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What is Thermage?

Thermage is a non-invasive, non-surgical, radiofrequency (RF) skin treatment to build collagen and tighten, smooth, & contour skin. There is no downtime and results will improve over several months. Existing collagen decreases ~1% each year and collagen production slows down with the aging process. Thermage is a non-invasive treatment that helps combat this natural aging process by stimulating collagen contraction and production. Minimal maintenance is required between treatments.


DSC Thermage Treatment Blog Gif featuring face being treated with Thermage FLX treatment on submentum area


Through impedance, RF energy translates to heat once in contact with the skin, which causes immediate collagen contraction and initiates the process for growing new collagen. Because Thermage is non-invasive, it is possible to treat even the upper and lower eyelids safely. Thus, Thermage is a great treatment for drooping or sagging upper eyelids or to soften fine lines around the lower eyelids. While most people typically treat the eyes, and/or face + neck, it is possible to treat skin almost anywhere on the body – chest, abdomen, thighs, arms, and even butt!

Image of woman posing with possible Thermage treatment areas delineated


Different treatment areas necessitate different treatment tips due to size differences. Treating the eye area requires a much smaller tip than treating the face or the abdomen. Each treatment tip can only be used once, which means each separate treatment requires a new tip. Every treatment tip comes with a certain number of “counts,” or treatment pulses wherein RF energy can be delivered. For example, a standard Thermage eye tip comes with 450 counts, which means the eye contours and eyelids are treated with 450 pulses of RF energy. This can be divided evenly between both eyes, or according to your individual treatment needs as discussed with your Thermage provider. At DSC, the standard face + neck Thermage treatment is 900 counts. These 900 counts can be evenly parsed between the face and neck or according to your specific skin concerns.

Thermage treatment tips are cryogen cooled, which protects skin from discomfort during treatment. Energy levels can be also adjusted to suit your individual comfort. It is not true that higher energy equates better results; Thermage treatments should be done at a level that you can tolerate comfortably. For additional comfort, vibration can be added as a form of distraction. There is no blood or downtime from Thermage; you can immediately resume normal activities post-treatment.


How to prepare for a Thermage treatment


DSC blog graphic titled "how to prep for thermage" at the top with the following text below: "remove contacts & bring glasses," "remove all metal jewelry," "cleanse skin," and "wear comfy clothes"


Remove contact lens and bring glasses to wear for 24 hours post treatment for a Thermage eyes treatment. This is because an eye shield is inserted like a contact lens to protect the eyeball while treating the eye area. Numbing eyedrops are used to make the eye shield insertion more comfortable, however, this can increase the chance of scratching your eye when reinserting your contacts. Therefore, it is best to avoid wearing contact lens for 24 hours after a Thermage eye treatment. The eye shield is only ever inserted into one eye at a time (the eye being actively treated).

Remove metal jewelry, as well as clothing with any metal pieces, such as bra hooks, zippers, buttons, or tabs. Thermage is a monopolar RF treatment; the RF energy travels from the treatment tip as an entry point to the return pad on the back as an exit point. Any metal in between may heat up and cause discomfort due to this design. Orthodontic braces are not an issue with Thermage treatments; gauze can be inserted in the mouth to prevent braces from pressing against cheeks when treating the face.

Discontinue active topicals such as retinoids or chemical exfoliants at least a day or two in advance of treatment to prevent skin irritation. Daily application of sunscreen to the face and neck is important as well.


What is a Thermage treatment like?


Treatment areas should be clean, dry, and free of any makeup or heavy skincare. It is best to come to your appointment with clean skin. Marking paper will be applied on the skin like a temporary tattoo to delineate grid marks in treatment areas. A return pad will be applied on the back or thigh and the return pad cable will be clipped to the return pad to allow the RF current to pass out of the body.

If treating the eyes, contact lens should be removed. Numbing eye drops will be applied to one eye at a time and an eye shield will be inserted to protect the eyeball. The eye shield is like an opaque contact lens and is only inserted on the side being currently treated. A water-based coupling fluid is applied to the skin during the treatment to improve RF conduction. The treatment tip will be inserted into the Thermage device’s handpiece to begin treatment. The treatment tip is placed on the skin according to the marking paper grid marks and RF energy is delivered across each treatment area. During each pulse, the RF energy will feel like warmth or heat. Each successful delivery of a count comes with a chime that lets you and your provider know the energy was successfully delivered.

Thermage CPT vs. FLX


Thermage CPT 4th generation device on the left versus Thermage FLX 5th generation device on the right graphic



CPT and FLX are different generations of Thermage devices. CPT, Comfort Pulse Technology, is the fourth generation Thermage device. FLX, Faster aLgorithm eXperience, is the latest, 5th generation Thermage device. The FLX face tip is 4.0cm² compared to 3.0cm² for the CPT face tip, allowing face + neck treatments to be completed in 900 counts versus 1200 counts respectively. This is because the larger tip allows more surface area to be treated per count. FLX also features improved cooling and energy delivery during treatment.


Thermage CPT face tip on the left versus Thermage FLX face tip on the right detailing differences between treatment devices - Thermage CPT treatment tip has smaller surface area of 3.0cm^2, is the fourth generation device, and needs 1200 counts for a total face + neck treatment, while the FLX tip is 4.0cm^2, 900 counts for total face + neck treatment, and is the fifth generation device



Contraindications for Thermage include: pregnancy, pacemakers, and metal surgical implants in treatment areas. People with pacemakers should seek non-RF alternative treatments, such as injectables or Ultherapy. DSC offers many rejuvenation and anti-aging treatments; contact us to discuss alternative treatments to Thermage.

DSC Laser & Skin Care Center

889 S. San Gabriel Blvd. San Gabriel, CA 91776