What is the sagging skin?
Of the phenomena linked to ageing, one of the most difficult to treat is the sagging of cutaneous tissues due to the loss of elasticity, volume and the structure of the subcutaneous connective tissues and of the skin. This phenomenon produces variable consequences from person to person, but it is a constant of the ageing process. The phenomenon affects all the tissues, of the face and neck, the arms, thighs, abdomen and buttocks.
Surgical techniques allow us to reduce the excess skin and to improve the sagging of the tissues, but they involve scars and a limited feasibility (it is not always possible to lift back everything, other than with really invasive operations, which are therefore reserved for super selected cases. So, to treat sagging phenomena it is possible to resort to some technologies which exploit a new production of collagen induced by thermal stimuli: our tissues, in fact, have a natural tendency to respond to heat with the contraction and neoformation of the collagen fibres, and the resulting firming of the tissues and reduction of the sagging. The thermal stimulus can be obtained with various energy sources, like radiofrequency and infrared.
What is the radiofrequency?
Radiofrequency is an electromagnetic current which is emitted from special non invasive devices and it is able to create the production of heat at the level of the dermis and the subcutaneous layer. The same effect of producing heat in depth in the dermis can also be obtained with a thermal infrared based source. The treatment can serve to tone not only the skin of the face and neck, but also of the abdomen, arms, buttocks and inner thighs as well as those areas where cellulite imperfections are present. The final effect is of an effective remodeling of the connective tissue, which is also effective for post acne scars and for the size of the pores of the skin.
Anti sagging techniques
The treatment procedures using these methods are carried out as an outpatient. No preparation is needed, they are not invasive and do not require an anaesthetic. These methods for tightening the skin are suitable for those who are looking to improve the elasticity of the skin without resorting to surgical procedures and without having to face a prolonged healing process. But they are not recommended for patients who are affected by a general disorder of the body (e.g. decompensated diabetes), during pregnancy, or for those affected by collagen or connective tissue conditions in general. Another contraindication is for pacemaker wearers, due to the possible interference on these devices by the current going through the body. Straight after the treatment, the skin in the area treated will feel relaxed with a possible redness which disappears within a few hours. But there is no interruption of one’s work and social routine. The definitive result is not immediate and takes a few months to consolidate. Compatibly with the natural ageing process, the effects are long-lasting and further treatments can be programmed at a distance of months.
The risks in treatments with anti-sagging methods are quite rare, but the potential side-effects of the treatment are given by the prolonged presence of a rash (it normally disappears after a few minutes), puffiness, most frequently around the eye-lids, cheek-bones and neck, and small bumps or hollows in the skin, which normally dissipate after about two-three weeks, alterations in the sensitivity of the skin, which regress in about a month. All of these after-effects disappear normally within a few weeks.
Thermage® is a high powered monopolar radiofrequency (6 MHz) which is carried out in a single treatment (repeatable, if necessary, after 6 months -1 year). The treatment uses a patented radiofrequency technology which has the American FDA approval. The device is equipped with a sophisticated computerized tip which releases a controlled quantity of energy each time the stimulus is delivered. The energy, in the form of heat, warms the tissue of the deeper layers uniformly, at the same time protecting the skin by using a cooling system. This method, which is clinically tested and boasts an important scientific bibliographical supporting documentation which has been published in important medical journals, has proved to be a real and effective remodeling procedure of the contours of the face. The procedure is simple and fast, in general well tolerated and does not restrict the patient’s routine. During the treatment, the surface of the skin is cooled continuously and so the heat only reaches the dermis and the subcutaneous tissue, without any danger of superficial burning or injury. In this way we achieve a homogenous and controlled heating of the dermis and the subcutaneous layer which leads to a relaxing of the tissue and a contraction and compacting of the collagen. As well as the immediate effect of relaxing the skin, in time, there is a remodeling of the collagen, of which there is a new, increased production, which contributes further to the rejuvenation process. Also, the procedure does not involve any post-operative downtime and the patient can go straight back to her social and work routine.
The results will be progressive over time, from the second to the sixth months, resulting from the contraction of the fibres and the formation of new collagen with an appreciable increase in the campactness and smoothness of the skin. The results remain stable for 2-3 years. The procedure has an excellent safety record with more than 250,000 treatments carried out all over the world.
The treatment is carried out on various areas, the forehead, the areas of the cheeks and cheekbones, the skin of the lower part of the face and the neck. Other than the face and neck, many other areas can be treated: the arms, abdomen and inner thighs, the buttocks and knees.
In general, the ideal candidate is a patient, in good health, of an age between 35 and 55, with a moderate level of sagging of the skin, or with a greater amount of sagging but who does not wish to undergo a surgical operation, or a patient who wishes to improve the appearance of her face in a non-invasive manner, by defining the contours and smoothing the features, or a patient with sagging skin on the abdomen, the buttocks, the inner arms or inner thighs. No specific preparation is needed for the treatment. One of the advantages of the procedure it that it allows the practitioner to adapt the therapy according to the patient’s level of tolerance. Each spot corresponds to a sensation of in-depth heat. This sensation of heat only lasts a fraction of a second and is preceded and followed by a sensation of coldness, which reduces the discomfort to the minimum. In some cases, and for certain areas (as is possible for vast areas of the body, as the thighs for example), if preferred, we can combine a mild sedative, which allows the patient to relax peacefully for the whole of the treatment. According to the area to be covered, the Thermage® treatment lasts from a few minutes up to about an hour; the time necessary for a full face, or even more extensive areas of the body. At the end of the treatment there may be some redness, and in some cases, slight swelling. Both of which disappear automatically within a few hours. Normally there is no pain. You can go back to your usual routine straight after the treatment.
In some patients the results are visible immediately, but this is not the rule, since you normally have to wait from four to six months. Since the effects are gradual, the change will not be immediate and will need to be assessed with photos taken before and six months after the treatment. The results are variable from patient to patient and therefore, whilst in some people they will be startling, perhaps even from the start, in others, they could be only modest. This is in relation to the type of skin to be treated and the individual response to the treatment. The result cannot be predicted exactly beforehand and in any case it is fundamental for the patient to have a realistic expectancy and to expect a significant revitalizing outcome rather than a lifting.
For the majority of patients one session is sufficient. It is possible, however to carry out another treatment 6-12 after the first one, with an aim to consolidating and improving the results obtained in the first session. According to the type of skin, the problem treated and the number of treatments carried out, the experience gained so far shows that the results are maintained, even for several years.
Ellman Pellevé ®
Ellman Pellevé® is a 4 MHz radiofrequency method which requires repeated treatments (generally every 15-20 days) and produces a progressive stimulation. In this case, as well, the treatment is absolutely non-invasive and is carried out by moving a handset over the skin which delivers energy to the area concerned. A session for the face lasts about thirty minutes and is completely painless, but it produces a progressive overheating of the tissues of the dermis and consequently stimulates the synthesis of new collagen. The process at the basis of the effectiveness of radiofrequency is linked to the transportation of energy to the deep dermis and to the subcutaneous layers without affecting the epidermis, which is protected by the continuous movement of the handset which prevents heat accumulating on the surface. The heating of the area treated produces different results, like the improvement of the circulation of the blood and the reabsorption and draining of excess liquids, but above all the neoformation of collagen with the resulting improvement of the elasticity of the tissues. The results are visible from the first treatments, but in particular in the following months. The effectiveness in fact is proportional to the new production of collagen, which is stimulated by the treatment which, being a biological mechanism based on the individual, takes some time before it is apparent. How long the results last depends on many factors, amongst which the patient’s age and lifestyle. Therefore, the treatment can be personalized on the basis of the patients’ different requirements.
Palomar LUX IR Fractional ®
The infrared handset of the Starlux Palomar station emits fractioned infrared radiation which reaches the deep tissues. The radiation causes a controlled increase in the temperature at the level of the dermis, which is able to stimulate its contraction and the neoformation of collagen.
This technology develops a series of micro infrared radiations which rain on to the dermis at a depth varying from 1 to 3mm. The heating of the deep tissue occurs in a discontinuous way (fractional), leaving micro-islets of tissue which are not treated directly. This is to guarantee maximum safety and prevent excessive heating of the area treated. The fractional heating of the dermis has shown to be capable of stimulating a biological response which leads to a remodeling of the collagen of the deep dermis. This helps to reduce the wrinkles and to give a new firmness to the relaxed skin, with lasting results.
The treatment is extremely well tolerated thanks to the cooling supplied by the handset, before and after every single hit. The cooling brings the point of the handset down to 5° degrees and guarantees an excellent control of the hot sensation which is produced during the delivery of the infrared energy.
As for all treatments aiming at toning the tissues by acting in depth and not on the skin, this one can be carried out on all skin types as well and in any season as it does not sensitize the skin to the light of the sun.