Skin Tightening

Our skin is a natural barrier protecting us against damage by the environment. It accumulates physical, chemical and solar damage over the course of our lives. Healthy, youthful skin is taut and has an elastic bounce. It has an intrinsic lustre and is devoid of irregular pigmentation.

In contrast, aged skin is characterized by wrinkles, appears dull, thin, crepe-like and has irregular pigmentation. Skin tightening treatments aimed at reversal of age-related skin laxity is a popular request among individuals seeking aesthetic rejuvenation.



How does damaged skin arise?

The skin achieves maximal thickness at around the third decade of life. Thereafter, dermal thickness decreases 6% per decade of life. With advancing age, there is reduced production of type I collagen, elastic fibers and ground substance (glycosaminoglycans and proteoglycans). The end result is skin thinning, loss of skin elasticity and firmness, and consequent formation of fine wrinkles that gradually progresses to deep wrinkles.

Skin damage is related to the cumulative lifetime exposure to UV light. The UVA light spectrum causes skin aging by activation of the metalloproteinase enzymes that cause degradation of collagen and elastic fibers. The UVB and UVC light spectrum causes direct DNA skin damage and is associated with skin cancer.

Smoking generates oxygen radicals that stimulate metalloproteinase enzymes involved in skin aging. In an interesting study of skin aging in twins, where only one twin is a smoker, it was demonstrated that the smoking twin always appears more aged than the non-smoking twin, with every 10 years of smoking leading to a 2.5-year perceived age difference.

Excessive caffeine consumption reduces collagen type I synthesis by up to 15%. This has been demonstrated at a blood concentration of caffeine corresponding with three or more cups of coffee per day.

How do I prevent aging changes in my skin?

The most important measure in maintaining skin health and delaying aging is prevention against UV light exposure. This involves the liberal use of sunblock and protective clothing when outdoors. Smoking cessation is also an important measure. Smoking cessation counselors and use of nicotine patches have been shown to help smokers stop smoking more successfully than self-attempted cessation programs. Sufficient sleep, reduction in caffeine intake, and a sensible diet, all contribute to good skin health. Finally, regular use of moisturizing creams and lotions is helpful for those with dry skin to maintain skin hydration and glow.


Non-surgical skin tightening is a popular request among individuals seeking minor aesthetic improvement while wishing to keep the recovery time to a minimum. Treatment options for skin tightening include high intensity focused ultrasound (HIFU) and radiofrequency skin tightening.



High Intensity Focused Ultrasound (HIFU)

HIFU delivers ultrasound energy up to a skin depth of 5 mm, which is converted to heat energy and creates a progressive thermal effect from the inside out. This heat causes shrinkage of loose collagen and elastin fibers of the skin and reduces the subcutaneous fat volume. Heat also stimulates inflammation and natural body tissue regeneration, both of which continue in the background for weeks after completion of the treatment.

Picasso Plastic Surgery uses a proprietary HIFU system that delivers energy in a fractionated mode. This system also combined with a 635-nm cold laser, which is ideal for biostimulation and enhancing skin glow. The treatment causes minimal pain and discomfort and each session lasts between 30 minutes to 1 hour.

No special post-procedural care is required and individuals may resume their usual activities following the procedure. Repeat treatments may be performed at 3- to 6- week intervals for optimal results before converting to maintenance treatment.

Radiofrequency (RF) body tightening

Radiofrequency body tightening is a non-surgical method that delivers deep heating of the dermal collagen fibers, the surrounding connective tissue and the adipocytes (fat storage cells). This may be combined with other low intensity skin tightening technologies, such as infrared light and vacuum, to further stimulate new collagen production, resulting in localized reduction of skin laxity and an overall improvement in skin texture.

Good candidates for RF body tightening are individuals with reasonably good quality abdominal skin seeking for minor improvement, and have a BMI of 25 or less. Typically, these are females who have very mild degrees of skin laxity following childbirth. This treatment is not a suitable method for weight loss.

We use a proprietary RF/infrared light/vacuum system that delivers treatment in a gentle, controlled manner that causes minimal pain and discomfort. Each session lasts between 1 to 2 hours.

A warm sensation and slight skin redness may be visible following treatment. Recovery is generally complete by 24 hours. No special post-procedural care is required and individuals may resume their usual activities following the procedure. Repeat treatments may be performed at 3- to 4- week intervals for optimal results before converting to maintenance treatment. A healthy diet and exercise regimen is required for maintenance of results.

Other non-surgical Skin Treatments

Non-surgical Skin Tightening: HIFU & Radiofrequency Tightening in Singapore