Skin-tightening programme

The Ality currently offers Oligio, which uses Monopolar RF 6.78 MHz technology to deliver radiofrequency energy into tissue, producing controlled heating and stimulating subsequent collagen remodelling. Oligio

As we age, changes in skin structure occur at more than one layer.

Collagen, elasticity, subcutaneous fat and facial supporting tissues can all change over time, leading to:

• ✓Drooping cheeks
• ✓Early lower-cheek laxity
• ✓A less-defined jawline
• ✓Skin that feels less firm
• ✓Less firmness beneath the chin
• ✓More noticeable facial folds

Skin-tightening devices therefore deliver energy into tissue to produce an appropriate level of heating and stimulate collagen contraction and remodelling.

The result does not come from surgically “pulling the skin up”, but from gradual changes in skin structure in response to the energy.

Suitable for people beginning to be concerned about:

• ✓Cheeks beginning to droop
• ✓Lower-cheek laxity
• ✓A less-defined jawline
• ✓Facial skin becoming less firm
• ✓Less firmness beneath the chin
• ✓Skin beginning to lose elasticity
• ✓Wanting to address laxity without needles or surgery

In particular, mild to moderate laxity is a group for which the evidence supporting Monopolar RF is relatively clear. Springer

A “large face” does not mean everyone needs skin tightening.

The underlying cause needs to be assessed.

Some people have more than one cause at the same time, so the whole face should be assessed rather than choosing a programme by its name alone.

Different types of devices use different forms of energy and target different tissue layers.

With Monopolar Radiofrequency, or Monopolar RF, radiofrequency energy produces volumetric heating in tissue.

This heating is associated with:

Some improvement in the apparent firmness of the skin or jawline may be noticeable after treatment.

However, the first day is not the final result.

Collagen remodelling takes time.

A study of Monopolar RF using Oligio in Asian participants found changes immediately after treatment, with continued improvement at follow-ups at 1, 3 and 6 months. Springer

This type of programme should therefore be assessed in terms of both:

Early results + gradual changes over time

There is no single day that applies to everyone.

Generally, changes gradually become more noticeable over 1–3 months after treatment as tissue remodelling progresses.

One Oligio study also found continued changes up to the month-6 follow-up, but the degree of improvement varies from person to person. Springer

This depends on:

• ✓The device and energy used
• ✓Energy level
• ✓Number of shots
• ✓Age
• ✓Skin quality
• ✓Degree of laxity before treatment
• ✓Fat volume and facial structure
• ✓Each person's collagen production
• ✓Natural skin ageing after treatment

For Oligio, a study followed participants for 6 months after one treatment and found that many continued to show changes in lower-face laxity during that period. This should not be interpreted as everyone achieving the same result or the effect “ending” immediately at 6 months. Springer

This depends on the device and the degree of laxity.

For some device types, a single session can be planned, followed by observation of changes over time before assessing whether another treatment is needed.

Not everyone needs a course with the same number of sessions.

Results from the previous treatment and the current skin condition should be assessed before planning the next session.

There is no single shot count suitable for every face.

The assessment needs to consider:

• ✓Facial size
• ✓Treatment area
• ✓Laxity
• ✓Jawline contour
• ✓Energy used
• ✓Number of passes
• ✓Shot-placement technique

More shots do not always mean better results

What matters is having enough shots to cover the area, used together with an appropriate energy level.

Common areas discussed during a skin-tightening consultation include:

Cheeks

For cheek tissue beginning to droop and skin becoming less firm.

Lower cheeks

Addresses areas where jowls or tissue accumulation along the jawline are beginning to appear.

Jawline

Suitable for people beginning to feel that their jawline is less defined than before.

Under the chin

Assessment may be appropriate when skin laxity is also present.

Neck

This depends on the device, applicator and doctor's assessment.

If the face looks heavy because of sagging tissue, improved firmness may make the jawline clearer and the overall face look slimmer.

However, if facial width is caused by:

• ✓Masseter muscles
• ✓A large amount of fat
• ✓Bone structure

Skin-tightening devices do not directly address those causes.

The reason the face looks broad should therefore be assessed before choosing a programme.

The cause of the double chin needs to be assessed.

If the cause is skin laxity, a skin-tightening device may help improve firmness in that area.

However, if there is a relatively large amount of under-chin fat, a skin-tightening device alone may not address the entire concern.

Some people have both fat and laxity, so each concern needs to be planned for separately.

Both address laxity, but work in different ways.

They may be included in the same plan for some people, but do not directly replace one another.

If the cheeks appear droopy because of substantial volume loss, tightening alone may not address every aspect.

Conversely, if volume is already present but the tissue is becoming lax, adding more volume without assessing laxity may make the face look heavier.

The sensation depends on:

• ✓Technology
• ✓Energy level
• ✓Area
• ✓Number of shots
• ✓Individual pain sensitivity

Monopolar RF commonly feels like pulses of warmth or heat.

Oligio has both a Cooling Spray and Vibration System, designed by the manufacturer to help reduce heat at the skin surface and disperse the sensation during energy delivery. Oligio

After treatment, there may be:

• ✓Redness
• ✓A warm sensation
• ✓Mild swelling
• ✓Temporary skin sensitivity or dryness
• ✓Tightness in the treated area

In an Oligio study in Asian participants, post-treatment redness was common and resolved within about 1–2 days in the study group. No serious adverse event was reported in that study. However, RF energy still carries a risk of excessive heating or skin injury if inappropriate energy settings or technique are used. Springer

Monopolar RF programmes generally do not create open wounds. In the Oligio study, participants were able to return to their usual daily activities after treatment. Springer

However, if redness or skin sensitivity occurs initially, you should:

• ✓Use moisturiser
• ✓Apply sunscreen
• ✓Avoid excessive skin heating or irritation
• ✓Follow the clinic's aftercare instructions

Skin tightening does not start with the question:

“How many shots are needed?”

Instead, it should start with:

“Which part of the face is becoming lax, and what is making the jawline less defined?”

Some people's main concern is skin laxity; others have fat, enlarged masseter muscles or volume loss.

The Ality therefore starts by assessing facial shape and the areas of concern before tailoring Oligio treatment coverage, shot count and energy level to each person.