Does Thermage Melt Fat?

In the early years with Thermage there were isolated reports of fat atrophy if the physician either did multiple pulses over the same area causing bulk heating if the tissue and possible fat atrophy or the patient was done under general anesthesia (not recommended) and there was no patient feedback. As far as I know, and according to the company there have been no reports of fat atrophy with the newer technology and tips as long as properly performed guidelines are followed

Thermage does not melt fat. The radiofrequency energy from Thermacool / Thermage causes the protein infrastructure of the skin, the collagen, to tighten by contracture. This is what can lift the forehead, and with that the eyelids, tighten sagging necks, loose skin of the belly, etc.
As with many procedures, there are indications and contraindications. Some people will be evaluated and found not to be candidates because they have bulging loose muscle or the fat is too thick. In the early days of Thermage, the protocol for treatment was not yet perfected and some fat thinning was noted.

When Thermage was first invented the technology and settings were completely different from what are being utilized many years later.  Current Thermage with the CPT technology and treatment parameters make this a safe and effective therapy where no fat is being "melted".