Blog with Dr. Irwin

Tag >> Thermage

Hi Dr Irwin, I bought biopolar radio frequency unit and when I did on my forhead my wrinkles become more visible, it was ok on my face and I looked more slim like an old lady, not like a healthy slim type? What did I do wrong?

Please don't try to do this yourself at home.  I'm guessing that you bought this off the internet.  You really don't know what your getting.  Some radiofrequencies used incorrectly can... more

Hello Dr. Irwin I LOVE your site! With that said, I've taken the time to go through quite a bit of your blog to get my question answered and still cant quite pin down what I'm looking for. So here is a bit about me and my question will follow. I just turned 40. The left side of my face is significantly more lax in skin texture (very visible) than my right. The other problem is I have significantly more pronounced crows feet/lines under the left side of my eye opposed to the right as well. I'm hoping to get the left side to match the age on my least the best I can. I HAVE started botox for all my problem areas. Great stuff. I've read great things about your thermage treatments and the tightening effects on the skin. I've also read great things on your DOT laser experience and results as well. My question is which one would you suggest to get the skin tightening results I so desperately want and also treat the pronounced crows feet? Thank you!

Thank you!   It would be interesting to have you look back at photos when you were 16-25.  Can you see the asymmetry even back then or younger?  Some people have an inborn (genetic)... more

Hello Dr Irwin, I am a 30 year old male who doesn’t smoke and has fairly loose skin for his age. Am I to young for Thermage? I went to see a Dr in London who recommended Thermage at a heat setting of 4-4.5, under local anesthesia and using 600 pulses. With your experience, is this safe and inline with the guidelines you undertake in your office?

Hmm ...... I'm a little puzzled as to why he/she is recommending local anesthesia.  All I can think is that the office might not have the newer Thermage equipment with the sapphire cooled... more

Is thermage suitable for for African or Afro Americans?

Yes -  it's extremely safe because it uses radiofrequency (a sound wave) and is not laser (light waves).   Radiofrequency based technologies like Thermage are safe for all skin... more

Can a person with permanent eye liner (upper and lower) have thermage? Does it do anything to the eye liner?

Each case is unique, but usually Thermage, which is a sound wave (radiofrequency), should not affect permanent eyeliner. Be sure to tell your physician about your permanent eyeliner during... more

Can you tell me how Thermage compares with the Titan laser?

The Titan has much less data and experience behind it although it claims to do the same thing.  It  uses an infrared wavelength (1100-1800 nm)  of light instead of radiofrequency (sound... more

Hi Dr Irwin, Can you please tell me if Thermage or radio frequency treatment can be performed if you have had had Botox within a month? I was about to have a radio frequency treatment and when my therapist realized I had recently had Botox, she said I have to wait 4 months to have the treatment as the paralyzed muscle would become irritated from the increased collagen... Is this correct? I have read your article about Thermage and you only mention to avoid dermal fillers and Sculptura... Regards Sharon, Perth Western Australia

She's not correct on this one.  Botox is injected into muscles and binds there within about 6 hours.  Most doctors tell their patients to be moderately careful for 24 hours or so - ie don't... more

I am a 43-year-old female with melasma. I have minimal sagging (cheeks, jowls) for which I am considering Thermage. Will the heat generated by the Thermage procedure aggravate my melasma? My melasma is under control with daily application of a hydroquinone mixture which also includes Vitamin A, Vit C and kojic acid prescribed by my dermatologist. I have read that lasers can worsen melasma so I want to be well-informed before I decide on the procedure. Thank you!

I never say never because we are all individuals but ....... in over 10 years of working with Thermage and several thousand treatments, we've not had a patient who's melasma became  worse. ... more

Hi there -- I thought your comparison of fractionated laser systems was very interesting. Could you compare these results with results/downtime of the eMatrix sublative rejuvenation system (radio frequency waves)? Thanks, Ginge

I've never seen a radiofrenquency system that equaled the overall results of a well done fractionated CO2 treatment with a good system (like Deka or the new Cynosure CO2).  BUT, if you are... more

Have explored different wrinkle reducing methods and do not like the idea of fillers, injections, laser or facelifts. Is Ultherapy a sound and effective way to help this issue? I have read about Thermage but read mixed reviews.

Both Ultherapy and Thermage generally do NOT reduce wrinkles. They are intended to tighten and lift slightly. Of the two, Thermage is better, in my opinion. It requires one treatment... more

What is the best anti aging for face & neck ... thermage or fraxel. I'd like to prevent or improve sagging and wrinkles. My eyelids are bad and I'm starting to get wrinkles over my lips. I've been using Botox & restylane but am thinking after reading your article that Sculptra may be better.

This depends on many factors like your age, the amount of sagging you have, severity of wrinkles, and your facial contours, etc.   As a general guideline, if you are under 45ish  and you... more

Hello Dr. Irwin. Your website is very informative. I am getting married in 4 weeks and will be vacationing on a cruise ship which will be in the Caribbean for 3 days. I where wide brimmed hats and sunscreen. I have been thinking of having full facial Thermage. I am 48 and my skin is definitely sagging. I want to look a little better for the wedding especially because the photos will be a permanent record. My self esteem is not very good these days because of these aging changes. I know I will feel so much better if I could do a little something about this for the wedding day. If I had the procedure done very soon, will I see some improvement by the wedding day? Also, if I want to get some lines and/or lips filled with Juvederm, how long after Thermage do I have to wait? Thank you in advanced for your time.

Congratulations on your wedding!   This is a little close to the time to see much with Thermage and it's tough to know without a picture if you have a good facial structure for it.   I... more

Is it safe to have thermage done around 2 days after botox for crow's fleet and forehead lines? Will it cause the migration of botox to other regions and thus causing complication or ineffectiveness?

It's fine to do the Thermage the next day even after Botox.  It doesn't take the Botox long to bind to the proper receptors at the junction between the nerve fiber and the muscle.  And,... more

I am interested in having Thermage done, but I just had botox done two weeks ago. Would it be wise to wait 6 months before having this done?

You're fine having the Thermage done anytime.  Occasionally we will do them 1 day apart if we have someone coming from Alaska, for example.  Botox is injected into the muscle and it binds... more

Dr. Irwin, what do you think of Skin Tyte (infrared tightening)? How do the results compare to Thermage? Thanks!

So far I'm not impressed.   Dr.... more

Dear Dr Irwin, Your site mentions that Thermage is coming out with a new body tip in 2008. I would love to know what your assessment of this new tip is, and whether it might be appropriate for reducing the atrophy associated with stretchmarks. I have stretchmarks on my breasts which appear 'indented' and would love to address this. Thank you.

Yes - they did come out with that reengineered Thermage body tip in 2008 but it was a disappointment.  I wish I could recommend it, but I really can't.  The body tip is expensive and the... more

I'm on a blood thinner could I be a candidate for thermage?

You're very unlikely to have any bruising with Thermage.   With radiofrequency devices like Thermage, blood thinners like warfarin are not a problem.   Dr.... more

I have had Thermage, but I was wondering what you think about Refirme? Is there anything new for skin tightening? Thanks

I really don't think (at least so far) that the results are better.  In my opinion, they are about the same, with the disadvantage of Refirme requiring 3 treatments instead of 1, being... more

Hi Dr. Irwin, I'm interested in doing Thermage around the eyes. I'm in my late 30s and have good skin although very thin around the eyes. When not animated (resting state) the skin under my eyes looks fine. However, when I smile and the skin under my eyes is pushed up, it gets a bit bunchy and crepey looking. Is there anything I can do to improve that? I do a little Botox for my crows feet which completely helps minimize my crows feet. I also had a lower lid blephoraplasty with fat repositioning over a year ago so there is no extraneous skin or fat in this area now. Do you think Thermage around the eyes would help? I know I might not see the results for 4 to 6 months. Any other suggestions? Thanks.

This is a good question since you are in your 30s still.  If the problem is more that there's a little loose skin, then eyelid Thermage is a good choice at your age.  If the problem is more... more

Hello, I am curious as to the best recommended treatment for excess skin on the abdomen after childbirth. I was 115 then became pregnant and gained 45 lbs. My youngest is now 8 and I would really like to be comfortable in my own skin again but cringe at the thought of tummy tucks. Thank you.

In my opinion, plastic surgery is still the best option for this problem.  If you have just a tiny bit of excess, you could consider body Thermage but I really don't see much result from... more

Hello I am a 44 year old female, who\'s considering a thermage or scupltra treatment to tighten around the jawline. What is the difference of the two and which one would you recommend?

Here are the two links that should help you (Sculptra) (Thermage).  Sculptra is an injectable liquid that adds volume and lift by slowlng building your own collagen.  Thermage is a... more

Dr Irwin I want to try to tighten the skin under my chin. My dermotologist center says accent lazer is the best way to go with a series a 6 treatments over 6 months. What do you think. is accent the best way to go?

The Accent system is a radiofrequency (read sound waves) based system that uses as it's marketing point that it uses 2 types of waves in the same system.  In my opinion, there really is no... more

Is thermage relatively safe now? I am interested in getting this procedure done but I don\'t want to risk facial fat loss. If so, can you recommend a good thermage doctor in the bay area? Thank

It's very safe.  The reports of fat loss were with the first generation of Thermage tips and had nothing to do with the technology.  Back then, there were individual doctors who were using... more

-------------------------------------------------------------- Dr. Irwin, I am 59 years old and am considering DOT therapy. However, I do not know a single person who has actually had this proceedure. Can you explain the difference between Dot and Thermage? Thanks so much for your time...Brenda

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... more

I had disk replace surgery and have titanium screws and braces to hold them in place. I would like to know if this would interfer with Thermage on my face?

Yes - it is fine to have a Thermage treatment.  Just let your doctor know too.  I have double checked with the company on this and my patients have had no problems.   Dr.... more

Is it safe to use Thermage to tighten the eyelids since the skin is thin?

Yes.  Thermage has a special FDA approved eyelid tip which is tiny and perfectly suited to delicate eyelid skin.  In our office, just to be extra careful, we put in small "intraocular" eye... more

Dear Dr. Irwin, I\'ve read and really like both of your books (your Best Face and Surgery-Free Makeover). I\'d like to try Thermage based on your recommendation in your book. However, I have a metal plate in my left shoulder which was put in about 5 years ago when I had a surgery to fix my broken collar bone. Is it safe for me to do Thermage or other similar type of radio frequency treatments for sagging skin? The metal plate was about 5 cm long,0.8 cm high and 0.5 cm wide. Thank you very much.

Forgive me if I answered this already.  I just may have not erased it. :)  Yes - it's okay!!  Dr.... more

HI Dr. I- I am 37 and really considering thermage for the eyes. I would like to tighten the area. I currently do Botox for the crows feet and bunny lines. They really make a nice difference but I am not completly satisfied. I think I am losing the volume under my eyes and around my mouth. I have high cheek bones which helps but I really notice the change :( I follow your skincare regimine and I have good skin overall but it\'s become significantly thinner and combined with my other issues I am wondering what you would recommend? Thank in advanced for your time.

At 37, it depends on what's bothering you the most.  Eyelid Thermage tends to be best if there is a just little "hooding" or slightly lax skin.  Eyelid Fraxel tends to be better if the... more

Hi Dr. I, Your website is fantastic! Thank you for taking time out of your very busy life and answering our questions. I am a Vietnamese 44 y/o female, and have lost 20 lbs. over the past 4 mo. I have very good skin with no wrinkles, or discoloration. My facial skin is now lax on the cheek and neck. what is the safest and best laser treatment for this? There are so many types out there?

Thank you!  The answer to this really depends on how much extra skin you really have.  If you have a lot, surgery could be the best answer.  But at 44, Thermage could be a great option for... more

Is it okay to do Thermage if I have a steel plate in my shoulder?

Yes, it's not a problem to have Thermage with your steel plate in your shoulder.  And, I doubled checked with the company on this one also.   Dr.... more

Hi Dr. Irwin, In what order would one consider the following treatments in your clinic: *Thermage *Fraxel or recommended laser tx. *Sculptra I\'m 51 and have had Botox, Restylane, and some Laser treatments over the past 4 years with good results. I\'m considering these other treatments down the line, so to speak!! Thanks!!

Your question brings up two good issues: customization and maintenance. 

First, the answer to your question really depends on your particular skin.  I think it would be bad medicine to... more

Hi Dr Irwin, What is the difference between the CPT and NXT Thermage machines? Do you recommend one over the other.

In my opinion, there is really very little advantage to you as a patient.  The results of the treatment are the same.  The CPT system is a a little faster (benefits the doctor) and it has a... more

What results have you seen using Thermage on thighs?

Not many.  We haven't been recommending it to our patients because the first 3-4 patients we did (with the new reengineered tips) had very disappointing results.  Theramge skin... more

Can I have a Thermage and Fraxel treatment on the same day? If not what is the recommended wait time between the two treatments?

I know that there are excellent offices who do this but it's a lot to take on in one day.  The Thermage should be done first, in my opinion.  I would recommend waiting at least 2-3 days... more

HI Dr. I have a question about the pads that form under the eyes. I am 37 and at times my eyes look puffy underneath. I wouldn\'t say the its are very prominent or lasting but I am becoming more aware of that area and now I am wondering how the \"pads\" form in that area?? Is it something that just appear one day or is it a gradual process and if so is there anything to keep them from forming??? I have good skin, I have a good skincare regime (influenced by you of course. I use the sunscreen and moisturizers,etc my eye area is really changing. Thank you in advanced for your time!!!

Under eye pads or puffiness are complicated because there are several different causes and sometimes they coexist together.  So....... causes can be:

1.  The skin on the eyelids loses... more

Thermage has a new tip now for helping lessen the pain level. I was told that now the doctors can turn up the radio F. and it will work better. My question is.. I thought that was the problem with fat melting a many years ago.. the high heat level. The doctors seem anxious to turn the levels higher now. What is your opinion about the higher level?

There is absolutely no data from the Thermage company, or anyone else,  that says this tip gives better results.  In my opinion, it's a marketing gimick.  The vibration does allow slightly... more

hi there, first off, love this site, its so informative and hands on!As a 25 yr old who has yo-yo dieted for the better part of my life, | am noticing that it has really taken a toll on my face in regards to skin laxity and even sagging the cheeks (i have a very full/flat face with little cheek definition to begin with) and have noticed it has begun to droop downwards, creating nosolabial folds and jowls:( I have received filler to alleviate some of this, with some success, and have been further recommended to do thermage to tighten and lift my skin back up. My issue, being from Toronto, is thermage is pricy here (3500-5000) and I\'d like to hear your input as to whether you feel this will benefit me or if I\'m too young for it. Thanks!

Thank you!!  Since you are twenty-five, I think it would be a good choice.  Everyone is an individual but generally younger patients see more results (I'm guessing it's because there's more... more

Should botox or other injectables be done before or after thermage?

Since the purpose of Thermage is to tighten a little, maintain the jawline and eyebrow position, and build collagen, the timing of Botox with it really isn't important.   But, if you're... more

Does thermage for eyes work in women over 58 years of age to lift the brow area?

If you don't have too much sagging it will help.  Plan on doing 2, or even possibly 3, treatments over 6-9 months for the best result nonsurgically.  Dr.... more

Have you heard of Ultherapy? is the manufacturer\\\'s site. I understand that it has just been approved this last fall. Would appreciate your opinion.

Ulthera is a ultrasound based technology designed as a competitor to Thermage the radiofrequency (also a sound wave) based system that can tighten facial skin and build collagen.   Neither... more

What is the best treatment for the under eye crinkles? Is it thermage or fillers or retin a or something else? Thanks, Bonnie

This is such a complicated question because it depends on sooooo many factors.  I'll try to make a long story short!  But, please see the section on eyes on this site.  

If you just have a... more

I am having Thermage soon and would like to have a mild Fraxel treatment 2 days later. Is that enough time to wait?

That should be fine.  You might have a little more swelling after the second treatment than usual.  Dr.... more

You discuss how long to wait after an injection to have Thermage or Fraxel, but is there any problem with having Thermage or Fraxel first and then an injection like Sculptra or Juvederm later? How long do you have to wait?

This is a hot topic right now because there is a synergistic aspect to combining various treatments well.  The problem is that there are virtually no studies at all on combining  treatments... more

Is it okay to have Thermage every 6 or 7 months after the age of 55? I need it that often and just wanted to know if it is safe.

Some of my collegues in Los Angeles tell me there are celebs doing it every 3 months (I am not recommending this).  We really don't have any studies to answer the question either.  Since... more

I had a baby almost three years ago. I was fortunate that I was able to loose the weight and escape stretch mark free(She weigh 10 pounds). I am 5'4 and weigh 130 pounds. I workout regularly so I'm in pretty good shape. I am thinking of trying a laser for my belly button area. The skin has lost the elesticity and that area looks so different from the rest of my abdominal area. I know you are against this type of thing incase of major weight loss but I wonder if you think that it would make a difference in my case? I have consulted with 2 doctors and of course, both said yes that it would make a significant difference. I still don't know if I trust the response. If you think it would is there a particular one you recommend? I so appreciate your honesty and straight-fowardness. Thank you again and again.

Good for you for getting back into shape!!  It's hard, isn't it. depends on which type of laser and how loose the skin is.  If it's more like a stretch mark around your... more

About 4 months ago I completed a Sculptra series and loved the results. My dermatologist initially recommended Thermage followed by Sculptra but I could not afford both at the time and opted for Sculptra. I can now consider Thermage or a laser skin tightening series but am concerned about effects it may have on the Sculptra. Are you aware of any problems with Sculptra followed by skin tightening or laser treatment? Thank you. Rhonda.

There is no study that I know of on this.  But I do have considerable experience over the past five years with both products.   I have my patients wait until 6 months after the last... more

I am 50 yrs old, I feel like I'm 30 but when I look in the mirror, I see differently. My face has always been thin and over the past 2-3 years I have developed this loose skin starting to sag under my chin - I am so self conscious of it. I was told that I should consider Thermage and Sculptra - right now I cannot afford both procedures, which one would you recommend to help with the sagging. Thanks so much!

If you are a low body weight person, loss of volume is probably more your issue, soI would definately vote for Sculptra (with the understanding that you'll need 2-3 treatments over a 6... more

I am 60 years old. I am considering Thermage on the face and neck. I have droopy eyelids. Will my results be substandard if I don't do the eyes at the same time? Thermage therapy is new at my dermatologist's office. How many procedures should a technician have done before they could be considered competent? I especially want to know how many procedures of the eye before the technician is considered competent? Thanks for your response! Cindy Fouche

I guess my first questions is ........did your dermatologist see you and think you would be a good candidate.  In my experience, if you have very mild hooding (upper eyelid sagging) and... more

dear sir i lost about 50 kilos and i have some dead skin on my abdoman will thermage work for me i m trying to escape surgery best regrds

No, no and more no!!!  It would be so nice if it did but it doesn't.  Thermage is best on tummies with just a little bit of excess skin and I'm still not impressed with body Thermage even... more

I am interested in your thoughts about the new Ulthera system of skin tightening?? Is it possible that it can tighten the sagging jowls and neck area?

There's not a lot of data on this system but my impression is that it works about as well as Thermage.  Which is to say that it works best in patients 30-50 with the expectation of subtle... more

I'm considering Refirme skin tightening for the neck/jowl area as well as fillers for nasolabial and marionette lines. Which should I do first... or does it matter? Thank you.

I would suggest doing the fillers first to see how much mileage you get from those.  You may change your mind about the laser.  Also, you didn't mention your age.  Like Thermage, if Refirme... more

Hi Dr. Irwin. Thank you for your Thermage info. I have had around 6 Thermage treatments over 4 and a half years. I have had very dramatic results because I do this treatment every 9 months and it works great for me. I look like I need no surgery at 56 yrs old. I have had 8 fraxel restore treatments and my skin looks great. I am too chicken to do repair. I did have old small acne scars before and reddness. My question to you is a safety one re. Thermage's long term safety, also if I am stretching my skin too much or thinning it somehow. I am asking just because I have done this often. It seems like most people really don't do it as much. This may sound silly, but I don't want to wake up and my skin falls off or has caved in. LOL. Thanks for your reply.

No -  you won't wake up some morning and have your skin fall off (like Dorian Grey)!!  Thermage has a good long term safety profile.  It's a sound wave that it delivered in a way that heats... more

Can you recommend a dermotologist in the Sarasota, Florida area who does Thermage? Thank you. Eleana Hall

Elena -  If there isn't someone on our website, it's because we don't know anyone there we can truly vouch for.  That doesn't mean though that there aren't good Derms there who do Thermage... more

What do you think of Body Thermage, like for the stomach, the buttocks, the upper arms?

In my opinion, the prior attempts at a body tip by Thermage have been plagued with problems.  Painful, minimal to no results, expensive and tedius.  In other words, not worth the money and... more

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