Dear Brenda - 

There is a big difference because Thermage uses radiofrequency (a sound wave) and has a gentle skin tightening effect.  There is no recovery time from it in general because there is no redness, bruising, discoloration, and very little puffiness afterward.  It is best for people with mild to moderate laxity (sagging) who have very few wrinkles and very little sun damage.  There is very little discomfort with it.

The "DOT" is a fractionated/pixilated carbon dioxide laser (a light wave) and is better for sun damage, wrinkles, and will remove some brown spots and provide a little tightening.  The disadvantage is the recovery time which ranges from about 4-10 days depending on the settings used.  The more aggressive settings yield more results.  There is a lot of swelling and redness for the first few days and then a sandpapery texture for a week or two. Most patients report  a 2-4/10 on the discomfort scale with an hour of a lidocaine based cream prior to the procedure.  Dr. I