Would Thermage help me or do I need fillers? (photos)

I feel like my face is too narrow and would like to not look so sad when not smiling. Do I need fillers or will thermage help. Thank you.

Doctor Answers 4

You don’t need much skin tightening, which is what Thermage does

Thanks for the question and including the photos as well. You don’t need much skin tightening, which is what Thermage does. You could benefit from some volume replacement in the cheeks and for this we would recommend that you have a consultation with a board-certified dermatologist or plastic surgeon and learn about the fillers that we are using in the cheeks.The HA fillers Voluma and Perlane can work well here. Radiesse Plus (with lidocaine) was just FDA approved this week and works well here as well. And Sculptra, given over time, can give natural and long-lasting results as well. The skills of the provider are the most important thing here so find someone skilled in how to best volumize the cheeks.


Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Thermage Under the Eyes

Based on the photos provided, Thermage would not be on the top of my list for providing aesthetic improvement. Thermage is a moderately effective soft tissue tightener which utilizes radiofrequency waves. For a younger patient with concerns about prominent tear troughs, use of a filler like Restylane would be more appropriate. Conservative volume addition to the cheeks could also be considered using Voluma.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 reviews

Thermage vs Fillers

If you feel your face is too narrow you can add volume with fillers.

To improve your cheek hollows I would recommend Sculptra. Sculptra is used to stimulate collagen production, helping to replenish volume loss. Sculptra is the only volumizer scientifically designed to stimulate natural collagen growth treating the underlying cause of facial aging. It is important to be aware that Sculptra is not an instant filler, but a collagen stimulator, improvement will be slow and progressive for up to 6 months after your last session. Sculptra is injected in a series of treatments once a month, usually for 3-4 sessions and the benefits of Sculptra last up to 2 years with optimal treatment.

I would also recommend Juvederm Voluma for the Mid Cheek. Voluma is specifically formulated to correct volume loss and enhance contour to the mid cheek area creating a subtle lift, giving a more youthful appearance. Voluma instantly provides a smooth, natural-looking appearance to the cheek area that last up to 2 years with optimal treatment.

If you want to improve laxity then Thermage CPT Total Tip is a great option. Thermage uses focused radiofrequency energy to stimulate the body’s own natural renewal process. A Thermage treatment can help improve the appearance of sagging or loose skin giving you a smoother, younger look with just one treatment and no down time. Our patients see results immediately off the table and continue to get improvement with Thermage CPT Total Tip treatment for up to 6 months as their skin regenerates new collagen.

It is best to consult with a Board Certified Dermatologist with plenty of treating these concerns to see what procedure is best for you.

For more information on Thermage click on the link below:

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 17 reviews

Facial Volume

Thermage is a fabulous laser for facial tightening.  The results of Thermage are facial rejuvenation and producing new collagen. Depending on how much volume you need you may need additional fillers or volumizers such as Voluma, Sculptra, or Restylane. Please consult a board certified dermatologist for a consultation to determine your specific best protocol. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.