I had been leery of Thermage too, but at 51, even though I'm slim and stay out of the sun, I had reached the point of wanting to do "something." My dermatologist has her patients' total trust in whom she recommends certain procedures for--I knew other patients of hers whom she steered away from this and other things.
But she thought I'd be a good candidate and I have to say I'm really happy. It's only been 4 weeks but I can tell a real difference. The sagging in my cheeks and around my face is definitely less, and the nurse who did my procedure paid special attention to my upper lip, to draw that up slightly--I'd been paying lots for Restylane there, but now I think I'll be able to use less, and it all looks really natural.
I also am excited because I know that "full results" will be seen over the next few months.
I would say, go to a dermatologist you really trust, and trust his/her opinion. Also insist on the third-generation "points," because it really is pain free. Out of 300 "jolts," I probably felt about 10, and those really weren't painful, more like, "Oh!" but before you get the "Oh!" out, it's over, you know? No numbing required. Especially cool was, the nurse did one side of my face and then called in the doc and she and I could look at myself in the mirror. I could already see my eyebrow--not even a problem area for me--was higher, as was the side of my cheek and my "cheekline."
I know it's expensive... and I'll be watching to see how long it lasts. But I'm all for holding off on that first face lift as long as possible.