Thermage and Fraxel Combination an Alternative for Facelift?

Question

I read that a combination of Thermage (one treatment) and Fraxel laser (3-5 treatments) gives a good alternative facelift. Some doctors in Europe sell this about 5,000 Euros. They call it "Thermafrax." Is this combination therapy effective for someone who does not want a surgery? Thank you.

Raffy Karamanoukian, MD, FACS · Answer

These nonsurgical alternative will provide results, but it is not fair to compare them to a fascial suspension or tightening procedure such as a facelift. A facelift treats the underlying fascial support of the face and is not equivalent to a skin tightening procedure.

Ron Shelton, MD · Answer

It can not replace a facelift for those who need such surgery, but it can tighten up the forehead and upper eyelids slightly. It can also pull up the jowl a little. It may be a very good treatment for those who absolutely won’t have surgery, but you won’t be happy if you want the same tightening as a facelift or browlift.

Michael A. Persky, MD · Answer

Hi Magia,
Fraxel re:store improves skin tone, texture, and color, but does little for skin tightening.  Thermage on the face and neck is successful in very carefully selected patients, and the rate of patient dissatisfaction is relatively high.  The two companies have merged, and they are promoting the combination treatment.  Many patients and physicians claim excellent results.
Fraxel re:pair by itself (fractionated CO2 laser) creates more volume in the midface, and tightens the skin of the face and neck.  Again, in properly selected patient's, Fraxel re:pair is an excellent alternative to a face/neck lift especially in patients who do not want to go to the operating room or go under general anesthesia. 
Patients who have had a second re:pair have shown even more improvement.  There will be a fair number of patients who likely will not need rhytidectomy if they maintain their re:pair treatments in the future.
Be well.
Dr. P

Jason R. Lupton, MD · Answer

Magia,
As a dermatologist who has personally performed both of these treatments for more than 5 years, I do not think these will give the same result as a facelift.  They are a nice alternative if you do not want to have surgery, or are not a surgical candidate, but Thermage and Fraxel do not make as impressive as a result as an invasive surgical procedure.  They are great procedures, however, as Thermage has no downtime and can help firm up the jawline and Fraxel tightens pores and evens out skin texture and tone. 
I would consider what your ultimate goal is and go in that direction - surgery if you have more pronounced facial laxity and wrinkling, and non-invasive procedures like Fraxel and Thermage if you are just trying to tighten and even out the skin but don't want or can't have much downtime.

Stephen Mandy, MD · Answer

Fractionated Erbium laser resurfacing is primarily to achieve improvement in sundamaged skin to correct pigment and vascular changes. It requires 3 or four sessions. I personally prefer a one procedure treatment with Active Fx, another fractional laser system. Thermage is done once and is a radiofrequency based system that tightens by causing a deep skin injury that results in new collagen formation that takes 3-4 months to occur. Combined they are effective BUT are absolutely not a facelift. They are very useful for the patient who sees early changes of sagging and wrinkling but who is not ready for, or cannot afford, a facelift. In general, younger patients (in their 40's) have the best results with Thermage and Fraxel.

George J. Beraka, MD (retired) · Answer

Hi!
Save your money for a good facelift.  Thermage can tighten the jawline somewhat, but the results don't come close to those of a good facelift.  And I don't think Fraxel does much.

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