Definition & Overview

Radio frequency skin tightening is a non-invasive aesthetic procedure that uses radio frequency or RF energy to correct laxity and improve skin’s overall appearance. It works by heating the deep layers of the skin, causing the collagen and elastin to become inflamed. The body reacts to the process by forming new collagen and elastin, which effectively firms up or tones the skin.

Who Should Undergo and Expected Results

Radio frequency skin tightening is recommended for those with loose or sagging skin particularly on the face, neck and chin, arms, thighs, and abdominal area. As a less conservative method, the procedure works best for mild to moderate cases of skin laxity and for those who seek a noninvasive alternative to facelift, liposuction, and tummy tuck. Individuals with residual skin laxity following a surgical procedure are also candidates for this aesthetic treatment.

Radio frequency skin tightening can be expected to effectively tighten up loose skin and eliminate sagging, leading to a general improvement in the quality and appearance of the skin. It can also eliminate wrinkling and achieve instant visible results that can further improve over an extended period.

How is the Procedure Performed?

Radio frequency skin tightening is performed in a hospital, clinic, or aesthetic center. It is an outpatient procedure but patients need to come back for about 8 to 10 sessions, each lasting an average of 30 to 45 minutes, to complete the treatment program.

During the procedure, the patient is first asked to lie down and the entire treatment area is measured then marked. A sedative or a numbing medication is then provided as well as a cooling gel to provide protection for the skin. Once the patient is ready, the aesthetician presses the tip of the radio frequency device on the patient’s skin, sending a pulse of heat into the deeper layers of the skin. The process is repeated multiple times over the treatment area to achieve maximum effects.

To ensure patient safety, the devices used in the procedure have a built-in cooling system that provides sufficient epidermal cooling during and after treatment. This way, the goal of the procedure is achieved without causing injury to the epidermis (the visible part of the skin).

Several different companies currently manufacture radio frequency skin tightening devices that differ based on the number of electrodes used, which determines the depth that they can penetrate. Presently, monopolar radio frequency devices are considered the safest and gentlest non-ablative choice because of their ability to deliver uniform levels of heat at controlled depths.

Some examples of these devices currently in use include Thermage, Venus Freeze, and VelaShape, which are produced by Solta Medical, Venus Concept, and Syneron, respectively.

Among these examples, Thermage was the first radio frequency skin tightening device to emerge. It has now been succeeded by the company’s latest model, the ThermaCool NXT. The new monopolar device is upgraded with several key new features including a Comfort Plus Technology tip that massages the skin as it delivers radio frequency energy. This is just one of the many new features that are added to radio frequency devices with the goal of improving patient comfort during treatment. Studies show that the upgraded Thermage device achieves immediate tissue tightening in as much as 87% of patients. It was also found that only 5% of patients found the procedure too painful, a significant improvement from the 45% of patients who complained of severe pain from earlier models.

In addition to monopolar devices, the Aluma, manufactured by Lumenis, is an example of a bipolar radio frequency device, while the Accent, produced by Alma Lasers, combines bipolar and unipolar technologies.

Possible Risks and Complications

Radio frequency skin tightening is a relatively safe and proven technique of tightening and rejuvenating the appearance of loose skin. However, it comes with a number of risks, most of which are related to its use of high-energy radio frequency technology which means that the procedure comes with a degree of radiation exposure.

In addition to this, many patients who undergo the procedure report to experiencing pain, causing most of them to require sedation or stop treatment altogether.

A number of negative long-term effects have also been reported in some cases, including:

  • Fat necrosis
  • Atrophic scarring
  • Skin deformity or depressions, usually caused by subcutaneous fat that dissolves due to radio frequency energy
    To help prevent or minimize the risks and complications, the procedure should be performed by licensed and experienced professionals.

Also, it is crucial that patients’ expectations are managed prior to the procedure. Radio frequency skin tightening produces less extensive and less dramatic results compared to more invasive surgical techniques such as traditional facelift or tummy tuck. Although some improvement is immediately noticeable following the procedure, it may take up to 6 months for the full effect to become visible.


  • Gold, M. (2010). “Update on Tissue Tightening.” The Journal of Clinical and Aesthetic Dermatology. 2010 May; 3(5): 36-41.

  • Gold, M. (2011). “The Increasing Use of Nonablative Radiofrequency in the Rejuvenation of the Skin.” Expert Review of Dermatology. 2011; 6(2):139-143.

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