Know Before You Book: Everything You Need To Know About Sofwave, The Collagen-Boosting In-Office Treatment

If I'm going to be honest with you, I sometimes get a tingle of anxiety that I haven't yet gone down the injectable route. I'm in my early-to-mid 30s, work in the beauty industry, and live in New York City—which is to say that most people I know are already a few years ahead of me. 

Of course, I don't think there's anything wrong with filler or neuromodulators. (I know they make a lot of people happy!) However, I just am not at a place in my life where my skin has given me so much concern that I've called up a dermatologist asking for an appointment and a syringe. But here's where the anxiety sets in: I don't want a decade to pass and end up regretting not having done it. There's so much conversation around "preventive" measures that a small part of me fears waking up one day and I'm the only person I know with a wrinkle. 

What makes this even more out of character is that I actually find wrinkles to be quite alluring and sexy. I love the look of a face that's been lived in, and don't dread wrinkles. I don't mind aging, I just don't want to feel like I'm the only one who's doing so. 

Unfortunately, I don't have a solution to this juxtaposition of feelings, and maybe I never will! 

But what I can tell you is that recently I've started researching alternative in-office procedures—ones that work with your skin to improve the regenerative process. Luckily for me, it's an area that's ripe for exploring. There are so many emerging technologies that can help improve the natural rejuvenation process, helping your complexion look its best for longer. And what I really appreciate about them is that they're not changing the skin or the face, just optimizing its healing potential. 

Sofwave is a skin treatment that uses ultrasound technology to stimulate collagen and elastin production. I'll explain how it does that in a second (along with what makes it so novel compared to other ultrasound devices), but I'd first like to give a brief overview of why we target collagen and elastin in the first place. 

Collagen and elastin are your skin's primary structural proteins. Collagen keeps skin firm and lifted, while elastin gives skin its spring, stretch, and suppleness. Together, they're responsible for many of the characteristics we associate with healthy, vibrant skin. At some point in the mid-20s, the balance of how much the skin produces versus how much is lost tips—and not in our favor. At this point, our natural supply of both declines, and we start to see many of the visible signs of aging, such as sagging skin and fine lines. 

So much of what we do in skin care is geared toward revitalizing that production—so our skin looks and feels like it might've in our early 20s. 

Which brings me back to sofwave. "After age 25, our collagen production goes down. Anything we can do to get that collagen production back up and turn that whole physiology back on, is a good thing. There are a lot of technologies that can improve collagen production in that dermal layer, but they all have downtime. With this, you can go back to life quickly after," says board-certified dermatologist Amy Lewis, M.D., Clinical Associate Professor of Dermatology at Yale University School of Medicine. 

Lewis explains to me that it uses seven parallel beams that bypass the epidermis (the surface of the skin) and enter the mid-dermal layer. This is where collagen and elastin are made, so it more effectively supports their production. 

This isn't the first ultrasound treatment to hit the market, but it is the most sophisticated. "With the way that the energy enters into the skin, it's more effective than ultrasound therapies of the past. It's a fixed depth, so it's only targeting the dermal layer where the collagen and elastin is being produced," says medical assistant Rebecca Manzi at the office of Amy B Lewis M.D.

The treatment is approved for the full face (with a focus on brows and jawline in particular), neck, chest, and on the body (to help with cellulite). It has no downtime whatsoever, but you will have to wait one to three months before you start to see results, with the full benefits at about the six-month mark. It's recommended for once-yearly treatments, but that's really up to you and your dermatologist. 

Oh, and it's pricey: Depending on the amount of surface area you're treating and the practitioner you go to, it will cost you anywhere between $1,500 to $4,500. A full face (which is what I got) starts at $2,500.

Sofwave works by improving collagen and elastin production. Unlike other ultrasound technologies that aren't as exacting, only targets the mid-dermis where the collagen and elastin are produced. The ultrasound energy heats the area, triggering a wound response. With this isolated wound response, collagen and elastin floods the area.

Collagen and elastin loss are the driving force behind sagging and wrinkles. Thanks to its ability to remodel collagen and elastin, skin is lifted and fine lines are smoothed. 

"In your skin, you have different layers of things—collagen, elastin, and so on. As we get older those layers don't lay flat and become hardened, which is why we get wrinkles," says Lewis, noting that this helps remodel those so it evens out the fine lines. 

According to Lewis, the brows and jawline are the two most popular areas of treatment. For both areas, there are a few routes to take that can treat the area, but this is one of the only noninvasive methods that requires no downtime. 

With age, the brows are a common area that starts to sag. "You can tailor what the person wants so well. Some people just want a brow lift—they're noticing that their brows have sagged and only want to target that area. We see people in their 30s asking for this. You can get that done really easily in 15 minutes," she says.

I had heard from fellow beauty editors and insiders about their experiences with Sofwave, so I knew beforehand that I should expect some level of discomfort. 

In fact, model and actress Veronica Webb described it to me as, "It feels like these hot pulses, almost like you're briefly touching the stove. I've heard it described as a 'hot stone massage,' but unless you've had natural childbirth in the woods, you probably wouldn't describe it as that. But I like it because there's no downtime."

I got to my appointment makeup-free and ready to go. I was taken to Lewis' treatment room and asked about what exactly I was looking to get out of this. I explained I'm in my early 30s, have relatively healthy skin, but was looking for an overall collagen boost in my face. 

We decided to treat the full face, so I was slathered with numbing cream from my hairline to the jawline. Numbing creams become more effective the longer it's left on, so we did 40 minutes—however, the time range could be as short as 15 minutes to a full hour. 

"There are different routes the specialist can take to help reduce the pain," Lewis told me, noting that they can numb the skin for longer, use nitrous gas, or even inject local anesthetic to block the more sensitive nerves. I suggest speaking up if you know that you have a lower threshold for pain, as your treatment provider can ensure they're taking the right steps to make sure it's as comfortable as possible. 

My practitioner, Manzi, showed me the machine, which had a curved rectangle tip a few inches in length. When touched to the skin, that tip delivers the energy waves into the dermis. The order of the treatment could vary depending on the practitioner, but for me Manzi explained that we'd do my face in zones: Left, right, forehead. Within the zones, she took my skin in smaller sectioned strips—doing horizontal passes, where she would stop every few inches. Just before we began, she handed me two stress balls. 

I got a little overconfident with the first few zaps. After giving the outer corners of my jawline a quick pass, Manzi stopped to ask how I was doing. I don't even feel it, I chirped back. Boy, would that change!

At a spot just before my chin, the sensation started kicking in. Burning is the closest sensation I can liken it to. Like you've accidentally touched a curling iron to your skin, and it takes you a second before you notice the rush of pain. But because it was targeting the dermis, it was almost like the burning was emanating from the inside, out. The stress balls started making a whole lot of sense.

I soon came to discover that there were areas that were more painful than others, and that was likely because it was near or on a nerve ending or just over bone. The fleshier parts—the ones plump with fat pads, like the cheek—I could deal with no problem. But around the lips, eyes, and forehead were the most aggressive.

Immediately following, I applied a gentle face cream, tinted moisturizer, brushed up my brows, and went back to work. There is minimal downtime to this treatment—skin looks no different before or after. 

For the next several days and weeks, I waited patiently to see my slow complexion transformation. I knew I wouldn't see it for at least one month, so in the meantime I utilized skin care products (like the below) that help optimize collagen production. 

"All of my patients have a skin care routine. I put them on something that's going to help support their collagen, whether it's a retinol or an antioxidant serum. And of course, sunblock, sunblock, sunblock," says Lewis. "A healthy lifestyle. Inside out, and outside in. I think people who want to look better are usually more invested in their health."

Personally, I use a vitamin C serum, peptide-infused cream, and a tinted mineral sunblock.

I got it in mid-March, which just now puts me at the three-month mark—when I'm at the height of my return on investment. As you can see from the photo, there are certainly aesthetic benefits to note: I look more lifted, toned, and refreshed. The fine lines on my forehead aren't whipped away, but they've smoothed out considerably. My eyes don't look so exhausted. 

No one tells you this as you get older, but it's not just aesthetic changes that happen to your skin: There are also noticeable differences in how it acts. It takes longer for skin to recover, like creases from the pillowcase seem to stick around longer, and it's more finicky to environmental stressors. 

It's like I've turned back the clock several years—my 32-year-old skin cells now operating at a level of a 25-year-old. It snaps back quicker, doesn't look so sallow at the end of a long day, and it feels more supple when I wash it. 

Not every treatment is for everyone—and you shouldn't rush out to try something just because someone says it's new and buzzy. And certainly the price tag on this treatment makes it cost-prohibitive for many folks. 

The first thing to note is that it's safe for any skin type and tone. This is notable as many in-office procedures usually have major caveats on who can and can't use it. For example, IPL devices and certain lasers aren't suitable for those with darker skin tones as they may cause hyperpigmentation or scaring. Or microneedling isn't ideal for those with acne-prone skin. But sofwave can be used on skin from pale to dark and dry to oily. 

But just because a product is safe for use, does not automatically mean you should rush to book it. It's important to consider what your goals are and if the intended procedure lines up with them. It's a healthy aging treatment that focuses on collagen and elastin production, so it's ideal for anyone who is starting to worry about fine lines, sagging, and loss of firmness. 

For those looking for a collagen reset, with minimal downtime, Sofwave is an effective solution. You may not see results for a full month after, but I found it to be worth the wait. Just be prepared to deal with pain during the treatment, and speak to your practitioner about ways you can limit discomfort.