How can I figure out if I’m a good candidate for Thermage or other noninvasive lifting treatments?

Dr. Irwin
March 22, 2015
Thanks for the info. on Thermage. I am 57 years old, and I am considering it. I want to be realistic about the possible results, so I appreciate the fact that you say that it won't lift "real jowls." But....how do you define a real jowl? When I look in the mirror I see the definition of my face is not quite what it used to be, but the jowls are not terribly prominent. How can I judge if I am a good candidate for Thermage? I seem to have also developed, during the last year, (and it seemed as a result of Juvederm which I had injected 8 months ago,but probably also normal ageing,)two little "pouches" on each side of my mouth, a bit bull-dog like....Does Thermage address this type of thing too? Thanks!

The truth is that this area is  the Wild West right now with device manufacturers and some doctors making all sorts of claims that really can’t be proven over a large group of women/men ………and all sorts of devices, treatment sequences and uses, etc being given clever marketing names when they really aren’t particularly new or different.

Anyone can post photos and make claims and you don’t know if that result is real (not doctored), a lighting issue (photography is hard to get consistent), or reflects a majority of people (not just the top 5% of responders).

Here’s what most board certified dermatologists and plastic surgeons can agree upon:

  • Radiofrequency and ultrasound treatments seem to work by heating existing collagen (it tightens just slightly) and the cells that make collagen (fibroblasts).  Those cells then make more collagen;
  • There is some early evidence that over time, elasticity (and increase in elastic fibers) may improve also;
  • It takes  about 6 months to see the full improvement from radiofrequency and ultrasound procedures.  There may be a little intial tightening that is related to the tightening of the existing collagen.  It takes months for  cells to make the new collagen;
  • Multiple treatments are better than one, especially important if over 45-50.
  • Women/men with more cells and collagen to start with (thicker versus thinner skin) seem to do better;
  • Thermage (the newest version is not painful) has the longest, most consistent track record.  Ultherapy probably gives equivalent results but is much more uncomfortable.  Exilis is not painful and may be just as good or better but protocols are still being worked out and there isn’t as much data on this.  It is probably more effective on necks and body skin though.

Hope this helps,   Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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