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In this video, Dr. Zelken answers the often asked but seldom explored question: how does energy based skin tightening work? Energy based skin tightening is definitely the next frontier in plastic surgery. You simply cannot beat the idea of shrinking skin without the long and risky scars. Sound too good to be true? Maybe it is. In many cases, energy based skin tightening is inadequate as a standalone procedure. Maybe refinements and enhancements in technology will change this in the near future. However, as an adjunct to more traditional measures, I have seen superlative results. In my practice, I use radiofrequency skin tightening in over 50% of my liposuction cases to allow the skin envelope to better conform to the underlying soft tissue sculpture. A side-benefit of heating a block of soft tissue, in my experience, is reduced bruising (as small blood vessels are cauterized) and reduced postoperative pain and swelling. As a rule of thumb, downstream benefits are even more important: collagen deposition around 6 weeks, visible soft tissue contraction at 3-4 months, and visible long term (final results) at 6-12 months. Still, there is something really nebulous about RFAL (radiofrequency assisted lipolysis) because you can't really see it in action. Unless you used FLIR imaging, which we've shown in previous videos, or you feel it with your hand (which is impossible through YouTube), OR I can show you on a block of freshly excised tissue. Sounds gnarly, but this is a special opportunity to not only see the sizzling fat (lipolysis in action), but to even see immediate mechanical contraction (denaturing of proteins and collagen)! Subscribe to our YouTube channel to see our next video: a hybrid, wide-awake mini tummy tuck + RFAL.