I was wondering if the thermi smooth procedure can be done over dermal fillers?

I have restylane in the tear troughs, and was considering having thermi smooth done under the eyes. Will it affect the restylane, or can the restylane interfere with the thermi smooth treatment itself? Thank you.

Doctor Answers 12

ThermiSmooth + Dermal Fillers: Precautions to Take

Dr. Edward Dickerson describes what precautions should be taken when combining ThermiSmooth treatments with dermal fillers.


Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 115 reviews

ThermiSmooth - Performed Over Dermal Fillers?

There are currently no studies demonstrating any negative effects to the ThermiSmooth procedure from the presence of dermal fillers such as Restylane or Juvederm; however, I would recommend against having dermal fillers injected in the area on the same day the ThermiSmooth treatment is performed to avoid any potential reactions. Theoretically the ThermiSmooth procedure could cause Restylane to dissolve more quickly, although the likelihood of this occurring appears small, since ThermiSmooth heats the dermis while a dermal filler injected into the tear trough is placed deeper. As in all cosmetic procedures, it is very important that you meet with your physician to evaluate the area and establish a personalized treatment plan.

Stanley Kovak, MD
Oak Brook Physician
5.0 out of 5 stars 5 reviews

ThermiSmooth + Dermal Fillers: Precautions to Take

Dr. Edward Dickerson describes what precautions should be taken when combining ThermiSmooth treatments with dermal fillers.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 115 reviews

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A great answer for your great question!

The presence of Restylane has not been demonstrated to negatively affect the results ThermiSmooth
treatment. However, the ThermiSmooth procedure could theoretically dissolve Restylane and therefore, I recommend that you wait at least
two weeks before or after having fillers to have the ThermiSmooth treatment.

Camille Cash, MD
Houston Plastic Surgeon
4.8 out of 5 stars 31 reviews

#ThermiSmooth is great for refining skin

#ThermiSmooth is great for refining skin
4-6 Treatments done two weeks apart can tighten and improve fine lines.  adding BBL fotofacials and fillers will give you the best result along with retin A  and other skin care.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 103 reviews

ThermiSmooth over dermal fillers

It can be done over dermal fillers like Juvederm and Restylane. I would not recommend it be done simultaneously in the event that there is a reaction. However, there is no contraindication for someone that has existing dermal filler in their face. 

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

ThermiSmooth and Fillers

Yes, ThermiSmooth can be used over your fillers like Restylane or Juvederm and probably will not cause it to go away faster though studies will have to be done to verify this is the case. The reason for this is that the skin surface is heated with the RF whereas the fillers are injected more deeply.  In response to RF induced heat at the skin surface the collagen in skin shrinks when heated to a sustained temperatures greater than 40°C. When the skin is heated to this level, this creates a physiologic process that stimulates fibroblasts to produce new collagen over time.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 147 reviews

Thermi smooth may or may not interrupt your dermal fillers.

Thermi smooth may or may not interrupt your dermal fillers. I recommend returning to your injector and discuss the treatment, as they will have a better idea of where the product is and where you will want thermi smooth. 

All the Best. 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 441 reviews

There are other treatments that work well around the eyes with less risk than Thermi.

While Thermi can be done around the eyes, there are other very good treatments such as EndyMed, Fraxel, Erbium Laser Resufacing, Thermage, etc.  that can be done around the eyes without affecting the filler and with much less risk. 

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Yes, Thermismooth can affect Restylane in tear troughs if done around the eyes

Thermismooth,  Thermage, Exilis, Venus Freeze all work by heating the skin to an unknown depth. They will all tell you that they are precise but they are not. Penetration of the heat is so variable and depends on hydration, skin thickness,  amount of collagen amongst other variables. They not only can affect filler but also fat. The only RF devices that are predictable as far as depth goes are the fractional microneedling devices of which Infini is the standout. I speak about Infini and am very familiar with the RF technologies. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 35 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.