What are the differences between EndyMed Pro and ThermiTight? Which one's better for skin tightening under the chin/neck?

ThermiTight (part of the ThermiRF system) is a radiofrequency catheter that goes under the skin after it has been numbed to heat the skin from underneath and to melt little pockets of fat.  This can be done completely awake with 1-2 days of downtime if you dont get liposuction at the same time.  I am not familiar with the EndyMed Pro but from the website description it appears to be a topical radiofrequency system to tighten the skin on its surface.  This is similar to the mechanism of "Thermage" and "ThermiSmooth", also part of the ThermiRF family.  When we heat the skin on its surface we are quite limited because we cannot heat beyond what the skin can tolerate without risking a burn.  When the heating is done deep to the skin and the skin temperature is monitored (as it is with the ThermiTight procedure), we have noted tremendous results that usually start to appear between 6-12 weeks after the procedure and continue to improve even at 18 months with just one procedure.  ThermiSmooth (and presumably EndyMed Pro) would require multiple treatments and still would not, in my opinion, achieve the results that one treatment with ThermiTight could achieve.  

You bring up an excellent point.  People seek care in improving their necks for different reasons.  Some have fat deposits that can be reduced with neck liposuction.  Others have platysma muscle bands that pull down and these can be improved with cutting and suturing (a traditional neck lift / platysmaplasty), while some need that plus skin tightening that requires cutting and suturing around the ears. Many patients see me in consultation in my NYC practice asking me if they can get a tighter neck without surgery. There are several treatments and energy sources that I can use to give patients a better profile of their neck.  Botox can help reduce the neck muscle bands temporarily, Thermage, Ultherapy, Pelleve and ThermiSmooth are external energies that can help tighten these tissues.  Liposuction can reduce the fat pad and make a big difference for the right candidate, but often the skin develops a crepy texture with long ridges and these can be improved with ThermiSmooth and the other external devices.  Fraxel Restore can help this crepy texture.  ThermiTight is an in-between procedure, in-between surgery and non-surgical treatments.  Local anesthetic is injected in the neck and the thermal probe is inserted underneath the skin and delivers the radiofrequency energy to the tissues I want to tighten. This can be done right under the crepy skin that results from liposuction or other techniques, including surgical neck lifts.

We use all three of these modalities for tightening of the neck and jowls.  Each works and each has advantages and disadvantages.  Each treatment is useful for the right indications. Endymed Pro  is painless with no recovery time.  It requires multiple treatments to achieve a good result.  The results are practitioner dependent and require the person performing the treatment to apply a great deal of effort in order to obtain good results.  With a competent person performing the treatment in a conscientious manner, results compare to Ulthera, though the satisfaction survey results are slightly less.  Still, for a person who wants painless treatment with no recovery, this is a great treatment modality.Ulthera (HIFU or High Intensity Focused Ultrasound) has a slightly higher satisfaction result.  This treatment is usually one treatment and is FDA cleared for the specific use of "neck lift".  The chief disadvantage of the treatment is that it is painful.  The company has continued to improve the treatment results with new protocols and procedures.  There is little or no recovery time.  For a person who desires one treatment and does not mind a degree of pain during the procedure, Ulthera can offer a lot.  Recently, we have used targeted local anesthesia methods to produce diminished pain, though this type of local anesthesia is "off label". Thermi-tight is different.  It is a "semi-surgical" procedure that is widely used for tightening skin.  An RF "thermistor" needle (similar to that used in spinal and heart procedures) is introduced under the skin to tighten it from underneath.  The procedure requires local anesthesia and there is swelling and can be bruising after the procedure.  Because the thermistor is placed through a needle hole, there are no "incisions".  We utilize this treatment for the patient that does not mind a recovery time or some pain during the procedure from the local anesthesia.