July 2, 2013

Reverse Facial Aging and Tighten Skin with Thermage

 Understanding Facial Aging 

Facial aging process begins with the surface and subsurface structural changes. Therefore it affects multiple facial tissue layers, including skin, fat, muscle and bone.
These tissue layers age interdependently, contributing to the overall facial appearance that is obvious on the outside.
With age, skin undergoes several changes, which include:
sagging skin, shrinkage of fat, muscle and bone.
Collagen loss is a key factor in the aging process. As skin ages, the middle layer of skin (dermis) thins due to collagen loss. This reduces the skin’s ability to retain elasticity (from elastin) and moisture (from hyaluronic acid).
What happens when skin ages?
1.Drier skin
2.Thinner skin
3.Less elastic skin
4.Skin more likely to wrinkle or sag
5.Reduction in collagen
The first tissue tightening treatment was addressed 15yrs ago with CO2 laser surgery. The term ‘tightening” describes gross contouring changes in the skin vs. superficial wrinkle reduction. Modern tissue tightening devices heat the deeper dermis and hypodermis to cause shrinkage of collagen which occur at target temperature of 59-64deg C.
Thermage is the pioneer in non-invasive technology to treat wrinkles, thicken and reverse skin aging and lift sagging skin.
So what is Thermage ?
Thermage is a monopolar, capacitively coupled radiofrequency system that non-invasively help smooth, contour and remodel skin, as well as reduce the appearance of cellulite, in a single treatment with little or no downtime
The modality of Thermage is radiofrequency.  

Monopolar ensures that the path goes deep and all the layers within that path will receive the heat necessary to provide a therapeutic effect on tissue remodeling.

In 2002 – Thermage was first commercialized with the launch of the ThermaCool system. 
The FDA clearance made it to be the first non-invasive eye lids treatment for skin wrinkles, and is still the only device cleared for eyelids treatment, which is a key component to full facial treatment.  

In 2006,  the larger body tip was launched.
Thermage is now indicated for use:

•as Non-invasive treatment of wrinkles and rhytids, including the upper and lower eyelids
  •    as  a non-invasive treatment for sagging and lax skin - a non-surgical"face lift"

•as Non-Invaasive treatment for creppy, thinning  on face as well as body
  • as temporary improvement in the appearance of cellulite

Then in 2008, the new Thermage CPT was launched.
This newer technology utilizes the capacitively coupled
 monopolar RF to achieve even more uniform volumetric
bulk heating of targeted treatment areas in a more
comfortable and less risky approach than previous
“Capacitive Coupling”, ensures the RF energy is uniformly and consistently transferred into the skin to generate the heat. This is key to provide an effective heating mechanism.  . 

 The uniformity and consistency of the heat generated is important to ensure the tissue receives the effectively energy to be heated by the movement of the electrons and ions.

The bulk heating approach creates greater tissue reaction.

In 2012, the new Thermage Total Tip was launched.
 The Total Tip  can deliver up to 2 times bulk heating than the previous Face Tip, giving  better and more immediate results, while making the treatment far more comfortable. 
More areas can also be treated at the same time, such as: full face and submentum treatment and small body areas such as arms, knees  
Thermage is the answer for complaints like “tired looking
 eyes”, “under eye bags”, “crow’s feet”, “my
make-up doesn’t go on smoothly anymore”
Thermage can also be combined with many other treatments. Many of the common aesthetic procedures only affect certain layers of the skin and there has been confusion among patients between a Thermage treatment, laser treatments and others, such as IPL, fillers, and Botox. 

Most laser treatments penetrate the epidermis and dermis, depending on the depth of the laser itself. In this, lasers can be an effective way to resurface the skin.

 Fillers are used to “fill in” areas with deep wrinkles or those areas that have lost volume and can penetrate into the dermal layer.

Thermage uses radiofrequency, which is able to be delivered through all 3 skin layers.

And finally, Botox,is used to treat wrinkles by paralyzing the muscles, bypassing the skin layers completely.

























  1. At our centre En-hanze Aesthetic CLinic , we have been conducting Thermage SKn Tightening treatments for almost 5 years now. Ony required to be conducted once every 2-3 years, it is very ideal for busy men and women who do not want any downtime. Our centre conducts Thermage for face, neck, décolletage, upper eye lid hooding, upper arms, tummy and even buttocks.

  2. Dear Dr. Sutina,

    Are you using the CPT Thermage in your clinic?


    1. Yes, we are now using the Thermage CPT which is the latest version of the Thermage system. This new CPT Thermage allows faster treatment time and also reduces discomfort during treatment. Also it is able to use the new Total Tip which can deliver 30% better results.

    2. The Thermage CPT treats skin faster and more comfortably. Major advancement. Patients are much more comfortable, and Dr is also more comfortable and therefore can deliver better results.


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