Thermage

What is ReFirme^TM?

Non-surgical face lifting refers to skin tightening technologies which tone, lift, and contour the face and neck without surgery. These technologies can re-build collagen, condense unwanted fat, and tighten the superficial muscular layer of the skin. Specifically, these technologies tighten loose skin on the brows, eyelids, the jowls and neck, and under the chin.

Fundamentally, all skin technology uses focused deep heat to achieve skin tightening. Currently, there are three ways of achieving the skin tightening: laser, radiofrequency (RF), and ultrasound. Each modality targets different depths of the skin, emits different type of heat patterns, and thus produce different clinical benefits for different conditions.

Commonly, combination of laser, radiofrequency, and ultrasound produce faster and better results. And further combining with botox and fillers create the best overall results.

Radiofrequency
ThermageTM
Thermage uses mono-directinal radiofrequency heat energy to tighten, lift, and compact the skin. This treatment stimulates collagen of medium and deep depth, tightens the fibromuscular fascia of the skin, and flattens down unwanted localized fat.
As a more costly option, this procedure is particularly suitable for thick-skin, heat-tolerant individuals who desire a convenient onetime treatment.

Thermage Face
This treatment tightens and contours the face by using electrical energy to produce collagen remodeling, growth, and fat shrinkage in select areas. Correctable conditions include early stages of nasolabial lines, jowls, and double chin.
Thermage Eyelids
This treatment improves early skin eyelid redundancy, improving hooding and fine wrinkles around the eyes.
Thermage Body
This treatment improves body wrinkling. Correctable conditions include skin wrinkling and cellulite associated with pregnancy, weight loss, and/or aging.

How does this treatment differ from the other options?

1. Most versatile one session skin tightening treatment
2. Suitable for chubby face, double chin, droopy eyelids, cellulite, stretch marks, and body wrinkling
3. Targets collagen and fat more comfortably than ultrasound
4. Appropriate for one time treatment for the heat tolerant individuals

What Conditions May Be Treated?

1. Thick skin
2. Chubby face
3. Double chin
4. Eyelid wrinkles
5. Cellulite
6. Stretch marks
7. Body wrinkling

Whom is the treatment for?

1. Patients with realistic expectation
2. Patients in good healthy conditions
3. Stable weight without frequent or excess weight gain or loss

Whom is the treatment not for?

1. Patients with unrealistic expectation
2. Patients with low blood sugar, dehydration, acute disease, autoimmune disorder, blood disorder, cancer, or on bleeding thinning medications.

How is the treatment done?

For the radiofrequency, the targeted areas are marked for contouring and lubricated with gel. The transducers are the then applied onto the skin to emit diffuse electrical energy to the superficial and medium depths of the skin. Multiple passes are performed in a directional lifting manner. Heat sensation will be felt.

Generally, a combination package treatment is required.

The treatment takes about half hour in an outpatient clinic setting.

Oral anesthesia may be used.

What results may be expected?

1. Reduced chubby face
2. Reduced double chin
3. Improved eyelid wrinkles
4. Improved cellulite
5. Reduced Stretch marks
6. Smoother body wrinkling

How many shots are used?
The number of shots for ultrasound will vary between 900 to 1200. The energy targets only the necessary areas of thick collagen and fribromuscular layer. Areas with thin collagen or absent fibromuscular layer will often further flatten down with heat energy and thus intense energy to the deep depth to these areas is not needed.

Do more pulses, shots, or lines make better results?

The short answer is “yes” for areas where one wants flattening. The answer is “no” for areas where one does not want loss of volume.

For these areas which excess plumpness or volume is not desired, more energy via more pulses, shots, or lines to these areas will flattening the areas down.

Areas where plumpness or volume is not desirable and thus enhanced energy may be warranted include:
1. lower cheeks
2. nasolabial prominence
3. jowls
4. double chin.

For areas which plumpness or volume is not desired, more energy via more pulses, shots, or lines to these areas will actually decrease the flattening the areas down, and produce more hollowed appearance.

Areas where plumpness or volume is to be maintained and thus excessive energy is not warranted include:
1. Forehead
2. Temples
3. upper cheeks

With combination technique, both ultrasound and radiofrequency energies are performed, all on areas where flattening where contraction is desired. Combination results are better than single modality ultrasound or radiofrequency alone.

Thus, where the skin tightening is targeted affects the aesthetic outcome and can either rejuvenate or age your look!

Does skin tightening with a single modality of laser, radiofrequency, or ultrasound provide the best skin tightening result?

The short answer is combination technique, not single modality, produce the best results.

Laser

1. focused columns of superficial heat energy, with gaps of no energy between columns
2. targets superficial collagen

Radiofrequency

1. uniform, radiant, circumferential, wavelike heat without gaps
2. targets deep collagen and fat more comfortably

Ultrasound:

1. focused columns of deep heat energy, with gaps of no energy between columns
2. targets deep collagen and muscle with intense heat.
3. While ultrasound can also be used for fat, monoploar radiofrequency provides far more uniform heat for better fat reduction.

The efficacy of skin tightening depends on:

1. Levels of heat:  superficial heat(superficial collagen), deep focused heat(deep collagen and muscle), and deep radiant heat(fat contraction).
2. Amount of heat
3. Sessions of heat
4. Combined treatment with other modalities such as laser, radiofrequency, botox, and fillers.

When will one see the results?

The results will be seen gradually within two months. After the swelling subsides with few days, the results will look more and more natural.

How long do the results last?

Results long one year or more. Duration of effect is similar regardless of sessions of treatments, but the magnitude of change will be determined by the number of sessions.

How to maintain or enhance my results?

Additional maintenance is required.
Healthy eating and exercise are helpful to enhance results.
Further treatment may be recommended to further results.

What is the recovery like?

Recovery lasts one day
Mild redness, swelling, pain, and occasional tingling are expected.
Prescription pain medications are generally not necessary.
Most people return to work and activities in one day.

Instructions

Cost of Treatments

Cost of treatment options ranges from three to four digits. An in-person consultation with your specialist physician will help to determine the best suitable solution to your own individual needs.

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