“The latest and most promising innovation in plastic surgery has been radiofrequency. Before radiofrequency, the only skin tightening we would see was from some fibrosis created after liposuction or VASER treatments, but it wasn’t truly skin tightening.”
That is Dr. Frank Agullo, and the new global numbers agree with him. The International Society of Aesthetic Plastic Surgery released its survey of procedures performed in 2025 at the end of September. Non-surgical procedures fell 15.7 percent worldwide. Ten non-surgical treatments are tracked. Nine of them fell. One rose.
The One Line That Went Up
| Non-surgical treatment, worldwide 2025 | Procedures | Change vs 2024 | Change vs 2021 |
|---|---|---|---|
| Non-surgical skin tightening | 1,528,552 | plus 23.3% | plus 52.3% |
| Botulinum toxin | 7,333,647 | minus 7.0% | plus 0.3% |
| Hyaluronic acid fillers | 4,737,957 | minus 25.2% | minus 10.3% |
| Hair removal | 1,150,365 | minus 22.6% | minus 37.3% |
| Poly-L-lactic acid | 426,019 | minus 33.7% | not tracked |
| Non-surgical fat reduction | 406,286 | minus 42.2% | minus 44.4% |
Source: ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2025. The United States did 360,329 of those skin tightening treatments, 23.6 percent of the world total, more than any other country.
Why Fillers Fell and Tightening Rose
Dr. Agullo wrote about the filler decline earlier this year, when the American numbers came out:
“I think the truth is that fillers have decreased considerably compared to other procedures, botulinum toxin still being number one. In my practice, I’ve seen more than a twenty to thirty percent decrease in the use of fillers, and a shift toward biostimulators and donor fat grafts instead.”
“Really, what I think is that there has been a huge tendency to overfill faces with fillers, and maybe that’s why it’s difficult to count.”
Patients who stopped adding volume did not stop wanting firmer skin. Radiofrequency is where that demand went, and Southwest Plastic Surgery now runs four radiofrequency devices for it.
Which Device Reaches Which Layer
“So far, I have been very happy with BodyTite and Renuvion J-Plasma. BodyTite treats the external skin and the internal fat as a bipolar radiofrequency device. Renuvion J-Plasma treats the subcutaneous tissue, the tissue below the skin, with radiofrequency and helium plasma. And Morpheus8 is limited to treating the superior layers of the skin, dermis, and subcutaneous tissue. QuantumRF treats the deep subcutaneous tissue and skin, creating contracture using higher delivery powers in a safe fashion.”
| Device | Where it works | Setting |
|---|---|---|
| Morpheus8 and Morpheus8 Cool | Skin surface, dermis, upper subcutaneous layer | Med spa (Cool) or operating room |
| BodyTite | External skin and internal fat, bipolar | Operating room |
| Renuvion J-Plasma | Subcutaneous tissue, helium plasma | Operating room |
| QuantumRF | Deep subcutaneous tissue and skin | Operating room |
In the Med Spa
The med-spa side of this growth is Morpheus8, and as of this month, Morpheus8 Cool. Dr. Agullo on why the cooled version matters:
“Morpheus8 is one of the most popular treatments we perform in our med spa. We also use it in the operating room, since we can treat both face and body, and it creates substantial skin resurfacing and skin contracture.”
“Morpheus8 Cool changes that dramatically. The treatments are the same, the depth of treatment is the same, the power is the same. It just makes the procedure so much more comfortable.”
“We still recommend two to three sessions with Morpheus8 Cool.”
In the Operating Room
“Overall, I always recommend skin tightening after liposuction, because liposuction itself is emptying out the tissue, but leaving the skin envelope looser than before, since the volume is not there to stretch it out. Delivering radiofrequency will create contracture, which will give us smoother results.”
“About 30% of the contracture is seen right away during the procedure. Another 30% occurs in the first one to two weeks, and the final third occurs toward the two-month mark.”
Who Should Not Expect Tightening to Do It All
“Massive weight loss patients may not be candidates. If we see a lot of stretch marks on the skin, or large folds with loss of collagen and dermal tears, the likelihood that the skin will contract is lower, and this would require excisional plastic surgery procedures.”
That is the honest limit, and it is also why the same ISAPS report shows body lifts and arm lifts rising alongside tightening. Energy tightens skin that still has collagen in it. Skin that has lost its collagen gets removed.
Pricing
Morpheus8 and Morpheus8 Cool are priced per area on the fees page, with full face and face-and-neck packages of three sessions. Surgical radiofrequency tightening with QuantumRF, Renuvion J-Plasma or BodyTite is priced by body area, starting at $1,000 for a small area, $1,500 for an intermediate area and $2,000 for a large area as of this writing, on top of any liposuction. The fees page is current.
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor every year from 2014 through 2026. He runs four radiofrequency skin tightening devices between the med spa and the operating room, and he has tried the newest one on himself.
Ready to Talk?
To find out which tightening treatment fits your skin, call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful
Find Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
