If Thermage is so great, how come people say they don't see results?

An important concept to remember that Thermage and any other procedure depends on many factors. The most important ones for Thermage are patient age & degree of skin looseness.

I would recommend Thermage to a patient comfortably if they have good skin elasticity and are not looking for a dramatic result. The problem with many Thermage recipients is that they were overpromised results and were not ideal candidates to begin with. Make sure the doctor you consult with is also a surgeon who performs surgery on your area of concern. If he or she ONLY knows how to offer Thermage, then how are they qualified to know when NOT to offer Thermage? If you give a carpenter only a hammer, how do you expect them to take care of a screw?

Also, Thermage is not a procedure that can be rushed through. A good Thermage treatment to the face can last several hours, like a facelift. Each pulse needs to be tailored to the patient's facial skin/area/structure. That being said, it will never replace the results of a facelift. But for younger patients who have subtle aging changes and for patients who do not want surgery, it is an excellent option to consider.

The results are long lasting, in the duration of years. It is not like Botox where you need to have it repeated every few months.

Thermage is NOT a treatment for everyone.  Good candidates are younger (the younger the better. . .but some results can be seen in 60+ year-olds but not as much as in people younger than 55), have slightly loose skin, and appropriate expectiations.

It will NOT pull skin as tight as a face lift.  It will NOT get rid of every line or wrinkle. 

Treatment tips and the devices (old Thermage platform vs. Thermage NXT) are not all equal.   Different treatment tips work on eyes, face, hands, body, or cellulite.  Some are better at skin tightening while others focus on circumference reduction. 

The provider must have experience will all of the different modalities and settings to effectively use the device.  They must be comfortable and have experience treating a wide variety of patients.

It is always better to underpromise and overdeliver.

Thermage CAN work well.  However, I find it best used as an adjunct to procedures such as SmartLipo, TotalFX, fat transfers, Botox, or fillers.  It is will NOT cure everything but can definitely play a significant role in the right circumstances.

Thermage generally disappoints patients since practitioners overpromise its benefits and do not choose appropriate candidates. Thermage can be somewhat effective for some patients although it fails for a large number of patients.

For those that it works on, Thermage provides minimimal correction (generally 1 - 2 mm). Combined with the need to repeat the procedure every year to 18 months, many patients are dissatisfied with the treatment and the money that they spent on it.  As a result, we would not recommend Thermage for most patients.