Thermage Overview

Doctor Michael Krueger uses a 'ThermaTip' device on patient.
Thermage treatments can actually stimulate collagen growth and tighten the epidermis. See more getting beautiful skin pictures.
Andreas Rentz/Getty Image News

When Oprah Winfrey talks about something, some people are bound to pay attention, and Thermage -- a non-surgical medical treatment created to rejuvenate sagging skin -- is no exception. The larger-than-life media mogul has featured Thermage on both on her talk show and in O Magazine in recent years, and as a result, more and more people have shown an interest in the procedure as a means of turning back the clock on the way they look [source: Singer].

Thermage is based on a simple premise: that restoring and stimulating new collagen growth will naturally make the skin look younger. You see, as we age, collagen fibers found beneath the outer layer of our skin -- the epidermis -- eventually loosen and droop [source: Glossary]. To compound matters, the body's ability to make collagen declines as years pass. Genetics, sun exposure and smoking also contribute to collagen's gradual loss of oomph [source: MedicineNet].


During a Thermage procedure, a physician marks the patient's skin with grid lines to use as a guide, and then uses a wand to apply radiofrequency energy to the designated areas. The energy from the Thermage wand heats collagen in the dermis, the skin's lower layers, which makes the collagen fibers contract. This contraction, proponents believe, tightens the epidermis and makes it look smoother [source: Thermage, Miller].

People can use Thermage on the face -- including lips and eyes -- as well as the neck, hands, abdomen, buttocks and knees. The treatment can also combat cellulite-dimpled skin -- the stubborn bane of many women's existence [source: Thermage].

Actress Ellen Barkin told Oprah's O Magazine in July 2007 that she'd been having three Thermage treatments a year for the past three years [source: Monroe]. Read on to find out what she has to say about Thermage's effects and how it feels.


Effectiveness of Thermage

For every doctor-patient duo singing the praises of Thermage, there's an equally vocal pair proclaiming the treatment is overrated [source: PRweb]. Actress Ellen Barkin, for example, told O Magazine that she's not sure what her thrice-yearly Thermage treatments are doing for her [source: Monroe]. Her age may have something to do with this less-than-enthusiastic endorsement: Barkin is in her mid-50s, and some research has shown that Thermage can be less effective for older people. There's just no way to get around it. Eventually, skin just gets too loose to benefit from the treatments [source: Bailly].

Your age is only one factor contributing to Thermage's effectiveness. A 30-year-old who's spent too many years trying to achieve the perfect suntan might also find the procedure ineffective. The same goes for smokers and people who drink quite a bit of alcohol. Basically, if you haven't treated your skin or your body well, Thermage will not work well for you [source: Kosova].


Clearly, Thermage isn't the fountain of youth for everyone, but there are patients who believe in its effectiveness. And some doctors say that, as they have learned to refine Thermage treatments, their results seem to have improved [source: Johnson].

Not everyone sees immediate results. In fact, results typically manifest between two and six months after treatment. Also, the effects of Thermage aren't permanent, but they can last from six months to four years [source: Bailly]. For some fortunate patients, Thermage delivers dramatic results. But you may be wondering if it's safe. Read on to learn more.


Is Thermage Safe?


The FDA approved Thermage in 2002, and when Oprah introduced it to her viewers in 2003, interest surged. But some critics pointed out that Oprah's show mentioned only positive outcomes of the treatment [source: Kosova]. Negative accounts do exist.


Patients of early Thermage treatments reported burning, blistering and scabbing. Some complained of problems with uneven contouring -- in other words, instead of level skin, Thermage left some areas indented, while others stood out. These early problems seemed to be the result of too much heat, which caused the melting of fat in the dermis, creating unacceptable dips and bulges in skin [source: Singer].

However, Thermage has evolved since its early days. Even doctors who question the treatment's effectiveness now acknowledge that the procedure is generally safe, when it's properly performed.

But that doesn't necessarily mean you'll completely escape pain or discomfort. In her O Magazine interview, Barkin said the treatment felt like burning rubber bands snapping her face [source: Monroe]. That was in 2007, and Barkin's opinion about Thermage being painful was shared by many at the time.

Despite recent improvements, there's no question that Thermage can still be an uncomfortable experience for some, and downright agonizing for others. Doctors and patients should talk throughout the procedure. If a patient's personal pain meter exceeds the hot-but-tolerable stage, he should ask the doctor to dial down the temperature used.

Now that you've learned that Thermage is generally safe, maybe you're ready to sign up for a treatment. Read on to learn how it stacks up against surgery.


Thermage vs. Surgery

A chance to skip the scalpel and avoid anesthesia -- and still repair aging skin -- might seem like a no-brainer. But the decision to choose Thermage over surgery isn't exactly cut-and-dried.

One "pro" for Thermage is that your convalescence will be minimal to nonexistent. You might be able to go for a Thermage treatment in the morning and be back in your office in the afternoon. At the very least, you'll be able to do anything you normally do -- even working out at the gym or outdoors (with sunscreen, of course).


On the other hand, if you've just had a surgical facelift, you'll spend some time recuperating at home. You'll have swelling, bruising and puffiness for two to three weeks, and you'll need to be careful of your stitches, which means you'll have to take a break from exercising and anything remotely strenuous for a few weeks [source: Schmid].

Despite the apparent advantages of Thermage, surgery might still be a preferable option for some people. In general, the more dramatic the result you seek, the more the scale tips in favor of surgery. If you're hoping to look 10 years younger, for example, surgery probably has a better chance of getting you there [source: Schmid]. Notwithstanding some positive reviews of Thermage, the fact remains that most people will see much more subtle results from the procedure than they will from surgery. How subtle is too subtle? That's a question you'll have to wrestle with before deciding which route to take.

Another thing to consider is the cost. Read on to find out how Thermage can affect your wallet.


Cost of Thermage

No matter which you choose, Thermage or surgery, you can count on one thing: paying for the procedure out of your own pocket. As you can imagine, insurance typically won't cover these elective procedures. And also as you would expect, surgery usually costs more than Thermage.

Consider the typical facelift. Prices vary from one location and doctor to the next, but the national average for physician and surgeon fees for a facelift was $6,792 in 2007 [source: Cosmetic Plastic Surgery Research]. And that's not the final cost -- there may also be anesthesia costs, facility costs, medication, medical testing and other miscellaneous services that add to it.


The cost of Thermage is estimated to be between $2,500 and $4,500 [source: Singer]. Again, there can be quite a variation in price, depending on what body part the treatment is addressing and where your doctor practices. Thermage for the forehead should cost about $750 [source: Schuck]. But unlike surgery, Thermage shouldn't involve numerous additional fees.

Thermage seems like a bargain, relatively speaking. But even if your Thermage treatment brings you dramatic results, those results won't last more than a few years -- three to four, tops, and likely a lot less for cellulite treatment.

It's probably safe to say that a good facelift will generally last two or three times as long as Thermage. When pressed, many doctors estimate that a facelift will last seven to 10 years or more [source: Facelift Q & A]. So when you compare the cost of surgery to the number of Thermage treatments you might have during that same time span, you'll see the costs of the two are closer than they appear.

Obviously, there's a lot to consider when choosing between Thermage and traditional plastic surgery. It's not an easy decision, but an experienced doctor can help you weigh all the options and decide if Thermage is a good alternative for you.


Lots More Information

Related HowStuffWorks Articles

  • Bailly, Jenny. "15 Treatments to Cure Ugly Skin." O: The Oprah Magazine. May 2009. (Accessed 7/20/09)
  • Johnson, Bill J., M.D. "Innovations Med Spa." (Accessed 7/20/09)
  • Kosova, Weston, and Pat Wingert. "Live Your Best Life Ever!" Newsweek. June 8, 2009. (Accessed 7/20/09)
  • "Wrinkles." (Accessed 7/20/09)
  • Miller, Scott R. "Thermage." Consumer Guide to Plastic Surgery. October 2008. (Accessed 7/28/2009)
  • Monroe, Valery. "Beauty Upkeep: The Ellen Barkin Plan." O: The Oprah Magazine. July 2007. (Accessed 7/20/09)
  • PRWeb. "Orange County Surgeon/Dermatologist Lenore Sikorski Draws Crowds at 'No Hype' Educational Seminars." July 10, 2009. (Accessed 7/20/09)
  • Plastic Surgery Info. "Cosmetic Plastic Surgery Research." Plastic Surgery 2001-2007. (Accessed 7/28/09).
  • Prevention Magazine. "3 Decades of Beautiful Skin." July 2008. (Accessed 7/20/09)
  • RealSelf. "Facelift Q and A." (Accessed 7/20/08)
  • RealSelf. "Thermage Skin Tightening." (Accessed 7/28/09)
  • Robert Wood Johnson University Hospital. "Dermatology Glossary." (Accessed 7/20/09)
  • Schmid, Wendy. "Skin Savers." Prevention Magazine. September 27, 2004. (Accessed 7/20/09)
  • Schuck, Jill. "The Connoisseur; Beam Me Up." The New York Times. April 15, 2007. (Accessed 7/20/09)
  • Singer, Natasha. "The Oprah Treatment." The New York Times. May 11, 2006. (Accessed 7/20/09)
  • Snead, Ellen. "The Dishrag." Los Angeles Times. May 28, 2009. (Accessed 7/20/09)
  • "About Solta Medical." (Accessed 7/20/09)
  • The American Society for Aesthetic Plastic Surgery. (Accessed 7/20/09)
  • Thermage. (Accessed 7/20/09)