What Are the Pros and Cons of Thermage?

Doctor Answers 10

Thermage is not always reliable

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Thermage is known for skin tightening, reducing fat and stimulating collagen production. There are some immediate results after the procedure, but for the ultimate improvement may take up to 6 months. Thermage results usually last for about 18 months and maintenance treatments are necessary, as we age. Side effects are rare but there is a chance of blistering or scabbing, when too much energy is delivered to the skin. Thermage is the best option for people who are not ready for surgery, but the results vary by individuals and cannot be predicted.

Thermage has lots of cons and not many pros.

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I don't think Thermage works.  I have many patients trying to avoid operations that delete surplus skin enlisting Thermage as a cure.  It just doesn't work.  If Thermage shrinks skin, it doesn't do it very much.

Pros and Cons of Thermag

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The pros of Thermage is that it is a one time procedure.  There is no discomfort and no after care.  It is a simple painless safe in office procedure to tighten the skin.  It is especially useful around the face, eyes, and abdomen.  The cons is that if you have poor skin laxity you may not be a good candidate. Surgery may be the only option if you are very wrinkled or have too much extra skin.


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Thermage Pros and Cons

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Pros - Thermage is used for skin tightening and collagen stimulation of the face, neck, eyes, and body.  We have many patients who use Thermage as maintenance to help keep the collagen framework of their skin tight.  The procedure can be beneficial for people hoping to postpone a surgical procedure.  Thermage can also be used to treat the upper eyelids.  Thermage typically requires one treatment. The results are most evident in six months and typically last for two years.

Cons - The results of Thermage, as with any non-surgical procedure, will never match a surgical result.  If you are looking for dramatic lifting, a more aggressive intervention may be best.  

Your provider should evaluate your needs and make recommendations based on your particular anatomy and concerns.  The office should also have before and after pictures of their own patients to help set reasonable expectation.

Kent V. Hasen, MD
Naples Plastic Surgeon
4.8 out of 5 stars 67 reviews

About Thermage

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Thermage is a technological breakthrough that harnesses the body’s own powers of healing and rejuvenation to create younger looking, more elastic and healthier looking skin with a completely non-invasive procedure. Results are long lasting, often tightening and improving patients’ skin appearance for years following treatment.

Since the procedure is entirely non-invasive, there are no pre-treatment requirements and patients can return to normal activities immediately following the procedure. Thermage typically takes between 20 minutes and two hours, depending on how much skin surface is to be treated.

The ThermaTip is briefly touched to the skin to deliver a capacitive radiofrequency energy beneath the skin’s surface. This is a deep uniform heating that affects the deep layers of skin and underlying structures, causing them to immediately tighten. Over time, the growth of new collagen is stimulated to provide further benefits for four to six months following the procedure. Along with the deep heating action of the ThermaTip, the Thermacool system continuously cools the surface of the skin during treatment, to protect the outer layer and prevent any discomfort or damage.

This is a painless treatment, one will feel slight heating, but the level is adjusted as necessary so there is no discomfort.

Jeffrey Ptak, MD, FACS
Phoenix Plastic Surgeon
4.7 out of 5 stars 8 reviews

Thermage pros and cons

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the advantages of thermage is that it has less risk than a facelift, virtually  no downtime and vitually no chance of bruising after the treatment. The disadvantages are that it can't give as perfect a result as surgery and there are risks, although of a small chance.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Thermage cons

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Thermage is supposed to shrink fat, tighten the support structures, and produce tightening and a more youthful appearance.

The cons to this are that there is some dependence on the operators skill. Burning has resulted, permanent hard spots (deep), discoloration, sensation changes. The most difficult to correct are irregularities in the contour. In other words, some areas may be sunken in while other areas may be high.

In short, the results may not always be predictable, and complications may not always be remediable.

Impressive results from Thermage in the right hands, but somewhat unpredictable

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Using monopolar radio frequency devices is wonderful in theory, but less predictable in application. To have a device which can improve texture and tightening without ablation of tissue would be ideal. Thermage has shown to be effective in both, however the small percentage of people who experience these results makes this option less attractive to me and my patients.

Peter J. Malouf, DO
Fort Worth Dermatologist
4.7 out of 5 stars 87 reviews


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Thermage was developed to tighten the skin. Early on, doctors were "cranking up the heat" on the device thinking that more is better when in actuallity, it began to melt fat under the skin and cause facial atrophy. Using it with the recommended settings it can improve wrinkles and offere moderate skin tightening.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Thermage for skin tightening

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Thermage uses radiofrequency energy to tighten the skin and give a lifted, tightened appearance. Many people are looking for a little skin tightening but do not yet need surgery. As a non-surgical treatment it appeals to those who cannot afford the several weeks of recovery after a surgical procedure or the expense or surgery, or do not want to assume the risks of a surgical procedure. There is no downtime after Thermage, and people can go right back to work and social engagements. The downside is that the results can take several months to be noticeable, and maintenance treatments are usually needed to get the best results. The more we can do the better results we see.

Jordana S. Gilman, MD
Washington Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.