Posted by: me | 2009-04-08

thermage. Is it safe?


I would like to know more about thermage. It sounds too good to be true. Are there any possible side effects ? Is it sfe? Could it burn or damage the skin?

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Expert ImageAnti-ageing expert

Hi Me, thank you for the question.

Firstly, there is no technology that will produce surgical like results. Unfortunately, the word ‘non-surgical facelift’ or ‘lunch time face lift’ does not yet apply to any of the technologies we have available today. The maximum improvement in all studies and with most of the skin tightening technologies today demonstrate a maximum improvement of around 30%. I have pasted the abstract of 3 studies that have been specifically performed with the Thermage machine indicating the results and benefits that one can achieve:

Thermage: Multicenter Study of Noninvasive Radiofrequency for Periorbital Tissue Tightening
Lasers Surg Med. 2003;33(4):232-42. Links

Lasers Surg Med. 2004;34(3):203-4.
Fitzpatrick R, Geronemus R, Goldberg D, Kaminer M, Kilmer S, Ruiz-Esparza J.
Dermatology Associates, 477 N. El Camino Real, B-303, Encinitas, CA 92024, USA.

BACKGROUND AND OBJECTIVES: This 6-month study evaluated the efficacy and safety of treatment with a nonablative radiofrequency (RF) device.

STUDY DESIGN/MATERIALS AND METHODS: Eighty-six subjects received a single treatment with the ThermaCool TC System (Thermage, Inc., Hayward, CA) and were evaluated for 6 months after treatment.

RESULTS: Independent scoring of blinded photographs resulted in Fitzpatrick wrinkle score improvements of at least 1 point in 83.2% (99/119) of treated periorbital areas. Treating physicians, without reference to pre-treatment photographs, noted improvements in 28.9% (48/166) of treatment areas. Fifty percent (41/82) of subjects reported being satisfied or very satisfied with periorbital wrinkle reductions. Objective photographic analysis showed that 61.5% (40/65) of eyebrows were lifted by at least 0.5 mm. Rates and duration of edema/erythema were very low (e.g., vs. ablative procedures). Overall 2nd-degree burn incidence was 0.36% (21 per 5,858 RF applications). Three patients had small areas of residual scarring at 6 months.

CONCLUSIONS: A single treatment with this RF tissue tightening (RFTT) device produces objective and subjective reductions in periorbital wrinkles, measurable changes in brow position, and acceptable epidermal safety. These changes were indicative of a thermally induced early tissue-tightening effect followed by additional tightening over a time course consistent with a thermal wound healing response. Copyright 2003 Wiley-Liss, Inc.

Source: PMID: 14571447 [PubMed - indexed for MEDLINE]

Clinical Parameters for Predicting Efficacy and Safety With Nonablative Monopolar Radiofrequency (Thermage) Treatments to the Forehead, Face, and Neck
(Sasaki, Gordon, Tucker, Barbara, and Gaston, Margaret) Aesthetic Surgery Journal 2007; Volume 27, Issue 4:376-387; August 2007

Patient selection is key to obtaining a successful outcome after nonablative monopolar radiofrequency (NMRF) treatments to the forehead, face, and neck. The objective of this study was to discover at baseline from patient demographics, skin and fat characteristics, measurable degrees of tissue mobility and photoaging, any predictors of a positive result under a standardized treatment algorithm.

Twenty-five patients (22 females, 3 males; average age 52.3 years) were selected randomly for NMRF treatments (2 nonoverlapping passes, additional passes for vectored contraction and contouring) between 350 and 450 firings with a 1.5-cm tips to the forehead, periorbitum, face, and upper neck. Patients were evaluated at baseline and monitored for outcomes beyond 1 year by a number of quantitative assessments.

At baseline and 3, 6 and 12 months, measurements of skin thickness, subcutaneous fat depth, tissue mobility, and wrinkle and fold depth were obtained at 9 different reference sites on each patient. Nineteen patients (76%) who progressively responded to NMRF energy over 12 months were observed at baseline to have a global mobility score (mean ± SD) of 3.4 ± 0.27 mm; 6 patients who were assessed to be nonresponders over 1 year of evaluation began with more tissue laxity and exhibited at baseline a larger global mobility score (mean ± SD) of 4.4 ± 0.60 mm. Other factors that were more likely to be associated with a positive response to NMRF treatment included minimal degrees of photoaging and shallower wrinkle/fold development. The variables of skin thickness and fat depth did not play significant roles in predicting positive responses to treatment. Side effects and complications were minimal throughout the study.

This study represents one of the first investigations that attempts to identify systematically objective baseline parameters that are more likely to be associated with positive responses to NMRF treatments to the forehead, face, and neck. Longer follow-up of patients and further studies are necessary to verify the preliminary findings.


Thermage Study: Radiofrequency Treatment for Middle and Lower Face Laxity

Arch Facial Plast Surg. 2004 Nov-Dec;6(6):370-3.

Fritz M, Counters JT, Zelickson BD.
Head and Neck Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.

OBJECTIVE: To compare the effectiveness of 1 and 2 radiofrequency (RF) treatments with the ThermaCool TC system (Thermage Inc, Hayward, Calif) on middle and lower face laxity.

METHODS: Twenty patients with mild to moderate laxity of the middle and lower face were randomly assigned to receive either a single RF treatment or 2 treatments spaced 1 month apart. Treatment energy levels were titrated to patient tolerance and ranged from 85 to 135 J/cm(2). Acute clinical response was recorded after each session. Standardized photographs were taken before treatment and at 1 and 4 months after the last treatment. Using a percentage scale, 4 blinded physicians experienced in dermatologic laser therapy independently rated improvement in nasolabial folds, marionette lines, jowls, laxity under the chin, and overall appearance. In addition, subjects completed quality-of-life surveys 1 and 4 months after treatment. Each patient paid the same fee for involvement in the study.

RESULTS: Eleven patients received a single RF treatment, and 9 patients underwent 2 treatments. All subjects experienced mild edema and mild to moderate erythema as an acute clinical response; no patients experienced burns, skin breakdown, or scarring. At 4-month follow-up, patients in the 2-treatment group received higher scores in all categories of photographic analysis; the difference in improvement in the nasolabial folds was statistically significant (P = .04). In self-assessment ratings, individuals receiving 2 treatments reported more improvement than subjects in the single-treatment group 4 months after treatment (P = .03). In both treatment groups, physician photographic assessment demonstrated continued improvement in all subsites between the 1-month and 4-month assessments (P<.05). Although the overall change noted by both patients and physicians was modest in most patients, 75% of subjects (n = 15) stated they would consider paying for additional treatments.

CONCLUSIONS: Two RF treatments yielded significantly better improvement than a single treatment in the nasolabial folds. Significant improvement in laxity after treatment was seen between the 1- and 4-month follow-up visits in both single- and 2-treatment groups. Although overall improvements were modest in both groups, patient satisfaction was relatively high.

Source: PMID: 15545529 [PubMed - indexed for MEDLINE]

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