Everything tight? Skin tightening from non-invasive to surgical.

Skin tightening

Firm and elastic skin is a sign of youthfulness and vitality. But as is so often the case, nature throws a spanner in the works: as we age, our skin loses firmness and elasticity – wrinkles appear and excess skin causes facial contours to sag. Various anti-ageing methods promise a remedy – but which ones actually have the desired effect and what about the downtime?


Skin tightening as a holistic concept

In our practice, the symbol of the pyramid stands for a holistic treatment concept. This applies to all our treatments but can also be applied explicitly to skin tightening. Non-invasive methods are at the bottom of the list, followed by minimally invasive methods, right up to the top with surgical procedures. The higher up, the greater the effectiveness and intensity of the treatment. As a general rule, the more pronounced the skin sagging, the more intensive the treatment. In most cases, the various methods can also be ideally combined. This applies in particular to medical cosmetics, which is always part of successful skin optimization.

Comprehensive and honest patient information is essential. Both the risks of surgery and the limitations of minimally invasive methods must be clearly and transparently explained.

The causes of sagging skin

Collagen and elastin are mainly responsible for the firmness and elasticity of our skin. Together with the body’s own hyaluronic acid, these connective tissue fibers ensure stable and supple skin. In the course of the natural aging process, various metabolic processes slow down, the production of collagen and elastin fibers decreases and the connective tissue becomes weaker. This results in a loss of volume and sagging skin areas.

The ageing process is largely hereditary. However, external environmental factors such as UV rays, particulate matter and individual lifestyle – i.e. diet, alcohol, smoking, etc. – also play a role that should not be underestimated when it comes to skin health. The statement “Anti-ageing starts at 20” therefore makes perfect sense when you consider that preventative measures are the best way to lay the foundations for healthy, young-looking skin.


Can medical cosmetics tighten the skin?

Admittedly, no cream in the world can even begin to replace a surgical facelift or eyelid lift – but the importance of medical skin care should not be underestimated. Because one thing is clear, advanced and highly effective ingredients can make a significant contribution to skin health and a younger appearance. They protect our skin from free radicals, strengthen the skin’s protective barrier and are even able to stimulate cell metabolism and fibroblasts.


… and what about tightening?

The combination of retinol and DEANOL has proven particularly effective for skin tightening. The active ingredient DEANOL stimulates the production of lecithins, which are important components of the cell membrane. Individual micro-muscle fibers (MYOFILAMENTE) are also tightened, which can effectively tighten the skin. In contrast to DEANOL, retinol does not stimulate the muscle fibers, but the collagen and elastin synthesis as well as the fibroblasts. The skin-rejuvenating effect has been scientifically proven and becomes apparent after 3 to 6 months of use. Lines are reduced, the skin is tightened, pores are refined and the skin tone is evened out.

The two active ingredients complement each other perfectly and can be used as a firming treatment for the face, neck and décolleté: Retinol at night and DEANOL during the day. Of course, skin rejuvenation does not happen overnight, but requires patience (at least 3-6 months) and professional application.

Minimally invasive treatments for skin tightening


Radio frequency

Radiofrequency has been used successfully in aesthetic medicine for a long time. Above all, the combination with classic microneedling makes the treatment even more efficient.

And this is how radiofrequency microneedling works:

Based on the principle of bipolar and monopolar radiofrequency, the thermal energy is directed into the dermis using superfine microneedles. The targeted heat development in the deeper layers of the skin leads to the formation of new collagen and elastin. The tissue is tightened from the depths without straining the surface of the skin.

Depending on the intensity of the treatment, an immediate effect is visible. The positive effect increases over the following days and months, as collagen and elastin are only gradually formed.

Immediately after the treatment, there may be slight redness and swelling, which can last for 1-2 days depending on the intensity of the treatment. After one week, the skin is completely regenerated.

More about radiofrequency microneedling


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Another minimally invasive tightening treatment is the HIFU high-frequency ultrasound technique. In this application, the connective tissue is heated precisely at a defined depth below the skin surface. This results in tissue tightening and the formation of new collagen and elastic fibers in the face, neck and décolleté. However, this treatment does not have an immediate effect. The tightening is carried out gradually over a period of three to four months. Ultrasound treatment can be a good alternative to a surgical lift, especially for middle-aged patients.

More about ultrasound treatment


Laser treatments are at the next level of the treatment pyramid. In contrast to a surgical facelift, the laser cannot achieve remodeling and facial shaping – the great advantage, however, is that the skin quality can be improved, which is not the case with a surgical lift.

The individual laser pulses cause the connective tissue fibers in the deeper layers of the skin to contract, resulting in a lifting effect. At the same time, the formation of new collagen and elastin fibers in the skin is stimulated and regenerative biological processes are set in motion, leading to skin rejuvenation.

Depending on the intensity of the treatment, 2-3 treatments at intervals of 4-6 weeks are recommended for lasting skin tightening.

More about laser treatment


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Facelift & eyelid lift

From around the age of 50, many people experience a clearly visible loss of shape or a lack of demarcation between the face and neck. If the neck and lower chin area have excess fatty tissue, severe wrinkles can also form in the neck region. A facelift or neck lift provides a remedy by restoring the harmonious overall appearance of the face and neck and improving the definition of the lower jawline. The facelift is often performed with a correction of the upper and lower eyelids.

More about the facelift


Basically, we can say that a conscientious skincare routine with antioxidant, protective and stimulating active ingredients is always worthwhile. Both for prevention (this also includes sun protection) and to gently stimulate cell renewal. Minimally invasive methods are the right choice for the first signs of sagging skin . The body’s own repair mechanisms can be activated and the production of collagen and elastin stimulated with laser, ultrasound and radio frequency. The tightening effect is of course nowhere near as pronounced as with a surgical lift – but it is much gentler, less painful and has a clear advantage in terms of risk and downtime. A facelift is still the most effective method of skin tightening and is the right choice for severely sagging areas of the face and neck.

And what about the phenol peeling?

The question is always how you define the term “tightening”. If the tightening is related to the smoothing of wrinkles, the phenol peel is definitely a tightening treatment. For tightening in the facial area, phenol peeling can almost completely replace a facelift. However, unlike a facelift, deep peeling is not able to lift sagging areas of skin. In addition, the phenol peeling cannot be used on the neck. In most cases, the only option for an effective neck lift is a surgical neck lift. The following illustration clearly shows the differences between facelifting and phenol peeling.

Combination of phenol peeling and facelift

Phenol peels and facelifts complement each other well in terms of indications and can be combined to a certain extent. However, there are limits. This is because peels increase the trauma after a lift depending on the type of peel and the extent. The general edema, the restriction of tissue perfusion and the pain must always be kept to a tolerable level.

You can find out more about phenol peel and facelift in this article:

Do you have questions about skin tightening or another treatment? Together with my team, I will be happy to provide you with advice at any time.