Non-Surgical Skin Tightening
A non-surgical skin tightening procedure can be an excellent option for patients in the early stages of aging as well as in older patients who wish to avoid surgery. Recent innovations in technology enable the safe use of heat energy within and underneath the skin to both trigger an improvement in skin quality as well as lift and tighten laxity. Dr. Forley uses a variety of effective delivery systems for radiofrequency (RF) energy such as FaceTite, BodyTite, AccuTite, Morpheus8, and Evoke to deliver meaningful improvements to his patients. In some cases, RF skin tightening is combined with fat contouring to achieve improvements in the jawline and neck, the upper arms, abdomen, hips, thighs, and knees. Evoke is a new non-invasive bulk heating device that delivers a sustained delivery of RF energy using surface electrodes to stimulate a remodeling of the jowls and neck in a series of 3-6 weekly painless treatments with no downtime. Ultherapy uses focused ultrasound energy to lift and tone the skin through a surface transducer that also enables visualization of the layers below the skin during the treatment. The gradual onset of results can last up to 18-24 months. Silhouette InstaLift improves jawline definition and facial folds with absorbable suspension sutures containing small, smooth cones that achieve a mechanical fixation of the sagging layers in a more uplifted direction.
FACETITE / BODYTITE / ACCUTITE / MORPHEUS8
Skin tightening without surgery is possible with the new InMode RF system that utilizes bipolar radiofrequency (RF) energy to achieve a lifting of sagging tissues. The FaceTite/BodyTite/AccuTite applicators require only a needle entry point to be positioned immediately below the skin. A painless gliding movement of the applicator, under local anesthesia, delivers controlled heating of the fibrous bands attached to the undersurface of the skin as well as the external skin surface. Morpheus8 is a RF device that can be used to remodel fat contours and enhance the overall tightening and qualitative improvement of the skin in a series of 3-6 monthly treatments. It has a synergistic effect when combined with FaceTite/BodyTite/Accutite. Most patients experience minimal post-procedure discomfort with minor bruising and swelling that usually resolves over 4-5 days. The scarless tightening and lifting process that the treatment initiates evolves over a span of 6-12 months and can last for several years.
Radiofrequency Assisted Liposuction (RFAL) is a technique that combines liposuction of unwanted deposits of fat from specific areas of the body including the face and neck, upper arms, trunk, abdomen, buttocks, hips, thighs, and knees with the InMode RF system. RFAL enables the treatment of localized fat deposits that do not respond to diet or exercise and simultaneous RF non-excisional skin tightening using the thermal field that flows directly from the tip of the cannula to the external surface electrode. This process enables the treatment of sagging tissues of the body without the more extensive visible scars that result from excisional surgical procedures.
Body treatments are now even more effective with the new Morpheus8 Body 3D technology. The redesigned treatment tip enables RF energy to be delivered in a unique radiating pattern of inner, middle, and external rings of microneedles for more effective delivery of a uniform tissue heating effect.

The application of Burst Mode enables 3 different depths to be treated in sequence with each pulse to create an even more inclusive treatment zone resulting in superior outcomes.

EVOKE
Evoke delivers precisely controlled radiofrequency (RF) energy below the skin to remodel the jowls and neck in a series of painless, non-invasive, no downtime treatments. Specially designed masks to position the surface electrodes for the lower face and jowls as well as the neck are connected to the base energy unit and applied securely to the treatment sites. The RF energy that is delivered through the electrodes is constantly calibrated to maintain a consistent therapeutic level of bulk heating for each 45 minute session. The feeling is one of a gentle warmth that is well tolerated. You will be able to sit up and read, use your phone, or work on your laptop while the hands-free treatment is being delivered. Following an initial clinical evaluation by Dr. Forley, a series of 3-6 weekly or biweekly sessions are usually advised for the best results. The gradual, natural appearing improvements that begin to appear over the first month will continue to progress for several months. Evoke can be used as an independent treatment or to enhance the results of other non-invasive procedures. It can also be used to improve the quality of the tissues of the face and neck and stimulate blood flow in preparation for surgical procedures. The interval for maintenance treatments will vary but the average is about 12-18 months.
ULTHERAPY
Ultherapy is a non-surgical treatment that uses ultrasound energy to safely lift and tone the skin without any downtime. The ultrasound image on the viewing screen allows Dr. Forley to see the precise level at which the energy is being delivered. The focused sound waves create targeted heating of the deep layers of the face, brow, and neck that have lost their elasticity and firmness over time. Because the sound waves pass directly below the surface of the skin, the deep support layer responsible for sagging is tightened without disrupting the skin. Ultherapy can also be utilized for treated wrinkling of the décolletage that frequently results from sun damage. Following an Ultherapy treatment, some early improvements may be visible with contraction and firming of the tissues but the building of new collagen occurs gradually over 3-6 months. The combination of contraction of the tissues and new collagen formation can achieve significant lifting and tightening results. Although the outcome does not duplicate that of surgery, the visible improvements of Ultherapy make it a compelling non-invasive option for those who are not ready to undergo a more extensive procedure. Dr. Forley uses selective nerve blocks with local anesthesia and the patient controlled Pro-Nox inhalational nitrous/oxygen gas system to decrease any discomfort or anxiety associated with the treatment.

MyEllevate
Loss of jawline definition and prominent vertical platysma muscle bands on either side of the midline of the neck are features that are characteristic of the aging process. They are often accompanied by a prominent fat pad under the chin and sagging skin that elicits the complaint “I hate my neck”.
Until recently, a surgical solution was the primary modality for addressing this array of aging changes in the neck. In many cases, however, early changes didn’t necessarily warrant a neck lift but were still troubling to those wanting to maintain a youthful appearance. Some patients seek a less invasive, non-surgical approach with less downtime and risk that can be performed under local anesthesia.
The MyEllevate treatment provides a safe and effective alternative to surgery with natural and long-lasting results.
Contouring of the jawline is performed with a continuous permanent suture support system that is inserted in a U-shaped pattern through tiny puncture sites in the neck with a specialized light-guided device.

71 year old female 6 weeks following MyEllevate Plus

67 year old female 6 weeks following MyEllevate, QuantumRF, and Morpheus8

Tightening of the suture defines the jawline and helps support the sagging structures under the skin to restore a more youthful and sculpted appearance. In addition, the suture system is used to mechanically divide the platysma muscle bands to further enhance neck contour. In some cases, the MyEllevate treatment can be combined with liposuction, FaceTite radiofrequency energy based skin tightening, and a skin tuck behind the ears to enhance the results. A soft neck collar is used for the first week to support the healing process but bruising and swelling are usually minimal.
SUTURE LIFT
The Silhouette InstaLift uses fully absorbable suspension sutures containing small, smooth cones that lift the tissues below the skin to improve facial folds and jawline definition. The specially designed sutures are placed under the skin using the attached needles to enable mechanical fixation of the deep layers of the cheek. Once the sutures are implanted, the lax tissues of the face are lifted by using the opposing orientation of the cones to compress and fix the loose facial layers in an elevated position. A process of biological fixation occurs over the first few months in which the cones become encapsulated by collagen thereby securing the lift in the desired position. The presence of the suture material itself gradually results in added volume and contour in the face due to its collagen stimulating properties. Results generally will last for a period of 18-24 months.