Non-Surgical Skin Tightening in Danville, CA
Skin Tightening Without Surgery in Danville, CA
Tightening the skin of the face and body without surgery is one of the most sought after things we do in cosmetic dermatology. Over the last decade a group of treatments has been developed that tightens skin non-invasively, by heating the dermis and boosting the collagen the skin makes there. These are not facelifts, and they are not as powerful as a facelift. But non-surgical tightening is now a recognised, highly effective, reproducible and safe group of procedures, and for most patients it gives them what they actually want: a firmer jawline and neck, without an operation and without disappearing from their life. Three types of device are now available, and they can be used on every skin type. Dr. Gallacher performs these treatments herself and will help you decide which one suits your skin best.
Firming loose skin on the face and body, without surgery, is one of the most asked for things we do. Over the last ten years a group of treatments has been developed that does it without cutting. They warm the deeper layer of the skin, the dermis, and get it to make more collagen. These are not facelifts, and they are not as strong as a facelift. But they are proven, they work well, they give a result you can count on, and they are safe. For most people they give exactly what was wanted: a firmer jawline and neck, with no operation and no long recovery. There are three types of machine, and they can be used on every skin colour. Dr. Gallacher does these treatments herself, and will help you pick the one that suits your skin.
Skin Tightening: the essentials
The short version
Thermage FLX monopolar radiofrequency, RF microneedling, and Exilis.
Thermage FLX, RF microneedling, and Exilis.
Patients seeking gradual improvement in mild-to-moderate laxity without surgery.
People who want a gradual improvement in mild to moderate looseness, without surgery.
Energy-based tightening can improve firmness but cannot remove excess skin or reposition deeper tissues like surgery.
These can firm the skin. They cannot take away excess skin, or move the deeper tissues back up, the way surgery does.
Thermage and Exilis are often low-downtime; RF microneedling typically causes several days of redness/swelling and carries procedure-specific risks.
Thermage and Exilis usually leave you free to carry on. RF microneedling usually means several days of redness and swelling, and it carries its own risks.
Typically gradual over weeks to months as tissue remodeling occurs; maintenance may be considered.
Gradual, over weeks to months, as the tissue rebuilds. You may want a top up later.
What is non-surgical skin tightening?
What is non-surgical tightening?
Non-surgical tightening uses controlled energy to heat skin or subcutaneous tissue, triggering collagen contraction/remodeling without cutting away skin.
Controlled energy is used to heat the skin, or the tissue just under it, which makes the fibres shrink a little and sets off rebuilding. Nothing is cut away.
Non-surgical skin-tightening treatments can improve mild to moderate laxity with less recovery than surgery, but the change is typically subtler than a facelift or other surgical tightening procedure.
It can improve mild to moderate looseness, with much less recovery than surgery. The change is usually subtler than a facelift or another surgical tightening operation.
Three types of device, and why the difference matters
Three kinds of machine, and why the difference matters
The devices in this field are usually sold to patients by brand name. It is more useful to understand the three categories, because the category tells you how the energy reaches your skin, how many visits you will need and how much recovery to expect.
Machines in this field are usually sold to patients by brand name. It is more useful to know the three groups, because the group tells you how the energy gets into your skin, how many visits you will need, and how much recovery to expect.
- Monopolar radiofrequency from the surface. Thermage FLX. The energy passes in through a treatment tip held against the skin, with the surface cooled at the same time. Nothing enters the skin.
- RF microneedling. Fine needle electrodes pass through the surface and release the radiofrequency at a depth we select.
- Combination radiofrequency and ultrasound. Exilis. Two forms of energy delivered together from the surface, on the face and on the body.
All three warm the dermis and set off new collagen production. What separates them is the route the energy takes, and that is what decides which one is right for you.
- Radiofrequency from the surface. Thermage FLX. A tip is held against your skin and the energy passes in, while the surface is cooled. Nothing goes into the skin.
- RF microneedling. Fine needles pass through the surface and release the energy at a depth we choose.
- Radiofrequency and ultrasound together. Exilis. Two kinds of energy at once, from the surface, on the face and on the body.
All three warm the deeper layer of the skin and get it making new collagen. The difference is the route the energy takes. That is what decides which one is right for you.
Radiofrequency works on every skin type
Radiofrequency works on every skin type
Radiofrequency energy is not absorbed by pigment. Unlike light and laser treatments, which target melanin and therefore need careful handling in darker skin, radiofrequency passes into the dermis regardless of skin colour and heats it directly. That makes this one of the few tightening options that can be offered right across the Fitzpatrick range. Needle based treatments still involve a small injury to the skin, so in richer skin tones settings are adjusted and pre-treatment and after-care are planned to keep the risk of temporary pigment change low. Dr. Gallacher assesses this at consultation and chooses the device and the settings accordingly.
Radiofrequency is not absorbed by pigment. Lasers and light treatments aim at the pigment in your skin, which is why they need extra care in darker skin. Radiofrequency does not. It passes into the deeper layer and warms it, whatever colour your skin is. That makes it one of the very few tightening treatments that can be offered to everyone. Needle treatments do make a small injury, so in darker skin the settings are turned down, and the skin is prepared and looked after afterwards, to keep the small risk of a temporary colour change low. Dr. Gallacher checks this at your consultation and picks the machine and the settings to match.
How do Thermage, RF microneedling and Exilis compare?
How do the three compare?
All three use radiofrequency in different ways: Thermage delivers energy from the skin surface, RF microneedling delivers RF through needle electrodes at selected depths, and Exilis uses monopolar RF with device-specific energy/monitoring features; some Exilis platforms also incorporate ultrasound.
All three use radio waves, but they deliver them differently. Thermage sends the energy in from the surface. RF microneedling puts it in through fine needles at a chosen depth. Exilis works from the surface too, with its own way of controlling and monitoring the energy, and some versions add ultrasound.
| Treatment | How it works, visits and recovery |
|---|---|
| Thermage FLX | Monopolar radiofrequency through a cooled surface tip. Nothing enters the skin. Usually one treatment of about an hour. Essentially no downtime. The longest track record of the three. |
| RF microneedling | Radiofrequency released through fine needles at a depth we select. Four treatments, about a month apart, about sixty minutes each. Topical anaesthetic sometimes used, redness for a few days. The best depth control, and the option that treats texture at the same time as laxity. |
| Exilis | Radiofrequency and ultrasound together, from the surface, face and body. A short course of comfortable sessions. No expected downtime. The gentlest of the three, and the one that covers body areas as readily as the face. |
| Treatment | How it works, visits and recovery |
|---|---|
| Thermage FLX | Radiofrequency through a cooled tip on the surface. Nothing goes into your skin. Usually one treatment of about an hour. Essentially no time off. The longest track record of the three. |
| RF microneedling | Radiofrequency let out through fine needles at a depth we choose. Four treatments, about a month apart, about an hour each. Numbing cream sometimes, and redness for a few days. The best control over depth, and the one that treats rough texture at the same time as looseness. |
| Exilis | Radiofrequency and ultrasound together, from the surface, on the face and the body. A short course of comfortable sessions. No time off expected. The gentlest of the three, and the one that handles the body as easily as the face. |
Diagram comparing surface radiofrequency, RF microneedling and Exilis skin tightening
A diagram comparing surface radiofrequency, RF microneedling and Exilis.
Thermage FLX: standing the test of time
Thermage FLX: the one that has stood the test of time
Thermage is the treatment that has stood the test of time. Monopolar radiofrequency has been used to tighten skin for over twenty years, longer than any other non-surgical tightening technology, and Thermage FLX is the current generation of it. That track record is the reason it remains the flagship of the three: the way it behaves is known, the results are predictable, and there is nothing experimental about it.
Thermage is the one that has stood the test of time. This type of radiofrequency has been used to tighten skin for more than twenty years, longer than anything else in this field, and Thermage FLX is the latest version of it. That long record is why it is still the flagship of the three. We know how it behaves, the results are predictable, and there is nothing experimental about it.
Energy is delivered through a treatment tip placed on the surface. The tip cools the skin at the same moment it heats the dermis beneath, so the collagen deep down is warmed while the surface is protected. FLX added automatic tuning of the energy to each area of skin, and vibration, which is what makes the treatment comfortable enough that most patients need nothing more than the device's own cooling. Most people describe a brief hot sensation as the tip fires, followed immediately by cold.
A facial treatment takes about an hour, and one treatment is usually all that is needed. That is unusual in this field, and it is a real advantage: one appointment, then the result develops on its own. Redness, if it appears at all, tends to fade within hours. Bruising and pain are uncommon and there is essentially no downtime. Measurable tightening appears gradually over the two to six months after the session and typically holds for one to two years, depending on your skin and the way you age. In this practice, Dr. Gallacher generally recommends repeating Thermage FLX at about one year, as part of an annual skin rejuvenation plan.
Thermage is a strongly operator dependent procedure. How the tip is placed, how the energy is stacked and how the area is planned all change the result. Dr. Gallacher performs every Thermage treatment personally.
The energy goes in through a tip held against your skin. The tip cools the surface at the same instant it heats the layer underneath, so the collagen deep down gets warm while the surface stays protected. The FLX version tunes the energy automatically for each patch of skin, and adds vibration, which is what makes it comfortable enough that most people need nothing beyond the machine's own cooling. Most people describe a quick hot feeling as the tip fires, then cold straight after.
A face treatment takes about an hour, and one treatment is usually enough. That is unusual here, and it is a real advantage: one appointment, then the result builds on its own. If you go red at all, it usually settles within hours. Bruising and pain are uncommon, and there is essentially no time off. The tightening appears slowly over the two to six months after the session, and usually holds for one to two years, depending on your skin and how you age. In this practice, Dr. Gallacher usually suggests repeating Thermage FLX at about a year, as part of a yearly plan.
Thermage depends heavily on the person doing it. Where the tip goes, how the energy is built up, and how the area is planned all change the result. Dr. Gallacher does every Thermage treatment herself.
RF microneedling: energy placed at the depth we choose
RF microneedling: energy put in at the depth we choose
The second group uses microneedles to carry the radiofrequency into the skin. Very fine needle electrodes pass through the surface and release the energy at a set depth, which means the heat is delivered exactly where we want it rather than being spread from above. The result is directed collagen production: we decide the layer, and the skin rebuilds there.
The second group uses tiny needles to carry the radiofrequency into the skin. Very fine needles pass through the surface and let the energy out at a set depth, so the heat lands exactly where we want it instead of spreading down from above. That means the new collagen is made where we aimed. We choose the layer, and the skin rebuilds there.
That depth control is the reason this group is chosen when laxity comes with texture. Because the needles create their own microscopic channels as well as delivering heat, one treatment can work on looseness, on fine wrinkles and on surface texture at the same time. It is also why the treatment is used on acne scarring and on skin that has been coarsened by sun damage.
These procedures are very well tolerated. They hurt a bit more than Thermage, so a topical anaesthetic is sometimes applied first, and the redness may last a few days rather than a few hours.
Dr. Gallacher performs the microneedling radiofrequency treatments herself and selects the needle depth for each area of the face, rather than treating the whole face at one setting.
That control over depth is why this group is chosen when the skin is both loose and rough. The needles make their own tiny channels as well as delivering the heat, so one treatment can work on looseness, on fine lines and on texture at the same time. It is the same reason this treatment is used for acne scarring and for skin coarsened by the sun.
These treatments are well tolerated. They hurt a bit more than Thermage, so numbing cream is sometimes put on first, and the redness may last a few days rather than a few hours.
Dr. Gallacher does the microneedling radiofrequency treatments herself, and sets the needle depth for each part of the face instead of treating everything at one setting.
RF microneedling: what a course involves
RF microneedling: what a course involves
Unlike Thermage, which is usually a single treatment, the RF microneedling devices need a course. Four treatments, about a month apart, is the standard plan. Each treatment takes about sixty minutes. The month between sessions is deliberate: it gives the skin time to lay down collagen from one treatment before the next one is added on top of it.
Expect to be visibly pink on the day, with redness settling over a few days, and pinpoint marks where the needles passed. Make-up can usually go back on once the surface has closed. Dr. Gallacher will tell you at your consultation what your own skin is likely to do and will plan the four dates around anything you have coming up.
Thermage is usually one treatment. The microneedling machines are not. They need a course: four treatments, about a month apart. Each one takes about an hour. The gap of a month is on purpose. It lets your skin build the collagen from one treatment before the next is added on top.
Expect to look pink on the day, with the redness settling over a few days, and tiny dots where the needles went. You can usually go back to make-up once the surface has closed. Dr. Gallacher will tell you at your consultation what your skin is likely to do, and will plan the four dates around anything you have on.
Exilis: radiofrequency and ultrasound together
Exilis: radio waves and ultrasound together
The third group combines two forms of energy. Exilis delivers monopolar radiofrequency together with ultrasound from a handpiece moved over the surface, with the skin temperature monitored continuously and the surface cooled as it works. The two energies reach different depths, which is what allows the same platform to be used on delicate facial skin and on the body.
The third group uses two kinds of energy at once. Exilis gives radiofrequency and ultrasound together, through a handpiece moved over the skin, while the temperature is watched the whole time and the surface is cooled. The two energies reach different depths, which is why the same machine can be used on delicate skin on the face and on the body.
There is nothing to recover from. Most patients describe it as a hot stone massage: warm, moving, comfortable. You can go straight back to your day afterwards, which is why it suits patients who cannot take any visible recovery at all. It is done as a short course of sessions rather than a single visit, and the number of sessions and the areas treated are agreed at your consultation.
There is nothing to recover from. Most people say it feels like a hot stone massage: warm, moving, comfortable. You can go straight back to your day afterwards, which is why it suits people who cannot afford to look treated at all. It is done as a short course rather than one visit. How many sessions, and which areas, is agreed at your consultation.
Exilis: questions patients ask
Exilis: questions people ask
The short answers to the questions patients ask most about Exilis.
Short answers to the questions people ask most about Exilis.
What does Exilis actually do?
It warms the dermis and the tissue just beneath it, using radiofrequency and ultrasound together. The warmth tightens existing collagen straight away and triggers the skin to make new collagen over the following weeks.
Where can it be used?
On the face and neck, and on body areas where skin has lost firmness. The handpiece and settings are changed for the area.
Does it hurt?
No. It feels warm, and the warmth builds as the handpiece moves. Tell us if it becomes uncomfortably hot and the energy is adjusted. No anaesthetic is needed.
How long does a session take?
Depends on the area. A face and neck session is typically well under an hour.
Is there any downtime?
None expected. The skin may look flushed and feel warm for a short time.
How many sessions will I need?
It is planned as a course rather than a single visit. The number is set at your consultation, against the area being treated and what you want to change.
When will I see a difference?
Some firmness can be felt early. The real change comes as new collagen is laid down over the weeks after the course, in the same way as the other two treatments.
Who should not have it?
Anyone with an implanted electrical device, anyone pregnant, and anyone with an active skin infection or broken skin in the treatment area. Metal implants in the treatment area are checked case by case. Dr. Gallacher goes through this at consultation.
Can it be combined with the other treatments?
Yes, in a planned order. Loose skin, lost volume, wrinkles and texture are four separate problems and they are usually best treated in stages rather than by asking one machine to do everything.
What does Exilis do?
It warms the deeper layer of your skin, and the tissue just under it, using radiofrequency and ultrasound together. The warmth tightens the collagen you already have, and gets your skin making new collagen over the following weeks.
Where can it be used?
On the face and neck, and on parts of the body where the skin has gone slack. The handpiece and the settings are changed for the area.
Does it hurt?
No. It feels warm, and the warmth builds as the handpiece moves. Say so if it gets too hot and the energy is turned down. You do not need any numbing.
How long does a session take?
It depends on the area. Face and neck is usually well under an hour.
Will I need time off?
No. Your skin may look flushed and feel warm for a little while.
How many sessions will I need?
It is a course, not one visit. The number is decided at your consultation, based on the area and what you want to change.
When will I see a difference?
You may feel some firmness early on. The real change comes as new collagen builds over the weeks after the course, the same as with the other two treatments.
Who should not have it?
Anyone with an implanted electrical device, anyone who is pregnant, and anyone with an infection or broken skin in the area. Metal implants in the area are checked one by one. Dr. Gallacher goes through all of this at your consultation.
Can I have it with the other treatments?
Yes, in a planned order. Loose skin, lost fullness, wrinkles and rough texture are four different problems. It is usually better to treat them in stages than to ask one machine to fix everything.
Who is a good candidate for non-surgical skin tightening?
Who is a good candidate?
The best candidates have mild-to-moderate laxity, realistic expectations and anatomy that does not require surgical skin removal or deep tissue repositioning.
Someone with mild to moderate looseness, realistic expectations, and anatomy that does not actually need skin removing or deeper tissues repositioning.
- Good candidates value gradual, natural-looking change and limited recovery.
- Significant jowling, neck banding or heavy excess skin may be better treated surgically.
- Active infection, open skin or significant inflammation may require postponement.
- Implanted electrical devices are a contraindication for Thermage FLX; each device has its own medical screening requirements.
- The people who do best want a gradual, natural looking change and very little recovery.
- Heavy jowls, bands in the neck, or a lot of loose skin, are better treated with surgery.
- An infection, broken skin, or significant inflammation, all mean waiting.
- An implanted electrical device rules out Thermage completely. Every machine has its own medical checks.
Safety, and who should wait
Safety, and who should wait
These are medical device procedures and they should be treated as such. Performed correctly they are safe and very well tolerated. Performed at the wrong depth, at the wrong setting or by someone without the training, they are not.
These are medical procedures using medical machines, and they should be treated that way. Done properly they are safe and easy to tolerate. Done at the wrong depth, at the wrong setting, or by someone who has not been trained, they are not.
Expect warmth, redness, mild swelling and tenderness afterwards. With microneedling, expect pinpoint bleeding and tiny scabs as well. Uncommonly, any heat based device can cause a burn, an irregular contour, a change in skin colour, a scar or a change in sensation. That is exactly why the depth, the settings and the operator matter, and why Dr. Gallacher performs these treatments herself.
Treatment is postponed if there is an active infection, broken skin or significant inflammation in the area. An implanted electrical device rules out Thermage FLX. Each device has its own medical screening, which is completed before anything is booked.
Expect warmth, redness, mild swelling and tenderness afterwards. With microneedling, expect tiny spots of bleeding and small scabs too. Less often, any heat based machine can cause a burn, an uneven contour, a change in skin colour, a scar, or a change in feeling. That is exactly why the depth, the settings and the person doing it matter, and why Dr. Gallacher does these treatments herself.
We put treatment off if there is an infection, broken skin or a lot of inflammation in the area. An implanted electrical device rules out Thermage FLX completely. Each machine has its own medical checks, and they are done before anything is booked.
What are the benefits and risks of non-surgical tightening?
What are the benefits and risks?
| Topic | Key points |
|---|---|
| Potential benefits | Gradual improvement in firmness, fine lines or mild laxity without incisions, with shorter recovery than surgery. |
| Common temporary effects | Warmth, redness, swelling, tenderness or temporary surface sensitivity; RF microneedling can also cause pinpoint bleeding/crusting. |
| Important risks | Energy-device risks can include burns, contour irregularity, pigment change, scarring or altered sensation. |
| Alternatives | Facelift/neck lift, dermal fillers for volume loss, resurfacing for texture, neuromodulators for dynamic lines, or observation/no procedure. |
What you can gain A gradual improvement in firmness, fine lines or mild looseness, with no cuts and a much shorter recovery than surgery.
What is normal afterwards Warmth, redness, swelling, tenderness, or the skin feeling different for a while. RF microneedling can also cause pinpoint bleeding and tiny scabs.
The risks that matter Burns, an uneven contour, a change in skin colour, scarring, or altered sensation.
Other options A facelift or neck lift, filler for lost fullness, resurfacing for texture, muscle relaxing injections for lines made by movement, or doing nothing at all.
Where these treatments stand next to a facelift
How these compare with a facelift
These are not facelifts, and they are not as effective as a facelift. A facelift removes excess skin and repositions the deeper tissues. No energy device does either of those things, and anyone who tells you otherwise is selling.
These are not facelifts, and they are not as good as a facelift. A facelift takes away excess skin and moves the deeper tissues back up. No energy machine does either of those. Anyone who tells you otherwise is selling you something.
That is the honest limit. It is not the whole picture. Non-surgical tightening has made great progress over the last decade, and for a large number of patients we now have a true alternative to facelifting: better tolerated, far less involved, no general anaesthetic, no scars, no weeks out of circulation. That is why these procedures are so popular. Most people asking about their jawline do not need an operation. They need firmness back, and they do not want to disappear for a month to get it.
Where surgery is genuinely the better answer, Dr. Gallacher will say so plainly. Heavy jowling, loose bands in the neck and a significant excess of skin are surgical problems, and no radiofrequency device will fix them.
That is the honest limit, but it is not the whole story. These treatments have come a long way in the last ten years, and for a lot of people they are now a real alternative to a facelift: much easier to take, far less involved, no general anaesthetic, no scars, and no weeks out of sight. That is why they are so popular. Most people worrying about their jawline do not need an operation. They want firmness back, and they do not want to vanish for a month to get it.
When surgery really is the better answer, Dr. Gallacher will tell you straight. Heavy jowls, loose bands in the neck and a lot of excess skin are surgical problems, and no radiofrequency machine will fix them.
What is recovery like for each treatment?
What is the recovery like for each?
Thermage and Exilis are generally designed as low-downtime treatments, while RF microneedling produces a controlled needle-and-heat injury and commonly causes visible redness or swelling for several days.
Thermage and Exilis are designed to leave you free to carry on. RF microneedling makes a real injury with needles and heat, and usually leaves you visibly red or swollen for several days.
| Treatment | What to expect afterwards |
|---|---|
| Thermage FLX | Redness or slight swelling, if it appears at all, usually settles within hours. Bruising and pain are uncommon. There is essentially no downtime and most patients go straight back to work. |
| RF microneedling | Visible redness and swelling for several days, with pinpoint crusting and some sensitivity. This is the one to plan around: leave a clear few days before an event. |
| Exilis | Warmth and a flush that passes quickly. No expected downtime. |
| Treatment | What to expect afterwards |
|---|---|
| Thermage FLX | If you go red or slightly puffy at all, it usually settles within hours. Bruising and pain are uncommon. There is essentially no time off, and most people go straight back to work. |
| RF microneedling | Visible redness and swelling for several days, with tiny scabs and some sensitivity. This is the one to plan around. Leave a few clear days before an event. |
| Exilis | Warmth and a flush that passes quickly. No time off expected. |
Comparison chart for Thermage FLX, RF microneedling and Exilis downtime and treatment approach
A comparison of recovery time and approach for Thermage FLX, RF microneedling and Exilis.
When do skin-tightening results appear and how long do they last?
When will I see it, and how long will it last?
All three work by getting your skin to build new collagen, and building collagen takes time. Some patients feel a change early. The measurable result appears gradually over the following two to six months.
All three work by getting your skin to build new collagen, and that takes time. Some people feel a change early on. The real, measurable result comes in slowly over the next two to six months.
After a single Thermage FLX treatment, the result typically holds for one to two years, depending on your skin and the way you age. In this practice Dr. Gallacher generally recommends repeating it at about one year, as part of an annual plan. After a course of RF microneedling, the collagen continues to build for several months after the fourth session. Exilis is maintained with occasional sessions.
You continue to age, and none of these stops that. What they do is put you back a step and hold you there while you keep up with it.
After one Thermage FLX treatment the result usually holds for one to two years, depending on your skin and how you age. In this practice Dr. Gallacher usually suggests repeating it at about a year, as part of a yearly plan. After a course of RF microneedling, collagen keeps building for several months after the fourth session. Exilis is kept up with occasional sessions.
You go on ageing, and none of these stops that. What they do is put you back a step, and hold you there while you keep it up.
How do I choose between Thermage, RF microneedling and Exilis?
How do I choose between them?
Non-surgical tightening has made great progress in the last decade. All three of these are excellent treatments, and the only real question is which one suits you.
These treatments have come a long way in the last ten years. All three are excellent. The only real question is which one suits you.
The answer depends on how much recovery you can take, how deep the energy needs to go, whether your skin also needs its texture treated, whether we are treating face or body, whether you mind needles, and how loose the skin actually is. It also depends on separating true skin laxity from lost volume, from lines made by movement, and from sun damage. Those are different problems and they respond to different things: filler, a neuromodulator, or resurfacing, rather than a tightening device.
Dr. Gallacher will examine your skin and help you decide which one suits it best at your consultation. She may recommend one, or a planned combination in a set order, or she may tell you that a tightening device is not the right answer for what is bothering you.
The answer depends on how much recovery you can take, how deep the energy needs to go, whether your skin also needs its texture treated, whether we are treating the face or the body, whether you mind needles, and how loose the skin really is. It also depends on telling genuinely loose skin apart from lost fullness, from lines made by movement, and from sun damage. Those are different problems, and they need different answers: filler, muscle relaxing injections, or resurfacing, rather than a tightening machine.
Dr. Gallacher will look at your skin and help you decide which one suits it best at your consultation. She may recommend one, or a planned combination in a particular order, or she may tell you that a tightening machine is not the right answer for what is actually bothering you.
Dr. Gallacher performs these treatments herself
Dr. Gallacher does these treatments herself
Every radiofrequency and laser treatment in this practice is performed by Dr. Gallacher. They are not delegated to an assistant, a nurse or a technician.
Every radiofrequency and laser treatment here is done by Dr. Gallacher. They are not handed to an assistant, a nurse or a technician.
This matters more here than patients usually realise. Thermage is a strongly operator dependent procedure: the number of passes, how the energy is stacked and how each zone is planned change the result far more than the brand of machine does. With microneedling radiofrequency, the depth is chosen by the operator, area by area, and choosing it wrongly is how the reported complications happen. There is no setting that treats a whole face correctly.
Dr. Gallacher is a board certified dermatologist, fellowship trained, and has served on the faculty at Stanford University and UC Davis. She selects the specific technology for each indication rather than putting every patient through whichever device the practice happens to own, and she does not cut corners on the number of passes or the treatment time.
That matters more than most people realise. Thermage depends heavily on the person doing it. How many passes, how the energy is built up, and how each area is planned all change the result far more than the brand of machine does. With microneedling radiofrequency, the person doing it chooses the depth, area by area. Choosing it wrongly is how the reported problems happen. There is no single setting that treats a whole face properly.
Dr. Gallacher is a board certified dermatologist. She did fellowship training, and she has taught on the faculty at Stanford University and UC Davis. She picks the right technology for the problem in front of her, instead of putting everyone through whichever machine the practice happens to own. She does not cut the number of passes or the treatment time short.
Illustrative result
What a result can look like
Illustration, not a patient photograph. Before and after non-surgical skin tightening treatment. It shows the kind of change this treatment is intended to produce. Individual results vary, and no outcome is guaranteed. Photographs of real patients are published only with written consent.
This is a drawing, not a photo of a patient. It shows a before and after for non-surgical skin tightening, to give you an idea of the kind of change it aims at. Results are different for everyone, and nothing is guaranteed. We only publish photos of real patients with their written permission.
Call, or request a consultation
Call us, or request a consultation
Call the practice on (925) 820-3376, or request a consultation and tell us the time that suits you. We will confirm it with you by email. Dermatology and Laser Centre, 770 San Ramon Valley Blvd #A, Danville, CA 94526.
Call us on (925) 820-3376, or request a consultation and tell us the time you would like. We will confirm it with you by email. Dermatology and Laser Centre, 770 San Ramon Valley Blvd #A, Danville, CA 94526.
Questions patients ask
Is non-surgical skin tightening as effective as a facelift?
Is this as good as a facelift?
No, and nothing that avoids surgery is. A facelift removes skin and repositions deeper tissue. What these treatments do is tighten and rebuild the skin you have, well enough that for most people wanting a firmer jawline they are now a genuine alternative to an operation. If you need real lifting, surgery is the stronger answer and Dr. Gallacher will tell you so.
No, and nothing that avoids surgery is. A facelift takes away skin and moves the deeper tissue back up. These treatments tighten and rebuild the skin you already have. They do it well enough that for most people who want a firmer jawline they are now a real alternative to an operation. If you need proper lifting, surgery is the stronger answer, and Dr. Gallacher will tell you so.
Which treatment has the least downtime?
Which has the least recovery?
Thermage FLX and Exilis. Thermage redness, if it appears, usually settles within hours. Exilis has no expected downtime. RF microneedling leaves you visibly red for several days.
Thermage FLX and Exilis. If Thermage makes you red at all, it usually settles within hours. Exilis needs no time off. RF microneedling leaves you visibly red for several days.
How many treatments do I need?
How many treatments will I need?
Thermage FLX is usually one, repeated at about a year. RF microneedling is four treatments about a month apart, each about sixty minutes. Exilis is a short course. The exact plan is confirmed at your consultation.
Thermage FLX is usually one, repeated at about a year. RF microneedling is four treatments, about a month apart, each about an hour. Exilis is a short course. The exact plan is agreed at your consultation.
Is RF microneedling safe?
Is RF microneedling safe?
It is an FDA-regulated medical-device procedure and many treatments are performed without serious complications. Provider training and correct device use matter.
It is a regulated medical procedure, and most treatments happen without serious problems. Training, and using the machine correctly, matter.
Can these treatments be used on the neck and body?
Can these be used on the neck and body?
Yes, depending on the device and the area. Exilis in particular is used on the body as readily as on the face.
Yes, depending on the machine and the area. Exilis in particular is used on the body as easily as on the face.
Can I combine skin tightening with fillers or resurfacing?
Can I combine this with filler or resurfacing?
Often, but the order and the timing matter. Laxity, volume loss, wrinkles and texture are four separate problems, and treating them in planned stages works better than asking one device to do everything.
Often, but the order and the timing matter. Loose skin, lost fullness, wrinkles and rough texture are four different problems. Treating them in planned stages works better than asking one machine to do it all.
Does it hurt?
Does it hurt?
Thermage FLX is almost pain free: a brief hot sensation as the tip fires, then cooling. RF microneedling hurts a bit more, and a topical anaesthetic is sometimes used. Exilis feels like a warm massage.
Thermage FLX is almost pain free. You get a quick hot feeling as the tip fires, then cooling. RF microneedling hurts a bit more, and numbing cream is sometimes used. Exilis feels like a warm massage.
Can these be used if I have darker skin?
Can these be used on darker skin?
Yes. Radiofrequency is not absorbed by pigment, which is why it can be used across all skin types. Settings are adjusted for your skin, and Dr. Gallacher will discuss this with you.
Yes. Radiofrequency is not absorbed by pigment, which is why it can be used on all skin types. The settings are adjusted for your skin, and Dr. Gallacher will go through it with you.
Who actually performs the treatment?
Who actually does the treatment?
Dr. Gallacher. Every radiofrequency and laser treatment in this practice is performed by her personally, not delegated.
Dr. Gallacher. Every radiofrequency and laser treatment here is done by her personally. It is not handed to anyone else.
Talk it through with a physician first.
Every plan starts with an assessment of your skin, your anatomy and what you actually want to change.
This page is general health information, not medical advice. It cannot tell you whether a treatment is right for you. Approved uses, risks and results differ from person to person, and product labelling changes. Ask us at Dermatology and Laser Centre about your own situation, or make an appointment, and seek urgent care for any serious symptom.
