Thermage: Radiofrequency Technology Renews Your Skin

Reviewed by Ruth Hillelson, MD

Radiofrequency (RF) energy is no newcomer to the field of medicine. For over 75 years this low-energy electrical current has had a variety of uses in both invasive and noninvasive surgeries. One of its newer applications is a product called Thermage. Other trademarked names for the radiothermoplasty procedure are ThermaCool, ThermaLift and Pelleve.

Cleared by the U.S. Food and Drug Administration (FDA) in 2002, Thermage uses RF technology to stimulate the production of collagen and elastin in the dermis as well as to contour subcutaneous tissues. Collagen plays a major role in the body's natural skin renewal process, keeping it youthful looking. Time and sun exposure take their toll, however, and as we get older collagen breaks down faster than our bodies can produce it. Skin starts to sag and wrinkle, and its texture gets rougher.

What Can Thermage Do for You?

Thermage reverses the collagen degeneration process by reaching deep down under your skin's surface. This approach differentiates Thermage from laser treatments and other technologies that heat only the superficial skin layers. The deep penetrating RF energy tightens the existing collagen and stimulates new formation of this protein. Skin looks tighter, smoother and more contoured, its tone and texture are improved, and the results are immediate. The best part is that there's virtually no recovery time associated with Thermage because the top level of skin is not heated during the procedure.

Thermage is approved by the FDA for use on the face, eyes and body. Facial applications significantly improve sagging skin, loose jowls, diminished definition along the jawline, sagging skin under the chin and small lip lines. Thermage can also be used on tired-looking eyes that have excess skin on the upper lids (hooding), wrinkles and fine lines, and unflattering crepey-textured skin. It can also significantly reduce the appearance of fat pads of the lower eyelids.

When used on the body, Thermage can tackle wrinkled or sagging skin on the abdomen, knees, arms, legs, hands and buttocks; unwanted bulges like love handles; contour problems; and cellulite. Almost anyone can be a candidate for Thermage, regardless of age, skin type or color, or previous procedures. The decision to go forward with Thermage should be made in consultation with a physician who is well-versed in the procedure. He or she can evaluate whether you're a good candidate for the treatment. Generally, candidates should be physically healthy, realistic in their expectations and well-informed about the procedure.

For the best results, you'll want to find a surgeon who has experience in a range of procedures and has earned the trust of his or her patients. The All About Facial Rejuvenation directory only lists surgeons who have completed extensive education and training, and have proven themselves to be skilled, compassionate medical providers.

There are a few contraindications for Thermage, including pregnancy, implanted hardware devices such as pacemakers or defibrillators, and malignant tumors in the treatment area.

The Thermage Procedure

Thermage is an office-based procedure that is performed in about an hour, depending on the size and condition of the area(s) being treated. For example, a facial procedure averages about 45 minutes.

Your physician will use a handpiece to deliver the RF energy to the agreed upon treatment area(s). The heat phase of each energy pulse from the Thermage handpiece lasts less than one second; 600 to 900 pulses may be needed to treat the entire face. You may experience a sensation of deep heating or mild pinching during the treatment, but any discomfort should be minimal.

When your Thermage procedure is over, you can reapply your makeup and return to your regular activities. Your results may be visible after just one treatment, but your skin will continue to tighten for up to six months afterward. Results will last for up to three years.

Thermage Risks

Side effects from Thermage are rare and short lived. They may include swelling, redness, blisters, peeling, bumps or dimpling. The best way to minimize your risks is to choose a board-certified plastic surgeon or facial plastic surgeon. Follow his or her advice to a T.

Thermage Cost

Thermage cost ranges between $1,000 and $5,000 per treatment, depending on your geographic location and the type and number of areas you have treated. Doctors in large urban areas tend to charge more than those in rural or suburban areas.

Since Thermage is a cosmetic procedure, it is not covered by medical insurance. You may be able to discuss financing or payment plan options with your physician.

The cost of Thermage will be higher if you choose to combine it with other procedures, such as a Fraxel laser treatment. These two treatments often go hand in hand, packing a one-two punch against the visible signs of aging on your face.

About the Reviewer of this Article

Ruth Hillelson, MD, F.A.C.S., has an extensive background in both cosmetic and reconstructive plastic surgery. She is a plastic and reconstructive surgeon who has practiced in Richmond, VA since 1985. A native of Rhode Island, Dr. Hillelson received her pre-medical education at Johns Hopkins University. She completed her medical school education at Harvard University, her internship and residency in general surgery at the University of Virginia, and her plastic surgery residency at the University of Kansas. She also completed a craniofacial and maxillofacial fellowship at the University of Virginia. For more information about Dr. Hillelson and her practice, visit

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