In recent years, we have seen a wide variety of options for laser skin tightening enter the aesthetic marketplace. Thermage is no doubt the most recognized technology, thanks to several demonstrations on Oprah and a few reruns.
Syneron's ReFirme has been growing in popularity with the help of singer Carnie Wilson, who underwent ReFirme treatments to tighten her skin post weight loss.
All of the providers listed to the right offer some form of skin tightening technology. Contact your nearest provider to learn more.  Thermage
Thermage targets the collagen incorporated in the under layers with Capacitive Radiofrequency (CRF) technology that tightens and contours the skin to create a smoother tone and more youthful appearance. A treatment will last from 20 minutes to 2 hours depending on the areas of skin the patient wishes to treat. One of the most compelling reasons for the Thermage popularity is its instant-gratification factor. Results begin immediately as soon as treatment takes place and improvements to the skin's texture and appearance will continue as new collagen grows, often for months. Like any medical technology, over time the providers develop techniques and strategies to maximize the potential of the treatment. Thermage has advanced in leaps and bounds thanks to the research and thoughtful treatment parameters of a key group of physicians. Contrary to rumors and noisy opinions, Thermage does work, and it does not hurt. You must ask your doctor if you can see before and after pictures, and if you can speak to other patients who have had Thermage. You also need to be realistic about your expectations and feel completely comfortable with what you're signing up for, because there is no non-surgical treatment alternative that will result in a surgical outcome. Several other technologies have entered the marketplace and are gaining in popularity as the public becomes aware of the existence of skin tightening procedures.
 Reaction By Viora
The Reaction by Viora is the first and only multi-frequency RF device that is FDA cleared. By applying bi-polar RF energy to heat the dermis, tissue fibers are strengthened and dermal collagen improves skin laxity, sagginess and texture. CORE technology distributes heat using multiple Radio Frequencies in 3 different treatment modes that target different tissue depths, from superficial layers of the skin to the hypodermis. The 4th mode - multichannel mode - creates a stronger, more accurately distributed thermal response that travels through all skin layers. Using proprietary CORE™ technology and an integrated skin cooling mechanism, the applied RF energy stimulates fibroblasts in the dermis to improve the skin's elasticity, enhance collagen secretion and induce the production of pro-collagen for long-term effects. After the first treatment, smoother contours and an overall improvement in skin texture and laxity is visible.
 Refirme by Syneron
Video: Extra, January 31, 2007; Carnie Wilson's New Confession - Carnie Wilson talks about her Refirme and Velasmooth treatments
Refirme offers a non-surgical and much less painful alternative for patients wanting to achieve skin tightening and improvement in skin laxity through wrinkle reduction on the neck, face, and other areas of the body. Another advantage of ReFirme is that with a pulse repetition rate of one pulse per second, and using Syneron's unique elos technology, the ReFirme treatment is one of the fastest and most effective on the market for the purpose of skin tightening and wrinkle reduction.
 Titan
Cutera, Inc. makes the Titan ("tighten") skin tightening laser, which is a safe, non-surgical process that uses an infrared light source to tighten skin and reverse the signs of aging. The Titan heats the dermis to cause collagen contraction while preserving the epidermis through continuous cooling. In addition, Titan can stimulate long-term collagen rebuilding that leaves patients with younger looking skin. This device has also been used successfully in other body areas such as abdomen, arms, upper chest, and thighs. Most patients notice immediate changes which gradually improve over sevearl weeks. There is hardly any pain, to the point of needing no anesthesia. There is no down time and no incisions or scars either. Many patients look much better and younger after the procedure, because the results are a remarkable natural look which plastic surgery rarely can match. In spring of 2006, Cutera introduced 3D Rejuvenation, a highly effective trio of laser treatments designed to target uneven pigment, pore size, wrinkles, and elicit collagen contraction over time. 3D treatment includes three of Cutera's best technologies: Photo Genesis, Laser Genesis, and Titan.
Aluma
Aluma skin renewal treatments turn back the clock and gently reverse the aging process. This revolutionary technique delivers energy safely and comfortably to the underlying layers of the skin, gently stimulating the production of new collagen, while protecting the outer layer of the skin. The new collagen that is formed plumps and smoothes the skin, making it appear more youthful. The Aluma system with FACES technology works by creating a controlled volume of heated tissue in the dermis (deeper skin layers). Improving on earlier technology such as Thermage, Aluma's technology is truly a breakthrough approach to treatment. The vacuum-assisted and bipolar radio-frequency (RF) handpiece conforms to the skin to allow the energy to safely bypass the epidermis (top layers of the skin) and places the dermis (deeper skin layers) directly in line with the beam of energy. The RF energy is restricted only to the intended target, thus limiting any pain previously associated with skin tightening methods. Energy is deposited deep within the dermis, creating a uniform and contained zone of heating, which results in collagen contraction and renewal with little to no discomfort. In the months following treatment, the body's natural processes result in the generation of new collagen and dermal remodeling. As new, "younger" structured collagen is laid down, the skin looks tighter, firmer and more youthful. A treatment typically takes only 15 minutes and patients can immediately return to work and their normal daily activities.
SkinTyte The SkinTyte procedure is available from Sciton. SkinTyte delivers uniform, targeted and deep heating to effectively treat the desired area stimulating collagen remodeling and contraction. Since there is no downtime, patients may resume their regular activities immediately following treatment. SkinTyte utilizes advanced infrared light technology to deeply heat dermal collagen while continuously protecting the treated epidermis with sapphire contact cooling for maximum safety and comfort. With no need for a topical anesthetic, the energy is delivered in rapid, gentle pulses to promote contraction and partial coagulation of the collagen, initiating the body’s natural healing process. Following treatment, a new foundation of collagen is created leading to increased skin firmness.
GentleYAG
The GentleYag laser treatment tightens the skin by transferring heat to the deepest layers of the skin. The non-ablative laser creates thermal injury below the epidermis resulting in a healing response to the upper dermis. This process then causes the dwelling fibroblasts to stimulate the precursors of collagen, elastin, and other proteins. By activating enough of your own collagen source, wrinkles and sagging skin can diminish within weeks after the treatment. Some patients have reported that they can see results in just a few days after treatment; however, the optimum results occur anywhere from 4-6 weeks after the treatment. If recommended, a second or third treatment may be done approximately 6 weeks apart. As gravity and the aging process naturally take place, the skin loses its youthful appearance, but this treatment is a great alternative to a surgical facelift.
Polaris
Polaris WR is FDA approved and is the latest in the Syneron family of cosmetic non-ablative technologies used for turning back the colck on age and treating skin problems. The Polaris WR is a non-ablative, skin rejuvenation device that uses dual technology - radio frequency and a diode laser. This particular combination of energies is what sets Polaris WR apart from the rest. The scientific principle behind the effectiveness of Polaris is the ability to allow deep dermal thermal (heat) penetration without damaging healthy tissues and with no deleterious effects on the skin surface. Like other non-ablative technologies, it creates just enough thermal stimuli to initiate collagen growth.
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