Evolutions Medical Spa’s Event Recap: Tightening and Lightening Your Skin, Without Surgery

Last week, Evolutions Medical Spa and Santa Barbara cosmetic surgeon Dr. Terry Perkins hosted an event that is a popular topic amongst many of our clients – skin tightening and skin lightening using advanced technology that gives results, without surgery. Read on for a full recap:

Part 1: Skin Tightening – Treating Skin Laxity

What is Skin Laxity?

Skin laxity, or “loose” skin, begins as a natural part of aging, due to damage and loss of collagen and elastin, but also related to sun damage.

Treating Skin Laxity

There are surgical options to successfully treat skin laxity such as:


  • Deep Peels: Chemabrasion, a deep peel that superficially destroys the epidermis and dermis, done under general anesthesia.

There are also successful non-surgical treatments:

    • Light-based treatment: such as the FotoFacial RF (photo rejuvenation), the safest and most effective intense pulsed light (IPL)-based treatment today.


  • Radiofrequency treatment: such as Sublative Rejuvenation, the newest skin resurfacing device with less downtime and discomfort.

How Do We Treat Skin Laxity Non-Surgically?

We have found that sustained heating of the dermis (the cells below the skin and the epidermis) has both short term and long term effects: Immediately it stimulates collagen contraction, which helps to tighten the skin while it also promotes long term stimulation of collagen remodeling – maintaining a strong collagen “support system” gives the skin strength and resilience.


Who Can Be Treated Non-Surgically for Skin Laxity?

    • Clients that have the best results have a minimum amount of excess fat in the area of concern and who have skin that is neither very thin or very thick.


    • Clients can be anywhere from 30 to 80+ years.


    • When treating skin laxity non-surgically, clients must acknowledge that the treatments will turn back the clock a few years, not decades!


  • Someone who is not ready for surgery, but ready to see a difference in their skin, is a great candidate.

The Titan Procedure: A Non-Surgical Skin Laxity Treatment

Titan uses an infrared light source to heat the dermis well below the skin’s surface. This heating contracts existing collagen and stimulates growth of new collagen. Although a single treatment may show a change in your skin, a series of two to four treatments is recommended for optimum results. Downtime is minimal, with maybe some mild swelling and redness for a few hours post-treatment. Clients have been successfully treated on many areas of the body. The most common areas treated are the jawline, under the chin, and the abdomen.

ReFirme™: A Non-Surgical Skin Laxity Treatment

ReFirme™ combines Bi-Polar Radio Frequency and Light energies to heat the dermal tissue within the targeted treatment area. Using significantly less optical energy than lasers and IPL’s, it ensures enhanced safety and a virtually painless procedure. It helps skin laxity, sagginess, wrinkles and textural irregularities and most patients see gradual and cumulative results throughout the treatment regimen. Common treated areas are the face, neck, abdomen, upper arms and knees.

Total Tightening: The Best of Both Worlds for Treatment of Skin Laxity


Total Tightening is an exclusive protocol designed by Dr. Perkins that most effectively addresses skin laxity without needles or surgery. Total Tightening combines ReFirme™ and Titan into one treatment to synergistically heat the entire upper half of the dermis. A series of 4 treatments is recommended for best results. Total Tightening is exclusive to Evolutions Medical Spa Santa Barbara!
Part 2: Skin Lightening – Improving Excess Pigmentation


What is Pigmentation?

Pigmentation is melanin in the skin. Melanin is produced by melanocytes and different skin types have differing levels of melanocyte activity.

melanin Why Does the Body Produce Melanin?

Every body has a normal production of melanin. The body also produces melanin in response to sun exposure (suntan = skin injury), trauma, and inflammation. Melanin production can be accentuated by hormones, birth control pills, and pregnancy.

Pigmentation Problems


  • If melanocytes are over stimulated, appearance problems can occur and can be commonly referred to as sun spots, age spots, “liver” spots, and freckles.
  • Post Inflammatory Hyperpigmentation (PIH) can cause darkening and discoloration as a result of an inflammatory reaction, or injury, to the skin. Common causes are scratches, burns, cuts, bruises or even certain rashes.
  • Melasma, darkening patches of the skin, usually appears on the face (although it can develop on the forearms and neck) and can be triggered by pregnancy, birth control pills, photosensitive drugs, sun exposure.

Treatment for Hyper Pigmentation

Sunscreen: Proactively protect your facial and chest skin year round using a good sun block every day.

Home Care: There are products that can be used at home to fade pigmentation (bleaching agents) and increase cell turnover.

  • Bleaching agents: Recommended bleaching agents are the Obagi Clear, which is Step 3 in the Obagi Nu-Derm system, Obagi C-RX Night Cream, both contain Hydroquinone, PCA Brightening Therapy, Nia24 products and retinoids.
  • Increase cell turnover: Alpha-Hydroxy Acids, Amino Fruit Acids and Retinoids all play a roll in expediting cell turnover.

Chemical Peels: Chemical exfoliation, which is what happens when a chemical peel is done, helps to achieve / maintain clear and youthful skin, especially because as we age, the natural exfoliation process tends to slow down, leaving skin dry and dull. Evolutions offers three types of chemical peels:

  • Phase Five Peel (light peel): low irritation and not a lot of actual peeling – a series of five is recommended.
  • Alpha Beta Peel (medium peel): a more aggressive medium-depth peel that stimulates new collagen and elastin. Clients usually see results in as little as four to five days.
  • Obagi Blue Peel (deep peel): the most aggressive peel that will significantly improve the complexion, leaving the skin firmer, clearer, smoother and healthier. Particularly good for pigmentation issues too.

Vibradermabrasion: a physical exfoliation to stimulate collagen. Vibraderm keeps your skin looking young and can be used to treat superficial pigmentation problems (with no downtime) and, in addition, improves penetration of products / peels. It is superior to microdermabrasion because there is no suction, which can cause broken capillaries.

Light-based Treatments: The FotoFacial RF is the “gold standard” for treatment of pigmentation. It works deeper than most chemical peels and is available in a series or combination with other treatments (FotoPeel, FotoPeel Plus, and Foto Genesis Packages).

Sublative Rejuvenation: The newest fractional resurfacing device available that is used to treat wrinkles, pigment, acne scarring, skin laxity, tone and texture that uses radiofrequency energy instead of light, so it is safe for all skin types. Less downtime and discomfort than older fractional laser devices, with customizable treatments available. Sublative Rejuvenation can be combined with other light-based treatments such as the FotoFacial RF or Total Tightening.

Chemabrasion: a surgical procedure that combines a deep peel with dermabrasion with approximately a one-week downtime. Chemabrasion treats wrinkles, sun damage and pigmentation issues.

In conclusion, Dr. Perkins stressed that the best way to treat sun damage is to prevent it – use sunscreen daily, year round. When pigment issues arise, however, there are a number of treatment options – from “at home” care to treatments at Evolutions.


For a complimentary consultation about skin tightening or skin lightening, contact Evolutions Medical Spa at 805.687.0212.