Near Painless, Nonablative, Immediate Skin Contraction Induced by Low-Fluence Irradiation with New Infrared Device: A Report of 25 Patients

BACKGROUND: Nonablative radiofrequency (NARF) has been the only method for producing noninvasive skin tightening. Nevertheless, significant pain during the procedure is an important downside of this technology. A new nonablative medical device, Titan (Cutera, Inc., Brisbane, CA, USA), capable of fluences much lower than those possible with NARF, was tested as a less painful alternative. OBJECTIVES: To produce skin contraction leading to lifting of eyebrows and/or improvement of lower face and neck skin laxity using fluences below pain levels. PATIENTS AND METHODS: Twenty-five patients were treated. Standardized photographs were obtained preoperatively, after a few days, a few weeks, and up to 12 months after the procedure. RESULTS: Immediate changes were obtained in 22 of 25 patients. Examination of photographs revealed that the initial improvement was maintained throughout the follow-up period. CONCLUSION: Immediate true skin contraction persisting through the immediate, intermediate, and long-term follow-up was found in the vast majority of patients in this group. Edema as an artifact simulating immediate improvement was excluded by serial photographs taken during the follow-up period. Skin contraction occurred at low fluences, below the threshold of pain. This, to the best of our knowledge, has not been previously described in the medical literature.