Apprehensive about Thermage? A review of the Thermage technology

I would like to try Thermage but am apprehensive due to some of the reviews I've seen on "" While I realize many of the negative effects are a result of older technology, and the overall satisfaction rating of only 33% (360 reviews) can be attributed to that, I've also read very recent reviews of patients having been treated with the latest version (with CPT) and still experiencing marks, atrophy, disfigurement, orange peel skin or other irregularities to texture. I am terrified that this could happen to me. Could you give me "real world" risk based on the procedure being performed by qualified practitioners? Thanks so much! In your review of Thermage for the body on this website, you stated that you weren't impressed with the results. However, you mention that a new body tip was coming on the market in 2008 which may give different results. Given that it is 2016 now, have you seen any evidence that Thermage for the body (particularly arms and knees) gets results?

I’m answering several questions in one on this one! Thermage (more here) and other radiofrequency devices like Ultherapy, Pelleve, Thermismooth, Exilis, etc. are a very “hot” area right now in skin. Some of them listed have longer track records (Thermage, Ultherapy). Some of them are newer with less data (Thermismooth, Exilis, Pelleve). They all use a similar approach.

How do Radiofrequency Devices Get Anti-Aging Results?

Radiofrequency devices like Thermage work by passing sound waves through skin in various ways to generate heat. The heat, when done correctly, shrinks the existing collagen (a little) and stimulates new collagen growth which takes place over about 3 months. These technologies, in general, work better on younger or thicker skin and less on thinner and older skin. There are always exceptions.

This makes sense right? The more collagen you already have and the more cells (fibroblasts) you have to make collagen, the better these tend to work. So that’s why you see such differing reports of effectiveness on the web. A 65 year old with thin skin is likely to see nothing in the way of results.

Also you have to take into account that the tool (these devices) is only as good as the person using the tool. There is a BIG difference between a scalpel in the hands of a med student versus a highly trained plastic surgeon. This isn’t quite the same but the point is, results and complications are mostly in the hands of the person operating the device!

Complications are important! So, I will tell you this. Our office did NOT “upgrade” to the Thermage CPT technology. We stayed with the prior version. We didn’t think the vibration that it creates adds to the results at all.   And the vibration, in my opinion, is hard on the wrists and hands of the person operating the device. Thermage and all of the these technologies are quite safe. IN THE HANDS OF HIGHLY SKILLED PROVIDERS!

Another thing to realize about researching on the web is that there are unethical companies who hire people, usually through “reputation management firms,” to post unfavorable posts on web sites about their competitors products.   Crazy right? We’ve had that problem occasionally at our office. It’s why I think that Yelp is just legalized blackmail. We don’t participate in any way in Yelp.


So to answer the above, and given a well trained person doing the procedure, I would still vote for Thermage, Thermismooth or Ultherapy (more painful) on the face/neck area. In my opinion, none of these devices work well enough on the body. YET (companies are working on this) to make it worth spending your money and time on them.

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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