Backgound video

Laser skin tightening explained: PicoSure, Erbium YAG and energy-based treatments compared

  • Blogs

A clinical guide to laser skin tightening in London, explaining how PicoSure and Erbium YAG stimulate collagen and improve firmness.

Laser skin tightening explained:
PicoSure, Erbium YAG and energy-based treatments compared

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.

Considering treatment? Compare all the options on skin tightening treatments page.

What does skin tightening actually mean?

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. They create a controlled stimulus that encourages the skin to repair and strengthen over time.

The effects of skin tightening treatments are gradual rather than immediate. They develop as collagen remodels in the weeks and months after 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. It is not a substitute for surgical lifting. Treatment selection is guided by realistic expectations and skin health.

Discover PicoSure
picolaser-treatment

Collagen stimulation but also tattoo removal

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. Different lasers therefore suit different concerns. This is why PicoSure is the choice for many patients looking to remove tattoos.

Talk PicoSure on WhatsApp

The role of PicoSure in skin tightening

PicoSure is a non-ablative picosecond laser. It is more commonly associated with pigmentation and clarity. Even so, 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. It also suits those seeking subtle tightening alongside better tone and brightness.

At the clinic, PicoSure is often used when downtime needs to be minimal. Skin quality, rather than structural change, is then the primary concern.

Explore PicoSure laser treatments in Marylebone
Picosure-laser-forehead-eye-protection

“For post-breastfeeding saggy or deflated breasts, especially for women with minimal signs of sagging and smaller breasts, Laser Erbium YAG can be an excellent option. This non-invasive treatment works wonders by lifting and tightening the skin around the breast tissue by gently heating it, to induce a thermal response. The process stimulates collagen production and encourages skin tightening, resulting in firmer, more lifted breasts.”

– Roma Sumskiene, senior aesthetic therapist at Dr Joney de Souza’s clinic, in conversation with Vogue

Erbium YAG laser and skin tightening

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.

Roma Sumskiene is a senior aesthetic therapist at Dr Joney de Souza’s clinic. As she explains, Erbium YAG lasers work by creating controlled injury. This prompts the skin to rebuild itself stronger and firmer.

That makes them particularly effective for more advanced texture changes. However, it also means they need more recovery time.

At the clinic, Erbium YAG is reserved for cases where deeper resurfacing and tightening are clinically appropriate.

Speak with a specialist
laser-treatment

Comparing PicoSure and Erbium YAG

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. The aim is long-term skin quality rather than short-term change.

Book a consultation

Why consultation is essential for skin tightening

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, you meet Dr Joney De Souza’s expert team for a consultation. They identify whether skin tightening is achievable with lasers. If it is not, alternative or supportive treatments may be more appropriate.

A considered approach to laser skin tightening

Laser skin tightening in London is most effective when approached conservatively and strategically. The right technology is matched to the right concern. Results are then allowed to develop gradually. This makes natural, sustainable improvement more likely.

At Dr Joney De Souza’s clinic in Marylebone, skin tightening is part of a broader skin health strategy. It is not treated as a standalone solution.

Book your consultation
dr-joney-clinic-inside
picosure-device-marylebone

Frequently Asked Questions on PicoSure & Erbium YAG

Ask us your question

What is laser skin tightening?

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.

How does PicoSure laser support skin tightening?

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.

What are energy based skin tightening treatments?

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.

How does Erbium YAG laser skin tightening work?

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.

Is PicoSure laser or Erbium YAG better for skin tightening?

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.

How long do laser skin tightening results last?

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.

Can PicoSure and Erbium YAG be combined?

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.

What is the difference between PicoSure and Erbium YAG lasers?

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.

Which laser is best for ageing skin?

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.

 4.9 ★★★★★ 268 reviews

Read our reviews

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.

I genuinely wouldn’t trust anyone else with my skin. Dr Joney de Souza remains my top recommendation for anyone seeking expert aesthetic care in London. He has a calm, professional manner and always takes the time to truly listen and understand what you’re hoping to achieve. His approach is natural and refined, you always leave looking like the best version of yourself, never overdone. The clinic is a beautiful, welcoming space in the heart of London, and the entire team is warm, knowledgeable, and highly professional. Dr Joney’s expertise and eye for detail are truly exceptional, and the results speak for themselves.
Daniele Bernardinetti
Daniele Bernardinetti
View on Google
I’ve known Dr. Joney de Souza for years and can’t recommend him highly enough. He’s a true expert in aesthetics — always professional, innovative, and genuinely caring. His treatments are subtle, natural, and always tailored to your needs. A standout in London’s aesthetic scene!
Osmar Pinheiro Bacelar Junior
Osmar Pinheiro Bacelar Junior
View on Google
I had treatment at Dr. Joney De Souza’s clinic one month ago and had a fantastic experience. Dr. De Souza was friendly, highly knowledgeable, and made me feel completely comfortable and at ease throughout the process. His great sense of humor also helped create a relaxed atmosphere. I’m really happy with the results and will definitely be coming back for regular visits. Highly recommend this clinic!
Daluna London
Daluna London
View on Google
The clinic is so very welcoming and really listens to how and what you would like to achieve, i have had several facial treatments and it has made such a difference to my confidence. David and everyone in the clinic are professional and experts in what they do, they treat you with a really personal service. My skin has never looked so clear or glowing .. I’ve had people stop and ask me what and where do I have my treatments .. thank you
Jayne Gates
Jayne Gates
View on Google
I had an excellent experience with Dr. Joney de Souza and his team. From start to finish, they were incredibly supportive, making me feel at ease throughout the entire process. Dr. Joney has both a sharp eye and a soft hand, striking the perfect balance between precision and gentleness. The team’s expertise speaks for itself, and their approach is as refined as it is reassuring. Highly recommended.

About us

The Dr Joney De Souza Skin & Laser Clinic is based at 49 Blandford Street in Marylebone. It is known for a refined, personalised approach to aesthetic medicine and skin health.

The clinic offers a carefully curated range of advanced treatments. These include Skinvive by Juvéderm. Each is designed to improve skin quality, hydration and radiance while preserving natural facial expression.

Every aesthetic treatment gets the same attention to detail and clinical integrity. The focus is long-term skin health rather than short-term cosmetic change. Consultation and tailored treatment planning guide each patient. The result is subtle, effective solutions that support healthy, luminous skin over time.

About Dr Joney De Souza
clinic-extrerior-front-door

Follow us on Instagram

Kind words that made our day 🤍

We were so touched to receive this lovely feedback from a recent client following her PicoSure face treatment with Roma - this one’s for David, Roma, and Dr Joney.

“From the moment I arrived, David and Roma made me feel so welcome and completely at ease. Roma was caring, professional, and took the time to explain the treatment thoroughly, making sure I felt comfortable and reassured throughout. Even after just one session, my skin already feels smoother and looks much more refreshed.”

Moments like this are exactly why we do what we do. It’s not just about the results (although we’re so pleased with how her skin is already responding!), it’s about making every client feel genuinely cared for from the second they walk through the door.

Thank you to our amazing client for such kind words, and to David, Roma, and Dr Joney for the warmth and care you bring to every single appointment 🫶HydraFacial: the secret to that red-carpet glow ✨

Ever wondered what actually happens during a HydraFacial? Here’s a look inside the treatment, step by step, at Dr Joney De Souza.

It begins with a deep cleanse and exfoliation to clear away impurities and prepare the skin, followed by gentle extractions that refine congestion with complete comfort and precision. 

From there, targeted serums and boosters are infused into the skin, tailored entirely to your individual needs, before LED light therapy supports the skin’s long-term health and renewal. 

The treatment finishes with an antioxidant infusion, sealing in radiance for that lit-from-within finish.

This particular treatment was our Deluxe HydraFacial, though for those wanting to elevate the experience further, our Platinum HydraFacial also includes lymphatic drainage, perfect for extra de-puffing and detoxification alongside all the usual glow-boosting benefits.

The result is skin that looks cleansed, replenished, and effortlessly glowing, delivered with the precision and care that defines every treatment here.

📍 Marylebone, London | 020 7043 0748 📱Sculptra vs Juläine: which biostimulator is right for you? 💭

Both Sculptra and Juläine are poly-L-lactic acid (PLLA) biostimulators - meaning rather than simply adding volume, they work by encouraging your skin to produce its own natural collagen over time, for results that look and feel truly you.

Sculptra is the original PLLA injectable, with a long-established track record for stimulating collagen and improving skin structure and firmness gradually over several months, with results that can last up to two years.

Juläine is a newer generation PLLA treatment, using more uniform, highly purified microspheres engineered to mix more evenly, which can help reduce inflammation caused by treatment. Like Sculptra, results build gradually, with visible improvements from a few weeks in and full effects developing over a few months. 

Both are excellent options for restoring facial volume, improving skin quality, and softening lines. The right choice really depends on your skin, goals, and what your practitioner recommends for you.

Not sure which is best suited to your skin and goals? Get in touch with us today to book your consultation.

📍Marylebone, London | 020 7043 0748 📱Product Spotlight | Daily Power Defense ✨

ZO Skin Health’s Daily Power Defense is one of those products that quietly does a lot of the heavy lifting in a skincare routine, and it’s become a firm favourite of ours here at the clinic.

Formulated with Vitamins A and E, it helps protect the skin against environmental damage and free radicals, while supporting barrier restoration and long-lasting hydration.
Over time, this can mean fewer visible signs of premature ageing and a stronger, more resilient complexion.

It’s a lightweight daily step, but one that adds up - the kind of product that supports your skin quietly in the background, day after day.

If you’re curious whether it fits into your routine, drop us a DM, or ask at your next appointment 📅

How can you find us?

Our clinic is located in Marylebone, London, in the heart of one of Central London’s most prestigious and renowned medical districts. Perfectly positioned for convenience and discretion, we are easily accessible from across the capital and beyond.

We welcome patients from Mayfair, Harley Street, Marylebone, Knightsbridge, Belgravia, Chelsea, Kensington, Fitzrovia and St John’s Wood, as well as international patients visiting London for specialist treatment.

Our location benefits from excellent transport connections, with close proximity to major Underground stations, mainline rail links and direct access to Heathrow, Gatwick and London City airports. Several secure parking facilities and convenient chauffeur drop-off points are available nearby, ensuring a seamless and comfortable visit.

Whether you are travelling from elsewhere in London, across the UK or internationally, our clinic offers a calm, private and exclusive setting in one of the world’s leading medical destinations.

Opening hours
Monday
9 am to 6 pm
Tuesday
9 am to 6 pm
Wednesday
9 am to 6 pm
Thursday
9 am to 6 pm
Friday
9 am to 6 pm
Saturday
Closed
Sunday
Closed
Dr Joney De Souza
49 Blandford St, London W1U 7HH
Get directions
Whatsapp