Thermage produces its effect via radiofrequency waves affecting the collagen fibers below the skin surface.

I normally prescribe an oral pain pill to be taken prior to the procedure. It is done in our operating room. A grid is temporarily tattooed on the areas to be treated which are usually the face/neck and a conductive lubricant is applied. A grounding protective pad is also placed.

Then, the electrode is applied to the skin to determine the optimum settings. This is followed by applying about 600 individual bursts of waves. Each wave lasts about 1.6seconds and during this time, the skin is cooled to prevent damage to the epidermis, the collagen is disrupted by heat and shrivels/contracts and finally cooling again. The latter decreases the unpleasantness of the pulse.

When Thermage was first used, it was often painful and with the new standardized techniques that I employ, it has become more uncomfortable than painful. Also, if it feels too warm in certain areas, we turn down the power setting.

The procedure takes about one hour. The grid pattern is removed as is the grounding pad. Any redness or swelling is very unusual. There are really no restrictions after the Thermage. It helps about 80% of the people that I do it on, and in most cases the results are immediately apparent. It works the least in someone with sun- damaged skin.

It will not give the results of a facelift but these require a surgery/recovery. Also, I have used this on other parts like the arms/ abdomen to achieve some tightening.
The effects with contracture of the collagen should continue over several months. The complications are minimal. Some cases of loss of tissue in the areas treated have been reported but this was before its standardization. I have not seen this on any of my patients.