Thermitight Practitioner; wondering if I need to find a plastic surgeon to do the procedure rather than an APRN?

A local medical aesthetic office offers thermitight but an APRN is doing the service. I have had other non invasive procedures from the same person with good results. But, looking at Thermitight procedure (which to me isn't really completely non-invasive since incisions are made and the probe is maneuvered under the skin ) I am wondering if I need to find a plastic surgeon to do the procedure rather than an APRN.

Doctor Answers 9

ThermiTight Procedure

ThermiTight is a procedure that involves making a needle stick in the skin to allow a probe to be inserted to treat the underlying skin and sub-cutaneous tissue. The tissue is first infused with an anesthetic solution to make the procedure relatively pain free.  As such it is invasive, but it is also quite a bit less than the surgical procedures requiring larger incisions, dissection, anesthesia, recovery pain and risks.  The person performing this or any procedure should have the background, training and experience to perform the procedure.  As to who may perform a procedure in your state this is usually decided by the Board of Medicine and Board of Nursing and govern by state law.  Personally, I feel it should be a MD who has the background, training, experience and specific interest in doing this for you.

Who does ThermiTight?

In my office, I perform all ThermiTight procedures personally.  I do not delegate them.  Even though the concept of "heating the tissue" seems simple, there is some finesse to both the diagnosis and the procedure.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 80 reviews

MD or practitioner

In my practice, I perform all of my injections and minimally invasive treatments such as Thermi tight.  I understand that there are some good NP's out there who have experience, but I feel you are in better hands with a MD!

H. Christopher Coley, MD
Greensboro General Surgeon
4.6 out of 5 stars 15 reviews

MD or APRN (nurse) to perform a ThermiTIGHT

Dear savingface60:

Each state has its own regulation over the scope of practice allow for a Advanced Practice Nurse Practitioner. Generally, they do not have any surgical training nor advanced anatomy understanding. ThermiTIGHT is a minimally invasive procedure which depends on the experience and skills of a MD to properly diagnose the tissue laxity problems and offer a full array of surgical, minimally invasive and non-surgical options for you to make you most informed decision. They may also not fully understand the mechanics and physics of the ThermiRF machine and complications associated with it. 

It is up to you to trust and feel comfortable that this APRN provides you the best quality of medicine and surgery. I recommend a Board Certified Plastic Surgeon or Facial ENT Surgeon skilled in all procedures to provide you the best options. 

All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 82 reviews

ThermiTight in your area

Thanks for your question. It’s always best to consult with a board certified dermatologist; particularly one that specializes in the treatment of your choice. In this casem ThermiTight. Best, Dr. Katz

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

Letting A Nurse Do ThermiTight

ThermiTight is a minimally invasive procedure that requires knowledge of anatomy and neurovascular distribution. This is not a procedure I would delegate to an RN or a PA. I would recommend have a surgeon perform the procedure. Please proceed with caution.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

ThermiTight and Non-surgeons

You bring up a very good question and one I have given a lot of thought to.  As a rule, I am opposed to physicians (or non-physician health care providers) who are not surgeons and have had no surgical training outside of medical school learning and offering surgical procedures in their offices.  There are many reasons for this, chief among them is lack of familiarity with common surgical complications and how to handle them.  Second most concerning is lack of understanding of surgical anatomy.  Now, both of those obstacles can be overcome with education, training, and experience.  I offer to teach many non-surgeons the surgical and anesthetic skills required to do ThermiTight procedures - those who have been trained by me, I know, at least were taught how to perform the procedure safely.  The problem is, there is no "official" oversight of many of these providers.  The ARNP you are seeing may well be an expert, despite lack of formal surgical training, but who would know?  If a doctor is "board certified" by a board with jurisdiction over that type of surgery, say, the American Board of Plastic Surgery or American Board of Cosmetic Surgery, then you, as a patient, can at least be assured that this person has demonstrated his or her knowledge and clinical judgment to a panel of expert examiners and been deemed to possess the required skills to perform procedures under that category of expertise (aesthetic or cosmetic surgery).  Each state has its own rules governing what can and cannot be performed by non-physician health care providers, such as ARNPs and PAs.  In some states, it would be illegal for an ARNP to perform a surgical procedure, maybe not in Nebraska.  ThermiTight is a surgical procedure, albeit a minimally-invasive one, and although rare, complications can happen and hopefully, any practitioner who offers ThermiTight also knows how to avoid complications and also how to deal with them in the rare event they should get one.  This doesn't exactly answer your question, because, I am sure that there are ARNPs out there who can do a wonderful and safe job with the ThermiTight, just as there are some board certified surgeons who have had too many complications.  The safest bet, is to go to a surgeon, but you could also pose some questions regarding training and dealing with complications and then if you are satisfied with the answers, go ahead with your ARNP; if you don't like the answers or feel that you are getting evasion and half-truths, then stay away.  As a  general rule, however, I would recommend a physician with a surgical background and cosmetic or aesthetic training for any surgical procedure over an ARNP or PA or non-surgeon physician.

W. John Bullis, MD
Bellevue OB/GYN
4.9 out of 5 stars 28 reviews

Thermitight Practioner--Plastic Surgeon vs. APRN

I suggest you go to an expert. Please go to a well trained physician who offers this treatment as they are the best trained if complications arise.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews


You would think that someone who did a surgical training of some sort would be better than someone who didn't ... at least, the surgeon has privileges to admit you to a hospital if you had an unforeseen complication.

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 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.