My feelings exactly- Thermage can be an excellent treatment in select skin types, the thicker the dermal layer,, the better the treatment (general statement), again a general statement- Ethic skin will respond better. Company denies any of this (marketing). Cost? Well the tip itself cost $1000, device even though its old its remarketed as CTP technology- low cost for the company, high cost for the doctor, good marketing. So, why do we still use it ? Demand by those who Thermage has worked, hence a population biased. This device is made by the company that sells Fraxel- again consumables - they make some excellent devices such as the Fraxel 1927 and diode driven C and B, and some horrible ones, like the CO2 RePair- with consumables. No Co2 laser should need a rolling pulse stacking head, the same goes for RF technology, its all about marketing their devices and gaining consumable profits. Hence the cost. I am not a big fan of marketing devices, but in some cases like Fraxel 1927, its great, but the cost is passed down to the consumer for older devices like Thermage and Fraxel RePair. Dr Isobel Walker.