A natural part of the aging process is for our skin to become less tightly bound to the underlying structures of the body resulting in sagging and jowling. These changes are caused by physiological changes in the dermis, including elastin fibers that have decreased abilities to tension the skin (think elastic), and lower volumes of collagen and hyaluronic acid (making the skin thinner). There are also changes as the fat layer below the skin decreases in volume, after which the same amount of skin covers less facial volume.

The great news is that we know the dermis responds to stress and controlled damage by rebuilding itself to a more youthful structure! In non-surgical cosmetic medical spas we use a variety of energy sources to deliver controlled energy into the skin in a manner that minimizes energy in the upper layers of the skin (epidermis), and maximizes energy absorption in the dermis, where the structures that hold skin tight are located. This stimulates new production of elastin, collagen and hyaluronic acid - creating more youthful, tighter skin!


There Are Four Great Ways To Tighten Skin At Spa 35


Near Infrared Skin Tightening

skin tightening before and after photos on the abdomen

The combination of a chilled plate for epidermal protection with near infrared energy delivers heat stimulation into the dermal layer of the skin. The result is increased production of dermal structures that hold the skin tight. 

The remainder of this page is focused upon near infra-red skin tightening.


Near Infrared (NIR) Skin Tightening

Collagen loss from the effects of chronological aging, sun damage and oxidative stress (such as that experienced by smokers) can produce wrinkles and looseness in facial and body skin. Similar to how a helium balloon looks when left overnight the decreased volume resulting from collagen and fatty tissue loss causes the skin to wrinkle because we have the same amount of skin covering a smaller area. Loose skin can be treated with the Alma NIR ST (Skin Tightening) system, a non-invasive, minimal downtime procedure.

With Spa 35® NIR Skin Tightening your collagen layer is rebuilt and encouraged to grow by the delivery of infrared light energy into your skin. The procedure produces safe, effective deep dermal heating, inducing neocollagenesis (growth of new collagen) without damage to the epidermis. The near infrared device exerts its biological effect on the skin through two major mechanisms:

The procedure generally consists of a series of eight treatments scheduled one week apart, thought your treatment plan may vary based upon your goals and budget. Each treatment last approximately forty-five minutes. These “out of office” treatments allow you to return to your normal daily duties (excluding strenuous activities) and do not normally create any down time. 

Treatment areas can include almost any part of the body. As an example a Spa 35® client treated her knees to tighten lax skin that discouraged her from wearing shorts in public.

Cellulite can also be treated with skin tightening. The production of collagen that results from skin tightening can reduce the appearance of Cellulite.

You can also visit the Alma Laser website for additional information by clicking on this link.

Hello, World!

What to expect from an NIR Laser Skin Tightening treatment:

** Results vary

** Results vary

  • Depending on individual goals and the condition of your skin, a pre-treatment plan may be recommended to prepare your skin for an Laser Skin Tightening procedure
  • Sun exposure to the treated area must be avoided prior Laser Skin Tightening procedure
  • During the procedure a warm instrument is passed over the treatment area, heating the deep layers of the skin
  • A Laser Skin Tightening procedure delivers pulses of infrared energy to the affected area, which heats the foundational layers of your skin, including collagen and elastin. The cells respond by creating additional collagen and elastin which increased the skin volume and tightens the skin
  • Pre and post care instructions, will be reviewed prior to your treatment
  • A series of treatments numbering from four to eight is typically necessary to achieve the optimum effect. During your consultation your Spa 35® Skin Specialist will provide a detailed recommendation with related product and services matched to your goals
  • Treatments may be repeated every three weeks
  • Minimal downtime

Skin Ageing Video, learn how your skin changes with age and from sun damage.

Why Chose Spa 35 Med Spa for Your Cosmetic Treatments?

The medical providers at Spa 35 Med Spa have been delivering cosmetic services for twelve years. Our staff includes Nurse Practitioners, Registered Nurses and Aestheticians.

Skin tightening restores the thickness and elasticity of your skin that as faded with aging

How does Laser Skin Tightening Work?

Laser Skin Tightening passes infrared energy into the skin, it is converted it to heat and absorbed your collagen . The energy source is designed to target its energy into the dermis to cause the foundational layers of your skin to rebuild. 

Some of the steps of a typical procedure include;

  1. Completion of a consultation with a skin care specialist. During this consultation discuss your concerns and goals. Every person is unique an needs an individualized plan. Develop your comprehensive plan to reach those goals that includes Spa 35® procedures and at home lifestyle changes and skin care habits.
  2. Schedule the Laser Skin Tightening procedure. Pick a time when sun exposure to the treatment area has been minimized to decrease active melanin production at the time of the procedure.
  3. Have the procedure done. It will take forty-five minutes to an hour. The hand piece emits near infrared energy and can feel hot on the skin. It's not excruciating, but there are more enjoyable things to do with your day. Your skin should feel very warm during the procedure.
  4. Follow the post procedure instructions.  Particularly important is avoidance of sun exposure. 
  5. Improve lifestyle habits that produce damaged skin. Increase healthy food intake that is rich in nutrients good for you and your skin (i.e. oranges for vitamin C), use a sunscreen with physical blocks (i.e. titanium dioxide), add Retin-A, vitamin C and peptides to your skin care regime.

** Results vary. Video showing the state-of-the-art Alma Harmony Infrared ST Skin Tightening laser.  Whereas photofacial treatments correct the superficial- and medium-depth skin problems, near infrared technology is used to treat deeper dermal laxity and skin aging. Narrated by Dr. Sam Lam.

Laser Skin Tightening Frequently Asked Questions

Is it safe?

The device that delivers Laser Skin Tightening, the Harmony®XL System, has been cleared by the FDA for more than 60 aesthetic and medical applications. Laser Skin Tightening is one of those approved procedures. As with many cosmetic treatments there are risks associated with Laser Skin Tightening, such as burning. Details on risks and contraindications are provided as part of the Laser Skin Tightening consultation and detailed in the informed consent.

Is there "down time" after an Laser Skin Tightening procedure?

Most patients can return to their daily activities immediately after the procedure.  You should avoid excessive exercise and sun exposure after the treatment. Details on risks and contraindications are provided as part of the Laser Skin Tightening consultation and detailed in the informed consent.

How much does Skin Tightening costs?

Pricing depends upon the type of Skin Tightening treatment and the treatment area. You can expect to pay between $999 - $3,499.

Scientific Studies on Skin Tightening Procedures at Spa 35 Med Spa

Lasers Surg Med. 2009 Jan;41(1):1-9. doi: 10.1002/lsm.20731.

Bipolar fractional radiofrequency treatment induces neoelastogenesis and neocollagenesis.

Hantash BM1, Ubeid AA, Chang H, Kafi R, Renton B.

Author information

Stanford University School of Medicine, Stanford, California, USA.



We recently introduced Renesis, a novel minimally invasive radiofrequency (RF) device, for the treatment of human skin. The wound healing response post-fractional RF (FRF) treatment was examined in human subjects.


The FRF system delivered RF energy directly within the dermis via 5 micro-needle electrode pairs. Tissue temperature was held at 72 degrees C for 4 seconds using an intelligent feedback system. The wound healing response was evaluated histologically and by RT-PCR up to 10 weeks post-RF treatment. Neoelastogenesis and the role of heat shock proteins (HSPs) were assessed by immunohistochemistry.


FRF treatment generated a RF thermal zone (RFTZ) pattern in the reticular dermis that consisted of zones of denatured collagen separated by zones of spared dermis. RFTZs were observed through day 28 post-treatment but were replaced by new dermal tissue by 10 weeks. HSP72 expression rapidly diminished after day 2 while HSP47 expression increased progressively through 10 weeks. Reticular dermal volume, cellularity, hyaluronic acid, and elastin content increased. RT-PCR studies revealed an immediate increase in IL-1beta, TNF-alpha, and MMP-13 while MMP-1, HSP72, HSP47, and TGF-beta levels increased by 2 days. We also observed a marked induction of tropoelastin, fibrillin, as well as procollagens 1 and 3 by 28 days post-treatment.


Our study revealed a vigorous wound healing response is initiated post-treatment, with progressive increase in inflammatory cell infiltration from day 2 through 10 weeks. An active dermal remodeling process driven by the collagen chaperone HSP47 led to complete replacement of RFTZs with new collagen by 10 weeks post-treatment. Furthermore, using both immunohistochemical and PCR studies, we successfully demonstrated for the first time evidence of profound neoelastogenesis following RF treatment of human skin. The combination of neoelastogenesis and neocollagenesis induced by treatment with the FRF system may provide a reliable treatment option for skin laxity and/or rhytids.

Click here to read this clinical study on PubMed

See comment in PubMed Commons below

Dermatol Surg. 2013 Feb;39(2):263-73. doi: 10.1111/dsu.12065. Epub 2012 Dec 28.

Prospective multicenter clinical trial of a minimally invasive temperature-controlled bipolar fractional radiofrequency system for rhytid and laxity treatment.

Alexiades-Armenakas M1, Newman J, Willey A, Kilmer S, Goldberg D, Garden J, Berman D, Stridde B, Renton B, Berube D, Hantash BM.

Author information

School of Medicine, Yale University, New Haven, Connecticut, USA. dralexiades@nyderm.org



A minimally invasive fractional bipolar radiofrequency (FRF) was developed.


To evaluate safety and efficacy of FRF in reducing face and neck rhytides and laxity.


This prospective, open-label, multicenter clinical trial enrolled 100 subjects with mild to severe facial and neck rhytides and laxity at seven centers in a per-protocol analysis. One single-pass FRF treatment was administered through five 32 g-needle electrode pairs at a preselected real-time fixed temperature of 62 to 78°C, energy duration for 3 to 5 seconds, and impedance restrictions of 200 to 3,000 Ohms, ensuring intradermal delivery. Five blinded dermatologists and plastic surgeons graded randomized standardized baseline and follow-up photographs of 53 and 42 subjects at 3- and 6-month follow-up intervals, respectively, using the Fitzpatrick wrinkle and Alexiades-Armenakas laxity scales. Subject assessments and adverse events were recorded in 100 subjects.


Blinded evaluations revealed correct pre- and post-treatment identification in 100% of scored cases, mean improvement of 25.6% on the Fitzpatrick Wrinkle Scale and 24.1% on the Alexiades-Armenakas laxity scale at 6 months, and 100% response rate for rhytides and 95% for laxity. Subgroup analysis revealed maximal rhytid reduction in the mean target temperature of 66.7, energy duration of 4.2 seconds, and volume of denatured collagen of mm(3) denatured collagen group. Adverse events included transient erythema, edema, and ecchymoses, resolving within 1 to 5 days, and two incidents of temporary pinpoint depressions. More than 90% of subjects were satisfied or very satisfied.


Real-time temperature-controlled FRF is a highly reproducible, safe, effective nonsurgical treatment of face and neck rhytides and laxity and provides important insights into neocollagenesis, neoelastogenesis, and clinical outcomes.

© 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc

Click here to read this clinical study on PubMed

A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: A pilot study

Article (PDF Available) in Climacteric

DOI: 10.3109/13697137.2014.899347 · Source: PubMed

1st Stefano Salvatore

41.68 · Ospedale di San Raffaele Istituto di Ricovero e Cura a Carattere Scientifico

2nd R E Nappi +33rd Nicola Zerbinati

22.77 · Università degli Studi dell'Insubria

Last Umberto Leone Roberti Maggiore

40.39 · Fondazione IRCCS Istituto Nazionale dei Tumori di Milano


Objective: This pilot study aimed to assess the efficacy and feasibility of fractional CO2 laser in the treatment of vulvovaginal atrophy (VVA) in postmenopausal women. Methods: VVA symptoms were assessed before and after three applications of laser over 12 weeks in 50 women (age 59.6 ± 5.8 years) dissatisfied with previous local estrogen therapies. Subjective (visual analog scale) and objective (Vaginal Health Index Score, VHIS) measures were used during the study period to assess VVA. Quality of life was measured by using the SF-12. A subjective scale to evaluate the degree of pain related to the laser application and the degree of difficulty to perform the laser procedure was used. Results: Fractional CO2 laser treatment was effective to improve VVA symptoms (vaginal dryness, vaginal burning, vaginal itching, dyspareunia, dysuria; p < 0.001) at 12-week follow-up, as well as the VHIS (13.1 ± 2.5 at baseline vs. 23.1 ± 1.9; p < 0.001). Both physical and mental scores of quality of life were significantly improved in comparison with baseline (p < 0.001). Satisfaction with the laser procedure was reported by 42 women (84%) and a minimal discomfort was experienced at the first laser application, mainly because of the insertion and the movements of the probe. Finally, the technique was very easy to perform in all women starting from the second application at week 4 and no adverse events were recorded during the study period. Conclusions: A 12-week treatment with the fractional CO2 laser was feasible and induced a significant improvement of VVA symptoms by ameliorating vaginal health in postmenopausal women. Further controlled studies should be performed to confirm the present data and to assess the long-term effects of the laser procedure on vaginal tissues.

Click here to read the full study on Researchgate.net

Maturitas. 2015 Mar;80(3):296-301. doi: 10.1016/j.maturitas.2014.12.006. Epub 2014 Dec 25.

Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser.

Perino A1, Calligaro A2, Forlani F3, Tiberio C1, Cucinella G1, Svelato A1, Saitta S4, Calagna G1.

Author information

Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.

Department of Public Health, Experimental and Forensic Medicine, Unit of Histology and Embryology University of Pavia, Pavia, Italy.

Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy. Electronic address: forlani81@gmail.com.

Department of Human Pathology, School and Division of Allergy and Clinical Immunology, University of Messina, Messina, Italy.



To evaluate the efficacy and feasibility of thermo-ablative fractional CO2 laser for the treatment of symptoms related to vulvo-vaginal atrophy (VVA) in post-menopausal women.


From April 2013 to December 2013, post-menopausal patients who complained of one or more VVA-related symptoms and who underwent vaginal treatment with fractional CO2 laser were enrolled in the study. At baseline (T0) and 30 days post-treatment (T1), vaginal status of the women was evaluated using the Vaginal Health Index (VHI), and subjective intensity of VVA symptoms was evaluated using a visual analog scale (VAS). At T1, treatment satisfaction was evaluated using a 5-point Likert scale.


During the study period, a total of 48 patients were enrolled. Data indicated a significant improvement in VVA symptoms (vaginal dryness, burning, itching and dyspareunia) (P<0.0001) in patients who had undergone 3 sessions of vaginal fractional CO2 laser treatment. Moreover, VHI scores were significantly higher at T1 (P<0.0001). Overall, 91.7% of patients were satisfied or very satisfied with the procedure and experienced considerable improvement in quality of life (QoL). No adverse events due to fractional CO2 laser treatment occurred.


Thermo-ablative fractional CO2 laser could be a safe, effective and feasible option for the treatment of VVA symptoms in post-menopausal women.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.


Laser treatment; Menopause; Vulvo-vaginal atrophy

Click here to read the study on PubMed