Fraxel or Venus Viva for Sun Damage? With Thermage?

Fraxel is a laser and Viva is a radio frequency treatment with needles, both are great for dark skin patients and will require multiple treatments (Viva is typically more). Both treatments address your primary concerns, but a main difference is Viva will help with laxity long term -- it improves fine lines and tightens more than lasers.
I combine all of our laser treatments with microneedling, PRP, and stem cells to improve your color, texture, and tone along with the healing process.  For volume I use Sculptra long term to build the skin's collagen; for faster results we will use different fillers depending on where the volume loss is located.
It is completely fine to do Thermage on the same day as your other treatments and should be done at least once a year along with ultherapy to get the best in skin tightening and laxity prevention.  Please see an expert in lasers and skin care. Best, Dr. Emer.

Fraxel and Thermage are an amazing way to treat your sun damage and tighten the skin.  I would start with Thermage first followed by Fraxel.  Depending on how much sun damage you have you may need three Fraxel treatments on your face scheduled a month apart.  Please consult an expert in lasers for the best cosmetic results.  Best, Dr. Green