If Thermage is So Great, How Come People Say They Don't See Results?

Thermage has a bad reputation for not working. I think this has to do with a number of factors. To begin with, the early machines and tips were not nearly as effective as the latest generation of tips and machines. Secondly, it has been oversold to people that are not great candidates and have too much loss of elasticity or gravitational changes. Lastly, there is a bit of technique involved to increase the probability for a good result and much of that has to do with pushing the energy more to get better thermal contraction of the tissue. Personally, having done it for almost 10 years on hundreds of patients and getting a 90 percent success of decent tightening I would tell you that it has to hurt a bit to consistently work. This is one reason I prefer to perform the procedure myself. Although Ulthera is the "new kid on the block" and is getting a lot of publicity, the new thermage total tip goes as deep to tighten tissue. Many physicians are coming back to thermage for more consistent results. While tightening within the first few months is the goal, I have seen thermage do an excellent job in prevention. This is an under appreciated but very important benefit if it helps delay the need for a facelift. But, it is very important to determine who is truly the right candidate so that the money is well spent.

Thermage has noticeable but very limited results.Like other skin resurfacing procedures it tends to tighten the skin to an extent to smooth some of the fine lines, improve pigment problems and diminish pore size. What they do NOT do well is to minimize jowls and other signs of facial soft tissue laxity. Only a mini facelift or facelift will take care of this problem in a significant fashion. This is why satisfaction after Thermage treatments are rated so low.

Thermage, like other non-invasive treatments, produces subtle changes.  Therefore, patients who desire more significant results will generally be dissatisfied with the outcome even though it has virtually no down-time.  The key, as others have indicated, is careful patient selection and understanding of the benefits and limitations of the treatment.  For a relatively young patient who is not emotionally or financially ready for facial rejuvenation surgery, the older patient who is not a good medical candidate for invasive procedures, or one seeking a modest improvement, it's a reasonable option.