A clinical guide to laser skin tightening in London, explaining how PicoSure and Erbium YAG stimulate collagen and improve firmness.
As interest in non-surgical skin tightening has grown, so too has confusion around the range of technologies available. Lasers and energy-based devices are often discussed together, despite working in very different ways and addressing different aspects of skin ageing.
At the Dr Joney De Souza Clinic in Marylebone, we approach skin tightening as an individual patient assessment rather than being ‘device-driven’. The focus is not on chasing firmness quickly, but on stimulating collagen in a way where the patient benefits from natural, lasting results.
In clinical terms, skin tightening does not refer to lifting or repositioning tissue. Instead, it describes treatments that improve firmness and elasticity by stimulating collagen and elastin within the skin itself.
As collagen production naturally declines with age, the skin can become thinner and less resilient. Energy-based treatments aim to address this by creating a controlled stimulus that encourages the skin to repair and strengthen over time.
The effects of skin tightening treatments are gradual rather than immediate, developing as collagen remodels in the weeks and months following treatment. For this reason, results tend to be subtle and natural, rather than dramatic.
At the clinic, skin tightening is understood as a quality-based improvement, not a substitute for surgical lifting, and treatment selection is guided by realistic expectations and skin health.
Energy-based treatments use laser strategies, light or thermal energy to trigger a controlled response within the skin. This response encourages fibroblasts to produce new collagen, leading to improved firmness and texture.
The depth, mechanism and intensity of energy delivery vary significantly between devices, which is why different lasers are suited to different concerns. This is why PicoSure is the choice for many patients looking to remove tattoos.
PicoSure is a non-ablative picosecond laser more commonly associated with pigmentation and clarity, but it also plays a role in skin tightening.
By delivering ultra-short pulses of energy, PicoSure stimulates collagen without disrupting the skin surface. This makes it suitable for patients with early signs of laxity or those seeking subtle tightening alongside improvements in tone and brightness.
At the clinic, PicoSure is often used when downtime needs to be minimal and skin quality rather than structural change is the primary concern.
Erbium YAG lasers have a longer-established role in skin resurfacing and tightening. By precisely removing micro-layers of skin, they stimulate collagen regeneration more directly.
As explained by Roma Sumskiene, senior aesthetic therapist at Dr Joney de Souza’s clinic, Erbium YAG lasers work by creating controlled injury that prompts the skin to rebuild itself stronger and firmer. This makes them particularly effective for more advanced texture changes, but also means they require more recovery time.
At the clinic, Erbium YAG is reserved for cases where deeper resurfacing and tightening are clinically appropriate.
Rather than viewing these lasers as alternatives, the Dr Joney De Souza clinic in London considers them complementary.
PicoSure is often used for early laxity, pigment and brightness
Erbium YAG is typically selected for more advanced texture change and tightening
In some cases, treatments may be staged over time, allowing the skin to respond gradually and predictably.
At the Dr Joney De Souza clinic, consultations focus on:
Skin type and sensitivity
Existing skin health and barrier function
Previous laser or injectable treatments
Recovery capacity and lifestyle considerations
This ensures that PicoSure or Erbium YAG is introduced at the right time and intensity, supporting long-term skin quality rather than short-term change.
Not all skin laxity responds equally to energy-based treatments. Factors such as skin thickness, age, lifestyle, and genetics all influence outcomes.
At the clinic, consultations with Dr Joney De Souza’s expert team focus on identifying whether skin tightening is achievable with lasers, or whether alternative or supportive treatments may be more appropriate.
Laser skin tightening is most effective when approached conservatively and strategically. By selecting the right technology for the right concern, and allowing results to develop gradually, patients are more likely to achieve natural, sustainable improvement.
At Dr Joney De Souza’s clinic in Marylebone, skin tightening is approached as part of a broader skin health strategy rather than a standalone solution.
Laser skin tightening refers to treatments that use controlled energy to stimulate collagen production, helping improve firmness and skin texture gradually over time. Results are typically subtle and develop progressively.
PicoSure is a non-ablative picosecond laser that can stimulate collagen without disrupting the skin surface. It is often used to improve skin quality, clarity, and early firmness concerns with minimal downtime.
Energy based treatments include lasers, radiofrequency and ultrasound technologies that stimulate collagen by delivering controlled energy into the skin. PicoSure, Erbium YAG, radiofrequency microneedling and ultrasound based devices all fall into this category, but they vary significantly in strength, downtime and results.
Erbium YAG laser treatment tightens skin by creating controlled resurfacing that triggers collagen regeneration. Because it treats more directly at the surface, it can involve more downtime than non-ablative laser options.
Neither laser is universally “better”. PicoSure is often used for early firmness concerns and minimal downtime, while Erbium YAG may be selected when more intensive resurfacing and tightening are clinically appropriate. Suitability depends on skin type, goals, and recovery tolerance.
Longevity varies. Collagen stimulation develops over months and results can last for many months, but skin continues to age and maintenance may be advised depending on individual factors and the treatment plan.
In some treatment plans, yes. PicoSure may be used to improve pigmentation and overall skin quality, while Erbium YAG is reserved for targeted resurfacing and tightening. A combined or staged approach can offer comprehensive rejuvenation when carefully planned by an experienced medical practitioner.
PicoSure and Erbium YAG lasers work in very different ways. PicoSure uses ultra short picosecond pulses to create a photo acoustic effect within the skin, stimulating collagen and improving pigmentation and texture with minimal surface damage. Erbium YAG is an ablative laser that removes controlled layers of the skin’s surface, triggering a stronger regenerative response and more visible tightening, but with greater downtime.
Ageing skin often benefits from a tailored approach rather than a single device. PicoSure is ideal for early signs of ageing, uneven tone and loss of radiance. Erbium YAG is more suitable for deeper wrinkles, texture changes and skin laxity. The best option is determined by skin condition, recovery tolerance and desired outcome.
Our patients return to us year after year for natural, balanced results. Every review reflects our commitment to precision, safety and a personalised approach to aesthetic care.
Based at 49 Blandford Street in Marylebone, the Dr Joney De Souza Skin & Laser Clinic is known for its refined, personalised approach to aesthetic medicine and skin health. The clinic offers a carefully curated range of advanced treatments, including Skinvive by Juvéderm, designed to improve skin quality, hydration and radiance while preserving natural facial expression.
Every aesthetic treatment at the clinic is approached with the same attention to detail and clinical integrity, focusing on long-term skin health rather than short-term cosmetic change. Through thorough consultation and tailored treatment planning, patients are guided towards subtle, effective solutions that support healthy, luminous skin over time.
