How Can I Tighten My Skin?

Skin tightening options depend on the degree of laxity and whether excess fat is also affecting the contour. In this 2020 episode, Darren M. Smith, MD, a plastic surgeon in New York City, compares topical products, energy-based procedures and surgical skin removal.

He explains how loss of skin elasticity contributes to laxity, then discusses the different goals of improving skin appearance, stimulating a tissue response and removing excess skin. The device and pricing discussion reflects his practice at the time.

Key takeaways

🔬 Moisturizing and removing loose skin are different goals.

Dr. Smith describes a temporary improvement in appearance from hydration while explaining the limitations of creams for substantial laxity.

🔬 Energy-based treatments rely on a tissue response.

The recording discusses radiofrequency microneedling through Morpheus8 and procedures using BodyTite, FaceTite and AccuTite. These are different techniques with their own risks and limitations.

⏳ Changes can take time.

Dr. Smith explains that the healing response develops over months; the episode's examples should not be treated as a promised result or schedule.

🔬 Surgery removes excess skin.

Examples include face and neck lifts, arm lifts and tummy tucks. Significant laxity can require a different approach from a less extensive concern.

🔬 Fat and skin need separate assessment.

Liposuction may enter the discussion when excess fat contributes to the contour, alongside consideration of the skin.

💬 Questions answered

Will a skin-tightening procedure also remove unwanted fat?

That depends on the procedure and the tissue being treated. The episode explains why Dr. Smith sometimes discusses liposuction separately: changing the skin does not automatically address the amount of underlying fat.

Are device treatments equivalent to surgical skin removal?

No. The recording distinguishes the goals and limits of device-based treatment from excisional surgery. The degree of laxity, expected change, recovery and scar tradeoffs belong in an individual consultation.

ℹ️ Current context for this 2020 recording

The FDA's October 2025 RF microneedling safety communication reports serious complications with certain uses, including burns, scarring, fat loss and nerve damage. It concerns RF microneedling specifically, rather than every radiofrequency procedure. Microneedling penetrates skin and should not be described as completely noninvasive.

The recording also discusses platelet-rich plasma (PRP). The FDA states that microneedling devices are not approved to deliver blood products such as PRP into skin. Discuss the evidence and risks for any proposed combination. All dollar amounts and treatment schedules in the audio are historical examples, not current quotes or individualized recommendations.

🎧 Episode chapters

01:21 — Skin elasticity and topical products

03:51 — Energy-based skin treatments

09:24 — Surgical skin removal

10:30 — Liposuction and PRP discussion

12:47 — Historical pricing and treatment schedules

14:19 — Risks and home-treatment claims

🔗 Related information

Explore Morpheus8 information, BodyTite information, tummy tuck surgery, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 12, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources