Which RF procedures for thighs? (Photo)

Question

I am 52, 110lbs, &have the trifecta of lax skin, cellulite, & crepey skin on my thighs. I wanted a thigh lift, but an MD at one place and an assistant at another said I was not a candidate for surgery given that none of these issues are that bad, although it makes me so uncomfortable that I don't wear shorts. They each recommended a different RF procedure based on what they own. Was hoping for an unbiased opinion on which is better: Profound RF, Pixel8, or Morpheus. Thanks!

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Camille Cash, MD · Answer

From your photos I'd agree that your laxity is not severe enough to recommend a thigh lift.  BodyTite would be a good option for you.  It is a minimally invasive procedure to tighten the skin that requires no general anesthesia.  You can further enhance your results with Morpheu8 treatments to address skin tone and texture.  For cellulite you may want to consider Aveli which is a one time treatment done in the office.

Lisa Vuich, MD · Answer

Thanks for your question. We have been performing RF microneedling since 2013 and I have experience with many of the devices on the market. I do not have personal experience with Pixel8 but it appears that it delivers heat up to 4 mm. This would not be a depth that could treat cellulite. I do have many years of experience with ProfoundRF on the face and body. It produces a nice smoothing and tightening effect, but again it is limited to only 2 depth options. Morpheus8 represents a significant advancement in RF microneedling with treatment depths up to 8 mm- far deeper than any other device I am aware of on the market. Its latest version with 'burst technology' allows the operator to deliver energy to three depths simultaneously, including a depth that would be capable of disrupting the fibrous septal network of the cellulite dimple AND dissolve some unwanted fat cells in the region- this means you get smoothing and tightening and fat cell reduction simultaneously. A series of 3 sessions is recommended. You will not be able to treat the thighs circumferentially in a single session due to restrictions on the amount of lidocaine that can be used in one day- so expect to divide the treatments up. For example you could do the back of the thighs as one session, and then separately the front of the thighs on a different date even if it is just a couple days later (allows time for the first batch of lidocaine to leave your system).  We switched from ProfoundRF for the body to Morpheus8 in the past couple of months because it is superior technology and will provide better results in fewer sessions. I hope that is helpful to you!

Daniel P. Markmann, MD · Answer

I have to agree with you 2 consults.  The little bit of laxity that you have is definitely worth the big scars of a body lift or thigh lift.   It'll be tough to get a "non biased" opinion because most of us only have one of the machines you mentioned.   There are some laser Guru's out there who may have them all, but most of us will be speaking from our experiences with our own selected machine.  I have the Inmode machines, Body Tite and Morpheus.  They definitely help improve skin tone, lessening the skin laxity and therefor the dimpling.   I usually combine this with Subcission which is a technique of releasing the bands under the skin that cause the deepest of your cellulite dimples.   
Good luck

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