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The Only Non-Surgical Number That Went Up in 2025

Black and white photograph of four women of different backgrounds seated close together in a dark studio, faces lit by a single hard light, bare skin and strong bone structure. Illustrative image, not patients. Frank Agullo, MD, FACS.

The International Society of Aesthetic Plastic Surgery just published its survey of procedures performed in 2025. Ten non-surgical treatments are tracked. Nine fell. Hyaluronic acid fillers fell 25.2 percent. Non-surgical fat reduction fell 42.2 percent. Even botulinum toxin slipped 7 percent.

Non-surgical skin tightening rose 23.3 percent, to 1,528,552 treatments. Since 2021 it is up 52.3 percent.

I Called the Filler Part

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. But truly, what I feel is that there has been such a decrease in the use of fillers that manufacturers and even med spas have become worried, as this is really the only thing they provide, since they do not have a way to provide surgical procedures, which are becoming far more common than hyaluronic acid fillers.

Where the Demand Went

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.

I run four radiofrequency devices. 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.

If I had to pick just one, I would pick QuantumRF over all the other devices, mainly because it delivers more power, and does so much faster, in a safe and controlled fashion.

The Catch

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.

The same report has body lifts and arm lifts rising. Energy tightens skin that still has collagen in it. Skin that has lost it gets removed. The full read, with the device-by-layer table and pricing, is on the Southwest Plastic Surgery site.

Why Me

Double board-certified, Mayo Clinic trained, Clinical Associate Professor of Plastic Surgery at Texas Tech, Castle Connolly Top Doctor 2014 through 2026. Four tightening devices in one practice, and I have tried the newest one on my own face.

Ready to Talk?

Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful

Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

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If I Could Keep One Skin-Tightening Device: The QuantumRF Answer

Black and white photograph of a woman in a fitted black bodysuit and trousers seen from behind in a dark studio, rim light tracing the line of her waist and back. Illustrative image, not a patient. Commentary by Frank Agullo, MD, FACS.

A patient asked me which skin-tightening device I would keep if I could keep only one. I have four. My answer, from the dictation this post is built on:

“If I had to pick just one, I would pick QuantumRF over all the other devices, mainly because it delivers more power, and does so much faster, in a safe and controlled fashion.”

The Thing Nobody Says About Liposuction

Here is why I care this much about a machine most people have never heard of.

“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.”

That is true of every liposuction. “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.”

“Since I’ve been using radiofrequency treatments, we’ve had better and better results in body contouring.”

Why This One

Each device heats a different layer. Morpheus8 works on the surface, “the superior layers of the skin, dermis, and subcutaneous tissue.” 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.”

QuantumRF goes deep and goes hard. It “treats the deep subcutaneous tissue and skin, creating contracture using higher delivery powers in a safe fashion.”

“So far, we’ve seen far greater contracture with QuantumRF than with any other device.”

The layer-by-layer breakdown of all four devices is in the full post on my practice site.

You Can Hear It

“As we’re delivering the energy during the surgery, we actually hear the fat and the connective tissue crackle, which translates into contraction we can visualize immediately.”

Then the rest arrives on a schedule. “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.”

Same incision as liposuction, about four millimeters. Same recovery, “usually five days to get back to normal, easygoing activity, and as soon as two weeks to return to exercise.”

Who I Turn Away

The limit is the skin itself, not the machine.

“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.”

Related reading: body contouring after GLP-1 weight loss, the lipo and tummy tuck cost post, and skin tightening by body area on my fees page.

The Point

“Body contouring is not just about removing fat. It is about shaping and tightening the skin for better overall 360-degree contours, and even muscle enhancement.”

Anyone can take fat out. I have four ways to make the skin follow, and QuantumRF is now the first one I reach for.

Ready to Talk?

Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.