Alternatives to Thermage for Loose Skin?

Morpheus8 provides both skin tightening and skin resurfacing improvements. The technology uses radiofrequency deep subdermal heating to effectively tighten skin and remodel the superficial texture, such as scarring and enlarged pores. Combining Morpheus8 with lasers can give both complexion and laxity improvements in one treatment, so it's an ideal add-on treatment for those who care about preventative sagging or scarring improvements. You can also add this on to liposuction or internal heating to get more improvement in the areas treated.  I suggest getting a formal evaluation with a cosmetic dermatologist to develop a treatment plan that works for you. Best, Dr. Emer

Excellent question. Thermage is an excellent choice for individuals that have experienced mild to moderate skin laxity and sagging in the jowl region. However, it is not the only choice. At our office, we also offer Ultherapy, which uses ultrasound energy to tighten the skin. Another option I love is CO2 laser resurfacing, which can dramatically tighten the upper and lower eyelids as well as the entire face when done properly. My favorite option for the upper neck is ThermiTight with micro-lipo. Please review my before and after photos and you will see what I mean. I encourage you to make an appointment with a board-certified dermatologist that specializes in skin rejuvenation procedures. Get an in-person evaluation and recommendations for the best treatment for you. 

Thermage has noticeable but very limited results. Other skin resurfacing procedures tend to tighten the skin to an extent to smooth some of the fine lines, improve pigment problems and diminish pore size. What they do NOT do well is to minimize jowls and other signs of facial soft tissue laxity. Only a mini facelift or facelift will take care of this problem in a significant fashion.

If you are a candidate for surgery and are considering a face lift, then you should consider that over Thermage. If you do not want surgery or if you have medical conditions that prevent you from having surgery, then Thermage is a good choice.  The newer technology allows sufficient tightening in some patients to see a dramatic improvement, although it is not as excellent a result as surgery.

The first thing to know is that none of the nonsurgical treatments such as Thermage produce the same results as surgery; in other words, there is no "nonsurgical facelift." We have learned a few things about optimizing results with Thermage however. One is that older patients, whose collagen in their skin is depleted, don't respond as well. The ideal patient is someone in their 40's to mid-fifties. The other thing is that Thermage applied immediately after liposuction enhances the skin tightening. A great option for some patients is to do a little bit of lipo under local anesthesia, followed by Thermage. (some pictures here: http://www.drbaxter.com/thermage.html and video here: http://www.theplasticsurgerychannel.com/plastic-surgery-procedures/body-aesthetics/liposuction/liposuction-combined-with-thermage-shows-promising-results.html)

Jowling can occur secondary to a loss of fascial support in the lower one third of the face. Thermage, unfortunately, cannot acheive a structural change in the underlying fascial support system and is thus less effective than a facelift. If you are considering a lesser procedure than a face lift, a mini lift may improve the appearance of jowling. In any case, results for jowling are typically seen only after a surgical procedure. Consult with your plastic surgeon.

There are no superior options merely alternatives such as Titan, Velasmooth, Accent.
However, none of these will achieve the degree of improvement that a facelift can perform. Granted there are more risks to surgery.
Non ablative interventions can achieve an improvement of 1-3 on a scale of 10 versus surgery which can achieve a 7-8.

Thank you for your message! Thermage is a great option for collagen building. As we age and lose collagen, the skin starts to sag which causes jowling. Thermage puts heat deep within the skin, creating an inflammation that your body heals by making collagen and elastin which in turn ideally tightens and lifts the tissue. Results are usually seen within 2-6 months. If the skin laxity is at a certain point, a surgical procedure may be needed. I would recommend a consultation with a provider in your area for further evaluation! 

If you have severe jowls and are older with poor quality skin then Thermage will be ineffective. You will need a facelift to get good results. However, if you have some mild sagging with good quality skin tone then you are the ideal candidate for this procedure.  Patient selection is very important. Also going to an experienced dermatologist is key.

Thermage is a very good procedure for tightening the facial skin in patients who only have relatively minor amounts of laxity. Such patients tend to be relatively young, generally 35-50 years old.

When patients have a greater degree of laxity, Thermage should be combined with a dermal filler such as Juvederm or Restylane. The dermal filler provides additional lifting of the cheeks and softening of the folds on the face. The use of Thermage and a dermal filler together will give completely natural appearing facial rejuvenation in patients who have a somewhat greater amount of skin laxity.

For patients who have more skin laxity and wish to achieve greater amounts of skin tightening, I recommend the Fraxel Repair laser. The Fraxel Repair laser is a very effective non-surgical skin tightener. It provides much greater skin tightening than either Thermage by itself or Thermage and a dermal filler. Fraxel Repair treatment results in visible skin tightening and significant improvement in wrinkles, fine lines, and pigmentation in the treated areas. The skin also heals with an improved texture.

Today’s options for non-surgical skin tightening are truly excellent and result in completely natural appearing facial rejuvenation. The key is to ensure that the correct procedure is performed on an appropriate patient in order to give the expected results. A patient who is considering non-surgical facial rejuvenation should consult with an expert in the field to determine which approach is best for that particular patient.

Take care and be well.

George Anterasian, MD