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ELOS™ skin tightening
ENG » Procedures » ELOS™ skin tightening
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The ReFirme Skin Tightening Procedure 

The Skin Tightening applicator is indicated for non-invasive wrinkle treatments. 

The Skin Tightening applicator uses a combination of an infrared light source and bi-polar radio frequency to bulk heat the dermis and affect dermal collagen in order to improve skin laxity, sagginess and texture. The infrared light source is a gentle pulse which is well tolerated by all skin types, and heats up the superficial papillary dermis and the deeper reticular dermis at about 1-3 mm in depth. This stimulates long term neo-collagenesis by initializing a fibroblast repair response to tissue heating. The simultaneous combination of infrared (at wavelength of 700-2000 nm) and bi-polar radio frequency provides deep dermal heating, up to 4-5 mm in depth, so there is immediate contraction of existing collagen fibers. This immediate tissue contracture is seen within minutes of the treatment and presents clinically as tighter and firmer skin sensation. 
 
The bulk heating of the dermal layers refers to the gradual and gentle accumulation of heat with each additional pass performed.
 
Collagen and elastin depletion in the dermis results in loss of the dermal volume, presenting as lines, wrinkles, laxity and sagging in the skin. The ReFirme Skin Tightening procedure stimulates long term collagen synthesis as well as the tightening of existing collagen fibers, giving an immediate firmed or tightened appearance. Fine lines and superficial wrinkles appear smoothed out and softened as a result of the tissue tightening and contraction from bulk heating. Laxity of the brow, jowls, neck and cheek areas is improved from immediate tissue contracture, and may continue to improve with the delayed collagen remodeling response.
 

 


Realistic Expectations
 
Deep folds or dynamic wrinkles (wrinkles caused by chronic movement of underlying muscles) are not realistic treatment indications, as there are other factors involved in those types of irregularities than simple depletion of collagen. 

Superficial acne scarring and enlarged pores show some improvement by building new collagen in the dermal area. 

The results of the Skin Tightening treatment may be improved in patients having superficial vascular and pigmented lesions in combination with the Skin Rejuvination treatment.
  
Pre-Post Treatment Care
 
Pre
• The patient should avoid skin irritation or intentional skin tanning.  
• The patient should arrive for treatment with clean skin. There should be no lotion, make-up, perfume, powder or bath/shower oil present on the skin in the area to be treated.
 
Post 
During the first two days following treatment, care should be taken to prevent trauma to the treated area by washing the area gently, without the use of abrasive and harsh products or excess heat. 
  
If superficial crusting or scabbing occurs, do not rub, scratch or remove the scab. Cleanse the area gently and pat dry. 

The patient should use a high factor sunscreen (>30 SPF) and protect the treated area from sunlight for at least two weeks following treatment.

The number of ST treatments depends on the patient and typically varies between 3-5 sessions, every 3-4 weeks. More sessions may be needed for aged skin. 
 
One touch-up session may be needed every ~6 months, according to the individual's response, due to natural processes of aging. 
 
Contraindications 
 
• Pacemaker or internal defibrillator. 
• Superficial metal or other implants in the treatment area.
• Current or history of skin cancer, as well as any other type of cancer, or premalignant moles. 
 • Severe concurrent conditions, such as cardiac disorders. 
• Pregnancy and nursing.  
• Impaired immune system due to immunosuppressive diseases such as AIDS and HIV, or use of immunosuppressive medications. 
• Diseases which may be stimulated by light at the wavelengths used, such as history of Systemic Lupus Erythematosus, Porphyria, and Epilepsy. 
• Patients with a history of diseases stimulated by heat, such as recurrent Herpes Simplex in the treatment area, may be treated only following a prophylactic regime. 
• Poorly controlled endocrine disorders, such as diabetes.
• Any active condition in the treatment area, such as sores, psoriasis, eczema and rash. 
• History of skin disorders, keloids, abnormal wound healing, as well as very dry and fragile skin. 
• History of bleeding coagulopathies, or use of anticoagulants. 
• Use of medication and herbs known to induce photosensitivity to light exposure at the wavelengths used, such as Isotretinoin (Accutane) within the last 6 months, tetracyclines, or St. John's Wort within the last 2 weeks. 
• Facial laser resurfacing and deep chemical peeling within the last 3 months, if face is treated. 
• Any surgical procedure in the treatment area within the last 3 months or before complete healing. 
• Tattoo or permanent makeup in the treatment area. 
• Excessively tanned skin from sun, tanning beds or tanning creams within the last 2 weeks. 
• As per the practitioner's discretion, refrain from treating any condition which might make it unsafe for the patient.
 
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