Should I get Refirme over Thermage?

Terrific Question. My medical spa, Accents In Sterling Heights, Michigan offers both technologies, Thermage and Syneron's Refirme. The most important thing for a client to understand is that this is not surgery and one should not expect a surgical outcome.
I am sorry to learn that your treatment was painful. It does not have to be this way. You can get very nice results without pain. The newest tips for thermage allow tightening without having extreme discomfort. The advantage of Thermage is one can obtain tightening through one treatment.
Syneron's emax allows combination treatments. If a patient wishes tightening and has some browns and reds on the skin that they wish to diminish, this is a terrific treatment. More treatments are necessary to achieve equal tightening with Refirme. I find a series of 5 to be of most benefit. Unlike thermage where we give patients medication to relax them during the procedure, patients who chose Refirme do not need this. Thus Refirme patients can drive themselves home; a major benefit for many.
Both treatments are progressive; where we see measurable improvements for up to 6 months after treatments. We have very happy patients with both treatments. Like yourself, we have many patients who have come back annually for repeat Thermage treatments. Clients see this as maintenance and as a method to hold off from surgery.
In regard to cost, pricing is similar. I offer all readers of Realself $250 off either procedure package (Expires December 31, 2008)

I am surprised that you said Thermage was painful. 

With the new CPT technology it should be painless. The energies we use require us to go over the treated areas several passes, usually six passes, to treat the skin. There is no reason why it should be painful to work. That is the beauty of Thermage! Since you had good results I would recommend repeating the Thermage but make sure your doctor has the new machine with CPT technology.