What is the difference between ThermiVA and MonaLisa RF treatments? How do you choose?

Doctor Answers 18

Different technnologies, similar effect

Both technologies are effective in shrinking vaginal tissues, leading to improved vaginal laxity, improvement or cure of mild to moderate urinary incontinence, and in many cases improvement in sexual and orgasmic function.  It also helps significantly with vaginal lubrication in women with postmenopausal atrophy.

Thermiva works by heating the vaginal tissues to a degree than new collagen and nerves form in the vaginal tissues, using radiofrequency energy.  The laser products work by using a laser to cut tiny little pits into the tissue throughout the vagina.  Both procedures are painless and cause similar effect in the vagina.  Thermiva has the advantage in that it can be used on the outer vagina / labia as well to treat cosmetic sag of the labia majora, not uncommon as women increase in age or have children.

Our practice uses Thermiva because we see it as more comfortable for our patients, and can also be offered at a lower price point than laser (as the laser equipment is nearly 3x the cost of Thermiva equipment).   Our patients have been tremendously happy with Thermiva.

Portland OB/GYN
5.0 out of 5 stars 2 reviews

Honest information on ThermiVa, FemiLift and Mona Lisa Touch


ThermiVa, Mona Lisa Touch, and FemiLift are all nonsurgical intravaginal treatments that can be used for vaginal atrophy and, at a different wavelength, probably for mild vaginal "tightening." Yes, there are differences, as well as similarities. ThermiVa utilizes RF ("radiofrequency wave") energy, while Mona Lisa Touch and FemiLift utilize laser, or "lightwave energy" to accomplish similar goals. (Click on link below for more info...) While there is good research evidence that the laser treatments may be used successfully to "relax" and help stretch tightened, atrophic vaginas, there is less robust, and no long-followup evidence that it reliably does the same for vaginal TIGHTENING (at a different power setting.) Ditto with ThermiVa. Both of these non-invasive modalities have their proponents, but  there is little ling-term data, and both therapies need to be regularly repeated: ThermiVa every 1-2  years, and Mona Lisa or FemiLift every 2-3 years, according to the companies that sell these devices.

I have used FemiLift and am intimately familiar with Mona Lisa and ThermiVa. Yes, they have a place, but please don't be swayed by all the hype. Both are probably OK for short-term mild vaginal tightening- good for women who havent has children & feel lax, or women who are with a "smaller" man and just need a bit of tightening, or a woman who will be having more children & needs some tightening until she can have a definitive surgical procedure after her last childbirth. They are also probable good for treating the upper vagina (no muscles up there...) in women with lax far upper vaginas and mild stress urinary incontinence.

But, if your issue is with significant vaginal relaxation,( "...sensation of wide vagina..."). you will be dissatisfied with either non-invasive modality-- time for a surgical tightening ("Vaginoplasty") and serious pelvic floot P.T. to strengthen your muscles!


Michael P Goodman MD

ThermiVa vs Monalisa

As a certified ThermiVA trainer in the Atlanta area, I have trained many doctors on how to safely use ThermiVA and we have the most experience with ThermiVA in Georgia. ThermiVa and MonaLisa are both effective for vaginal tightening. However, ThermiVa is the only technology that can treat both the outside and inside of the vagina. The probes for ThermiVa is a one time, non reusable probe! Themiva is a wonderful procedure for vaginal tightening for vaginal laxity, stress urinary urgency, orgasmic dysfunction, labial reduction. ThermiVA is the latest technology for vaginal rejuvenation without surgery, or downtime. The excellent results from Thermiva has been supported by studies, patient testimonial, and numerous reviews. In our certified center, those that are not candidates for ThermiVa are offered other options such as labialplasty or vaginoplasty during the confidential consultation.

However, your best plastic surgeon has the experience, training, and results that relates to you. Do your research and find a real Plastic Surgeon and book a paid consultation. Free consults are just a sales pitch and does not work in your best interest. People always say “you get what you pay for”. This is very true in Plastic Surgery.

Below are other criteria to use when selecting a Plastic surgeon.

Questions to ask your potential plastic surgeon (Answering NO is a big red flag)

1) Are you a plastic surgeon? (You should research the differences between cosmetic surgeon & plastic surgeon. Make sure that your plastic surgeon is a trained surgeon! You may be surprised)
2) Are you board certified in Plastic Surgery? (Board certified in what? You are looking for the American Board of Plastic Surgery. There are many boards and some are fake. Make sure that the certifying board is a member board of the American Board of Medical Specialties or the American Osteopathic Association.)
3) Will the procedure be performed at a fully accredited & certified procedure room or ambulatory surgery center, or hospital
4) Do you have hospital privilege to perform the same procedure you do in the office? Which Hospital?
5) Do you offer complication insurance. How do you handle complications and revision (it does happen, it better to be safe)

The most important decision is to do your homework well. Good luck.

Stanley Okoro, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 158 reviews

ThermiVA vs MonaLisa

MonaLisa RF uses a fractional CO2 laser to stimulate collagen and some downtime, unlike the ThermiVa. Both procedures are painless, and treat the same conditions.

Jenny Weyler, MD
Worcester Physician
5.0 out of 5 stars 6 reviews

THERMiva & MonaLisa, why we made our choice.

Both procedures are painless and cause similar effect in the vagina. THERMiva allows for treatment with the outside labia area, whereas MonaLisa does not.

Our practice decided on THERMiva because it has NO re-usable components reducing the risk of infection. THERMiva can also be offered at a much lower price point than laser (as the laser equipment was nearly 2x the cost of THERMiva equipment).

We have been very pleased with our decision as every patient has been over the moon with the experience, treatment, and success with THERMiva.

Donna Chester, MD
Anchorage OB/GYN
5.0 out of 5 stars 1 review

Radiofrequency heat vs CO2 laser

Ultimately, the differences are in the technology and the end results. Though they both treat for lubrication, ThermiVa also treats the outside labia, whereas MonaLisa does not. I've created a comparison chart on my blog linked below for your reference.

Jayesh Panchal, MD
Edmond Plastic Surgeon
5.0 out of 5 stars 24 reviews

Difference Between ThermiVa (RF) And MonaLisa Touch (C02)

ThermiVa uses radio frequency waves that produce energy. This energy gently heats the vaginal, labial and surrounding tissue to create an improvement in collagen. This creates healthier, tighter tissue. It also improves stress incontinence that may women have with age or childbirth and improves the ability to have orgasms. The Mona Lisa uses a laser such as a fractional CO2 laser. The lasers that can help externally need special handpicks and local anesthesia. If you want vaginal tightening, plus vulvar tightening, enhanced sensation with no down time and completely painless, you should choose ThermiVa.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 118 reviews


#ThermiVA uses RF (Radiofrequency) whereas the #MonaLisa and #FemiLift use a CO2 laser. Both cause rejuvenation effects to the vaginal area. The difference is that ThermiVa can also be used on the labia and clitoral area and is not painful.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

What is the difference between ThermiVA and MonaLisa RF treatments? How do you choose?

Mona Lisa Touch and Femi Lift are both fractional CO2 laser treatments. ThermiVA is a radio frequency based device. This technology is not able to raise tissue temperatures sufficiently to promote new collagen growth (Neocollagenesis), which is necessary for any lasting results. It has been shown that Neocollagenesis occurs ONLY when the tissues are heated to 60-70C. ThermiVa absolutely does not heat tissues to 60-70C, but only achieves perhaps 45-50 degrees Celsius. By heating the vaginal lining tissues, ThermiVa causes swelling, or edema. There is no scientific basis that supports the notion of ThermiVa producing long lasting results Fractional laser devices, such as Femi Lift by Alma lasers, actually have been shown through rigorous scientific study, to promote Neocollagenesis by heating the vaginal lining tissues to 60-70 degrees Celsius. Furthermore, Femi Lift also causes fractional ablation of the vaginal lining, resulting in regrowth of a thicker and more youthful vaginal lining. In my practice we have treated dozens of patients with Femi Lift and I have nor seen a single treatment failure. Furthermore, most, if not all of my stress urinary incontinence patients (mild to moderate severity) have completely resolved their SUI. Lastly many have posted that ThermiVa is a "newer" technology. That is just patently untrue. Fractional CO2 laser technology was first used clinically in the early 2000's. Radio frequency has been in use since the 1980's and the external application (like ThermiVa) was how RF was first used. People, do your homework and do not trust those who are untruthful!

Steven M. Gitt, MD, FACS (in memoriam)
Phoenix Plastic Surgeon
4.8 out of 5 stars 36 reviews

Thermi Va (RF) versus Mona Lisa (CO2)

you can acutally do both treatments to get improvement as one uses heat to stimulate collagen/tightening and the other uses laser to cause wounds that heal and tighten.  It depends on the condition being treated.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

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.