Both ablative and nonablative technologies can rejuvenate the skin. They can also be used to treat acne scarring. Nonablative technologies like intense pulsed light can treat brown spots and control redness associated with rosacea.
"If you think of the face as a balloon, it is losing volume over time," says Dr. Narins, a dermatologic surgeon in New York.
"You can make the balloon tighter by taking out the skin or you can fill it up again. If you fill it up and smooth it out a little, that can essentially give back that youthful look," she says.
"We use Thermage® (a radiofrequency machine made by Thermage®) on the face, neck or forehead," Dr. Narins says. "In some patients it gives a really good result. In others, it gives a moderate result, but it is not a facelift. It induces the body to make collagen and tightens the area. We use it in combination with Botox and fillers. You can get unbelievable rejuvenation when you use the three of those in combination."
In some instances, patients require an invasive surgical procedure, such as a facelift, because the patient's skin is so loose, Dr. Narins tells Dermatology Times.
Facelift vs. fillers
"About 10 percent of people need to go for facelifts, but the other 90 percent will look great with filling, because the filling substance not only fills, but induces collagen that smooths out the skin," Dr. Narins says.
"When you combine the 'no downtime' procedures, you can get a great result. There has been a tremendous decrease in the number of facelifts because of the fabulous way we can fill by volumizing now, and not just filling in lines," she says.
Some of the nonablative procedures involve technologies such as lasers, intense pulsed light (IPL) and radiofrequency devices, Dr. Narins says. The ablative technologies, such as fractionated CO2 laser, a CO2 laser or medium peel mean about a week downtime for the patient.
"You get much, much more tightening from these treatments," she says. "If you want to treat acne scarring, there is nothing as good as a CO2 laser."