I have had a total of 3 Titan's and combined this with 3 Laser Genesis. The results have been amazing and I was skeptical initially. The results of Titan seem to vary a great deal and I can only conclude that the biggest factor which will determine outcome is the level of experience that the person performing the treatment possesses.
I am an RN and performed this procedure on myself (I moonlight PT in a medispa). I am 41 years old and keep myself up to date on latest techniques to maximize results. I would recommend that anyone seeking this treatment ask that they consult with the actual person who will do the treatment. The technique which I use on myself and my patients is the mobile delivery technique and I would ask for that specifically. When this method is utilized, the settings can be adjusted very high and there is absolutely no pain at all. The secret to a successful outcome is multiple passes (at least 4-5) over the same area before moving on. I typically use 150 pulses for a full face.
My own results have been pretty phenomenal. My skin is nice and taut and just looks more supple than it did 10 years ago. Admittedly, I did not have visibly sagging skin to begin with but it had started to lose it's bounce. Also, my nasolabial folds decreased significantly.
Although you are not supposed to see immediate results, I feel that I was able to observe them very quickly. And it just keeps getting better.
I am always surprised to read reviews from people who didn't benefit from the Titan. Unfortunately, it simply wasn't done correctly. ALWAYS ask about experience level and if possible ask what technique they employ and ask an estimate for the number of pulses they use. It really makes the difference.