and spider veins. The two big pathways in facial rejuvenation are skin laxity and skin surface problems. Skin laxity is largely treated with some kind of surgical option, whether it is a minilift or a more classical full lift. Increasingly, individuals with very early laxity or a small amount of residual laxity after a surgical facelift are being treated with energy-based treatments specifically designed to address skin laxity.
  • Intense Pulsed Light (IPL) Intense pulsed light is one energy driven treatment that uses a high-energy flashlamp to deliver multiple wavelengths, or colors of light, in a short bursts or camera-like flashes. This light source energy creates waves just like an ocean, but now these waves are inside your body. These treatments can be focused on certain wavelengths and pulse durations for treating different conditions such as age spots, unwanted hair, rosacea and telangiectasias (broken blood vessels). They do not serve as a useful treatment for wrinkles. Typically two to four treatments are required separated by several weeks each. The person emitting the light source needs experience and technique to know just how to achieve their goal without hitting and damaging non-target areas. An overkill of IPL treatment can result in damage, such as the zebra stripes seen on an arm that formerly had only brown spots.
    Watch this video of an IPL treatment in action plus before after photos showing how it has successfully treated a variety of different skin conditions.

  • Thermage – Although often referred to as a laser, Thermage® actually operates with radio frequency current that typically is delivered in the form of two treatments. It was born as an anti-aging, minimal down time, non-surgical treatment. Radiofrequency energy is delivered in postage stamp size spots over the face in two passes. This causes heating in deep layers of the skin, which the body responds to over time with some skin tightening. There is little recovery after each treatment. Risks in a conservatively performed treatment seem to be minimal. Unlike many light based treatments, Thermage® is not restricted to light skinned individuals or those without a suntan. However, excessively aggressive treatments can cause skin burns and damage to underlying fat and muscle, resulting in depressions or other deformities. This illustrates why it is important to accept what a treatment can reasonably provide, use it in appropriate circumstances and not try to push it too far. When it comes to Thermage®, more is definitely not better. Also, these treatments are not for the person whose extreme skin laxity is screaming for a facelift. A more suitable patient is someone early in the aging process or who has undergone surgical skin tightening with a small amount or area of residual laxity. Despite its potential flaws, Thermage is still an excellent choice for facial areas where little fat or muscle exists. Again the experience of the technician is key.

  • Titan™ Titan™ is the second principle treatment available for skin laxity. It is a light based treatment that uses pulses of light to create deep skin heating while surface layers are simultaneously cooled. The skin surface is protected from blistering while deep layers undergo thermal changes that stimulate the body to add new collagen and tighten the skin. After several treatments and several months for your body to respond, laxity is diminished. Durability of the improvement seems to last up to two years or maybe a little longer if you respond well. This is significantly less than the typical duration of improvement obtained with surgical lifting. Watch a video where the Titan is demonstrated on the popular TV show, The View
The Effectiveness of Energy Driven Devices
The biggest issue with non-surgical skin tightening as it stands today is the degree of improvement. Controversy exists over what percentage of patients are non-responders, but suffice it to say that it is a substantial number. We only find out if a given patient will respond several months after treatment. This is a frustrating aspect of the current state of the art in non-surgical skin rejuvenation.

Combining radiofrequency and fractional resurfacing, a procedure which has been coined Thermafrax, may produce more consistent results. It seems that there is synergy between the two procedures, once again advocating the concept of combination therapies. Fraxel treatments show more immediate results with improvement of skin tone, texture and subtle tightening, while Thermage treatments will augment the tightening effects. The advantage of this combination approach produces the immediate effects seen with Fraxel and the delayed effects seen with Thermage, as well as the complimentary approaches of both - with the former addressing resurfacing and the later addressing three dimensional skin tightening.

Continued research is working toward overcoming this obstacle. Researchers have devoted increasing attention to ultrasound technologies for rejuvenation over the past few years. Energy can more easily be directed beneath the skin using ultrasound than laser and radiofrequency while keeping the skin safe. Non-surgical skin lifting and correction of cellulite are the two principle examples of problems requiring fixes deep within the skin.

The take home message about all of these non-surgical shrinking devices is that these techniques are not a substitute for the surgical lifting procedures. A surgical facelift produces a greater degree and durability of improvement, but at a greater consumer cost in terms of dollars, recovery time, incisions and possible scars.Energy driven treatments are appropriate for minimizing early aging changes and skin defects long before surgical procedures are warranted. In fact, skin tightening and wrinkle reducing treatments with lasers and other energy delivery devices in combination with volume restoration can postpone the need for a facelift or other surgical skin removal procedures for some time. These combination approaches are the mainstay of modern strategies to maintain and restore a youthful facial appearance in the least invasive manner possible.

Want to learn more about laser treatments?

To learn about the milder, franctional lasers, click here.

To learn about the more aggressive fractional and field ablative laser treatments, and what you can expect from them in terms of downtime and results, click here.

© 2011, 2013 by Lois W. Stern

Lois W. Stern is the author of Sex, Lies and Cosmetic Surgery and Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour as well as numerous magazine articles. Her Professional Edition DVD is a popular aid to office staff while interacting with their patients.

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