Invasive Vs. Non-Invasive Skincare: How to Choose the Right Path for You

As we age, many of us wish we could turn back the hands of time, or at least look like we have. While aging is something worth embracing and celebrating, our feelings about it aren't always that simple. We want to look our best and feel our best – no matter our age – which means that many of us may have at least considered procedures and treatments that combat visible signs of aging. If you yourself have reached this point, you know that there are two primary types of treatments available: invasive and non-invasive. Not sure how far you're willing to go? Let's look at the risks and benefits of many common skin care treatments to get a better understanding of what's available. 

What is invasive skin care?

The most commonly accepted definition of an invasive procedure is one where a trained professional – usually a plastic surgeon – penetrates the skin with an incision to make structural changes to the skin. Generally, invasive procedures require time for recuperation and are accompanied by the same significant risks as any surgery.

Pros of Invasive Procedures

For people looking for a dramatic change, invasive procedures can seem appealing. Take, for instance, one of the most popular invasive skincare treatments: the facelift. Also referred to as “rhytidectomy” by plastic surgeons, facelifts are an effective way to tighten loose skin or sagging skin and eliminate wrinkles quickly. This surgical procedure lifts the skin on one or both sides of the neck or face, tightening facial muscles and readjusting how skin falls over the face.[2] Other procedures, like thread lifts, are considered only “minimally” invasive procedures by the American Society of Plastic Surgeons. Sometimes called a “lunchtime lift,” a thread lift places absorbable barbed sutures under the skin to create tautness in the face and neck. Thread lifts are ideal for small, contained areas like the eyebrows, neck, or temples.[3] Cons of Invasive ProceduresGoing “under the knife” can be a monumental commitment with a hefty price tag: the average cost of a facelift, excluding anesthesia and recovery, is about $8,000.[7] While invasive skin procedures offer noticeable results, they can come with lengthy healing time and potentially serious health risks. The recovery period for invasive procedures may take weeks and commonly include pain, swelling, and bruising. Results are usually permanent unless corrected by more surgery. Other possible adverse effects worth considering include::

• Nerve injury resulting in temporary weakness or numbness in the skin. In some cases, nerve changes may be permanent.[4]
• Invasive surgical procedures often require local or general anesthesia, which carries its own risk of adverse reaction.[4]
• Significant hematomas -more commonly known as bruises - can result in prolonged discoloration.[5]
• People who have pre-existing conditions, like diabetes, or who are chronic smokers may experience a longer healing process than usual.[4]
• Scarring can differ from person to person. Individuals who tend to develop keloid scars may require further treatments to manage scarring. Keloid scars are raised and much more noticeable than typical scars, and can result in uncomfortable itching.[5]
• Temporary or permanent hair loss may occur at the sites of the incision. Hair transplantation can regrow hair in areas where hair loss is permanent.[6]

What is non-invasive skin care?

According to the American Society of Dermatological Surgery, non-invasive skin treatments utilize non-surgical measures to improve the appearance of the skin. [8]

Pros of Non-Invasive Treatments

Non-invasive skin procedures are ideal for people who want to skip the downtime that more invasive treatments require, for those looking for more gradual and/or natural-looking changes, or for those who would like to avoid the significant health risks and costs of an invasive procedure. Whether in-office or at home, non-invasive skin treatments typically take less than an hour and the results - though less dramatic- can last for up to a year or more. Plus, non-invasive aesthetic treatments come with minimal risks; when adverse effects do occur, they're often temporary.[9]Unlike many invasive surgical procedures, most non-invasive skin tightening treatments can be applied beyond just the face and neck to other areas like the legs, arms, and hands. 

Cons of Non-Invasive Treatments 

While non-invasive treatments tend to be gentler, in-office procedures are often expensive and may still come with some risk of infection or other side effects. At-home devices tend to range in their quality and effectiveness, making it difficult to evaluate what options are worth the time and money. As a general guide, look for products that have data-validated claims to support their efficacy. 

In-Office Non-invasive Skin Tightening Techniques

If you're considering a non-invasive treatment, you have plenty of options. Here are some of the most popular in-office treatments.

1. Ablative Laser TreatmentsAblative laser treatments, also called laser resurfacing, remove the outer layers of damaged skin to encourage the creation of new skin cells. Ablative lasers use intense light wavelengths to slightly wound the skin. This triggers the skin's healing response, stimulating new collagen formation to help repair the damage. As the skin heals, damaged skin is sloughed away, revealing smoother and tighter-looking skin beneath it. This can be especially helpful for deep textural imperfections including wrinkles and acne scarring. In fact, JAMA Dermatology recognizes ablative laser treatments as an effective form of scar treatment.[11]Ablative laser treatments require considerable pre-treatment and post-treatment attention. A physician may prescribe an antiviral medication before and after the procedure as a precaution if you are prone to infections. Some treatments may require sedation, depending on the type of ablation and the treated area. After treatment, you can expect pain, swelling and discomfort for up to two weeks. You'll also need to avoid unprotected sun exposure to prevent serious sun damage. [12]
2. Non-Ablative Laser TreatmentUnlike standard ablative laser treatments, non-ablative laser treatments for skin tightening stimulate collagen production to improve skin texture without wounding the skin. Because this non-invasive skin resurfacing procedure is gentler on the skin, the recovery time is much shorter and less painful. Non-ablative skin tightening skin treatments may not offer the same level of results as ablative laser procedures, but over time they can result in smoother skin and a more even skin tone.
3. Ultrasound for Skin TighteningMost of us are familiar with ultrasound's use in medical diagnostics and obstetrics, but ultrasound energy is also beneficial for keeping the skin firm and smooth. Ultrasound targets the lower layers of skin below the epidermis. During the procedure, ultrasound is transmitted through the skin to heat the skin at depths of up to 5mm. The gentle heat stimulates collagen production, resulting in firmer-looking skin. Targeting specific areas, ultrasound skin tightening rejuvenation treatments can improve elasticity in places where it's often needed the most - the middle and lower face. When used on sagging skin in these areas, ultrasound treatments can offer a viable alternative to a mini-facelift.[13]In fact, a 2018 study published in the journal Plastic and Reconstructive Surgery evaluated the effectiveness of focused ultrasound on 50 adults with lower and mid-face sagging. After six months, participants were assessed by third-party evaluators and also by a self-assessment questionnaire. The evaluators saw improvements in 93% of the participants. About 85% of participants themselves saw positive changes in their skin, according to the self-assessment questionnaires.[14]The side effects of ultrasound treatments for skin tightening are often temporary. During the procedure, clients may experience some discomfort. Afterwards, redness, numbness, and slight bruising may occur for a short period.[15]
4. Radiofrequency (RF) treatmentsLike ultrasound treatments, radiofrequency (RF) energy can be used to heat the skin in order to boost collagen production. RF treatments concentrate heat onto the upper layers of skin to reduce wrinkling and tighten minor sagging. A 2018 study published in the Annals of Dermatology found that three RF energy treatments performed over six weeks [16] on older adults resulted in significant wrinkle reduction. Another small study focused on the use of RF energy for facial contouring. Of the 11 participants in the study, 73% saw improvements in facial contours when RF was combined with electromagnetic treatments.[17]Radiofrequency treatments are available for use on the face, neck, and body and are performed in-office. Treatments can also be combined with other non-invasive aesthetic procedures, like microneedling and ultrasound to target multiple layers of skin. Because RF energy heats skin layers, side effects include burning and temporary pain.[18]
5. LED Light TherapyThe sun's ultraviolet rays are dangerous for unprotected skin, but not all light rays are harmful. In fact, light rays of different frequencies can actually have healing properties. LED light therapy harnesses red, blue, and near-infrared light to safely renew and firm damaged skin. LED light therapy not only stimulates collagen but also kills acne-causing bacteria that can trigger breakouts. Interestingly, NASA initially used LED light therapy aboard space shuttle missions to promote wound healing. In fact, a published study indicated that LED light therapy promoted skin healing in 40% of its participants.[20] Soon, researchers noticed that skin that was exposed to the therapy also appeared smoother. [19] Side effects are minimal when LED treatments are conducted in a dermatology office.
6. Chemical PeelsChemical peels, also called chemexfoliation or derma-peeling, utilize a variety of chemical agents to exfoliate skin cells on the mid to outer layers of skin, encouraging new cell development and collagen synthesis. [21] A chemical peel fall into three categories based on strength:[22]

• Superficial peels that use mild acids to penetrate the outermost layers of skin.
• Medium peels use glycolic acid or trichloroacetic to remove the outer layers of skin and those right beneath the top layer.
• Deep peels that reach the middle layer of skin, using phenol or trichloroacetic acid to remove damaged cells.

Superficial peels are available for at-home use, but deeper peels generally require an office visit. These deeper peels can be painful and often require significant downtime following the procedure. Most chemical peels increase skin sensitivity and irritation, while deep chemical peels can cause swelling, burning, and redness, with significant post-procedural discomfort.[21],[22]

7. Botox

Botox is a derivative of clostridium botulinum bacteria, the same toxin that causes botulism or muscle paralysis. Botox cosmetic treatments paralyze specific facial muscles in order to reduce repeated skin movement that causes wrinkles.[23] Delivered through an injection, Botox is a non-invasive skin tightening procedure because no surgical incisions are necessary. Despite the fact that it is generally regarded as safe, it's important to note that Botox does have risks and that there are safer, natural botox alternatives. Some individuals may experience rare anaphylactic reactions. More often, however, side effects include bruising, bleeding, or pain in the treatment area.[24],[25] Long-term side effects are not fully known, as the product wasn't approved for cosmetic use until 2002.

8. Injectable Dermal Fillers

According to the American Board of Cosmetic Surgery, more than one million adults receive injectable dermal fillers every year. Injectable dermal fillers tighten skin by filling facial areas that have lost their volume, like the cheekbones or lips. By filling sunken and sagging areas with a gel-like substance, these treatments visibly plump fine lines and wrinkles. Dermal fillers can be made from a number of substances, including fat injections, Poly-L-lactic Acid, and hyaluronic acid. Natural fillers that contain ingredients that are easily absorbed and metabolized by the body can last anywhere from 6 to 18 months. But results depend on the area filled, the patient's metabolism, and how deep the fillers are injected. Synthetic fillers, on the other hand, can last much longer. The Food and Drug Administration cautions against the overuse of injectable dermal fillers, and does not advise the use of fillers on large areas of the body. Side effects include bruising, infection, allergic reactions, and discoloration.[26],[27]

Making Informed Skin Care Decisions

Choosing between invasive and non-invasive skincare treatments depends on your desired outcomes, tolerance for risk, and budget. Invasive procedures offer dramatic results but come with significant costs and risks. On the other hand, non-surgical skin tightening provides more gradual improvements with minimal risks. For those seeking safe non-invasive options, OneSkin's topical supplements offer a natural way to support skin health without the need for any invasive procedures. Plus, our products require no downtime, allowing you to enjoy the benefits of improved skin health without interruption to your daily routine. By understanding the pros and cons of each approach, you can make an informed decision about the best skin care regimen for your needs.

Key Takeaways:

• Skin loses its elasticity over time, causing sagging and wrinkles.
• Invasive treatments for skin tightening - like facelifts - offer dramatic results, but the procedure comes with major risks, like nerve injury and infection.
• Creams and lotions can moisturize the skin, but most formulas don't reach deeper skin layers for prolonged skin tightening effects.
• OneSkin's Topical Supplements offers many of the benefits of non-invasive in-office treatments, but with no downtime.

References

1. https://www.asds.net/skin-experts/skin-treatments 
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678000/ 
3. https://www.plasticsurgery.org/cosmetic-procedures/thread-lift 
4. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/facelift
5. https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059
6. https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059
7. https://www.plasticsurgery.org/cosmetic-procedures/facelift/cost
8. [8] https://www.asds.net/skin-experts/skin-treatments/non-invasive-skin-tightening-treatments
9. https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical-procedures/skin-tightening/
10. https://www.sciencedirect.com/topics/materials-science/cosmetics
11. https://jamanetwork.com/journals/jamadermatology/article-abstract/1787836
12. https://www.mayoclinic.org/tests-procedures/laser-resurfacing/about/pac-20385114
13. https://pubmed.ncbi.nlm.nih.gov/24267423/
14. https://journals.lww.com/prsgo/fulltext/2019/12000/use_of_micro_focused_ultrasound_for_skin.1.aspx
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695420/
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929946/
17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360959/
18. https://www.americanboardcosmeticsurgery.org/are-radiofrequency-treatments-really-safe/
19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148276/
20. https://pubmed.ncbi.nlm.nih.gov/11776448/
21. https://www.aad.org/public/cosmetic/younger-looking/chemical-peels-overview
22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122508/
23. https://www.cdc.gov/botulism/general.html
24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874868/
25. https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/guide-botox-type-injectables/
26. https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/guide-botox-type-injectables/
27. https://www.fda.gov/consumers/consumer-updates/filling-wrinkles-safely
28. https://www.health.harvard.edu/staying-healthy/led-lights-are-they-a-cure-for-your-skin-woes
29. https://www.ncbi.nlm.nih.gov/pubmed/22256622
30. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/microneedling-devices#risks
31. https://www.genome.gov/genetics-glossary/Fibroblast
32. https://www.genome.gov/genetics-glossary/Fibroblast
33. https://www.sciencedirect.com/science/article/pii/S0022202X15
34. https://parjournal.net/article/view/3863
35. https://www.health.harvard.edu/staying-healthy/do-retinoids-really-reduce-wrinkles
36. Zonari, A., et al. Senotherapeutic peptide treatment reduces biological age and senescence burden in human skin models. Npj Aging, 9(1), 1-15. 2023.