Treatment of loose or crêpey skin of the abdomen.

Although it is impossible to put more elastin back into the skin, and therefore it is impossible to get the true springy nature of the skin back, it is possible to tighten up the skin therefore reducing the loose and crepe like appearance.

To do this, we need to affect the collagen - the protein that provides the strength and structure of the skin.

Like all proteins, collagen is sensitive to heat. You can think of it like the egg white which is a very similar protein. Normally, the egg white is runny. With heat, its nature changes and it becomes thicker and more solid eventually becoming rubbery and then hard.

If we are able to treat the collagen with just enough heat in the skin, we can get all of the protein to contract causing a tightening of the skin, but without going so far that we get the hardness and lumpiness of a burn.

The technique that has perfected this is called Thermage.

Thermage passes a radio frequency alternating current from a hand piece through the skin to a surface electrode placed usually on the back. The hand piece forms a square of about 1.5 cm x 1.5 cm. It is designed to cause heating in the skin and tissues directly under the skin, to make the collagen contract and tighten in all directions. Although the early Thermage machines were very painful due to this heat, the current Thermage machines heat and then instantly cool the skin using a very efficient cooling system.

As such, patients can get the effect of the heat but with much less discomfort.

To ensure that the whole abdominal skin gets treated, a transfer is placed on the abdominal skin made up of lots of squares 1.5 cm x 1.5 cm. The operator can then use this as a guide to make sure that each square and then each overlapping part can be treated in turn mean that over the course of the treatment (usually 1 1/2 to 2 hours) all of the skin is treated.


How quickly are the results seen?

When the skin is heated, there is an immediate collagen contraction and so there is some improvement seen immediately. However like all healing, full contraction and therefore full effect is only seen after 3 to 6 months. This is the stage when all healing has occurred and the full contraction of the collagen fibrils has happened.


How long do the effects last?

The effects on the collagen itself do not wear off. However, other factors can start stretching the collagen again, just the same way that the collagen was initially stretched to cause the problem in the first place.

With age, the collagen slowly deteriorates and the skin becomes thinner, meaning that over time the skin becomes loose and crêpier. However, if it is any age, then this should be a very slow process. Of course if the original cause of pregnancy or obesity, a sudden change such as putting on weight suddenly or a further pregnancy will stretch the collagen once again and so the effect may be lost. In essence therefore, the effect of Thermage should be very long-lasting on the skin of the body provided the patient has good nutrition, no further pregnancies and keeps a fairly constant weight.

Of course if there is a further pregnancy or stretching, it is quite possible to form further Thermage in the future.