AskID: laxity of skin around the eyes and jawline

We ask Professor Ryan about the best treatments for laxity of skin around the eyes and jawline:

‘For women in their 40s and 50s, there is a rapid decline in collagen production, with a 30% reduction in the collagen content of skin during the first five years of menopause. This leads to skin laxity and wrinkles which can be very prominent around the eyes, jawline, jowls and neck. The most effective remedy is surgical intervention with a facelift, necklift or blepharoplasty but most patients now prefer to avoid the downtime, cost and morbidity of surgical interventions and opt instead for minimally-invasive procedures to help tighten and lift sagging skin. Exilis Ultra 360 and Ultherapy are two of the most effective procedures to tighten and lift the skin around the eyes and the sagging jawline.

Who do these devices work?
Exilis Ultra 360 is the only device of its kind that simultaneously applies the combination of two very popular energies, radiofrequency and ultrasound. Heating of the skin and subcutaneous fat stimulates new collagen and elastin formation to produce visibly tighter skin while reducing excessive subcutaneous fat. It is suitable for anyone with skin laxity and sagging anywhere on the body; thin, crepey skin around the eyes, a lowered brow, sagging under the chin and jawline, subcutaneous fat deposits, loose skin on the neck or lines & wrinkles on the décolletage. It is suitable for all skin types.
Ultherapy is a non-invasive procedure that harnesses the precise ultrasound energy to lift and tighten the skin on the neck, under the chin, the eyebrows and lines and wrinkles of the décolletage and chest by stimulating collagen production. Ultherapy uses precise ultrasound energy to target the deep structural layers of the skin without disrupting the skin’s surface to lift and tighten skin of the upper and lower face, the neck, under the chin, the eyebrows. Ultherapy only uses ultrasound technology, so does not provide fat reduction or target deep wrinkles in the same way that radiofrequency does.
How many treatments are required?
A series of 4 treatments of Exilis are usually scheduled one week apart for optimal results. 

Typically just one treatment of Ultherapy is needed. Some patients may require more treatments of either device, depending on their age, the areas to be treated and the severity of skin laxity.
How soon do I see results?
Although it typically takes about 3 months for your body to produce collagen after the Exilis procedure, patients often report visible tightening within a week after just one session.
The results of Ultherapy may take longer to show, with instant results being much rarer than Exilis. Although you may begin to notice changes after two to three months, it could take up to six months to see the final result and there can be more dramatic lifting with Ultherapy than with Exilis.
How long do results last?
Since both procedures stimulate a person’s own collagen production, how long the results last depends on the individual. The treatments produce new collagen, but the individual’s natural aging process will dictate how long that result is maintained. Future touch-up treatments with Exilis or Ultherapy can help provide more control over the aging process, which varies by individual. Exilis treatment for subcutaneous fat deposits can last for as long as you maintain your weight with a balanced diet and exercise.
What about down-time?
Both procedures are non-invasive and require no recovery time. The treated skin areas can sometimes become flushed the hours after the procedure and there can be minor tenderness in the area.
What about pain?
Exilis treatment is completely pain-free. Patients describe a pleasant warming sensation, similar to that of a soothing hot stone massage. Ultherapy is known for being painful, requiring the use of several pain medications which we will prescribe.