LEARN, SHOP & CHAT ABOUT PLASTIC SURGERY, BEAUTY AND ANTI-AGING
You're here: Home > Message Boards > Non-Surgical Cosmetic Procedures & Treatments > Non-Surgical Cosmetic Procedures

Plastic Surgery, Beauty, Skin Care Message Boards & Blogs

Our message boards are for all of us who want to talk, listen, share, and support fellow women and men interested in discussing plastic surgery, beauty treatments, pregnancy, gynecological concerns, aging, and various health conditions. You can read messages without logging in. To post a message, please log in or register. It's free...and being a member gives you access to important information. By using the Message Boards, you agree to the Message Boards Policies.

SUBSCRIBE: Sign up to get newsletter with weekly popular topics discussed on the boards  
 

Thermage- Why some have fat loss and other great results?

Chat about all the new and established non-surgical cosmetic treatments and procedures

Thermage- Why some have fat loss and other great results?

Postby wineaux » Fri Jan 19, 2007 1:57 pm

I was scheduled to get Thermage done next week. Now I am totally freaking out due to the posts about fat loss. I called the Doctor in a panic and he assured me he has done thousands of the procedures and has NEVER had had a problem with fat loss. I called 2 of his prior patients who gave him and the thermage procedure glowing reviews.

Does anyone know if there have been any studies by Doctor's or Themage to determine the cause of the fat loss. Are certain individual's more susceptible to the problem. Ie: thin skin , or low body fat to start with?

Trying to reconcile why some have great results and others are devastated.

Would really appreciate feedback.
wineaux
 
Posts: 2
Joined: Thu Jan 18, 2007 9:46 pm



Postby LookinUp » Sat Jan 20, 2007 8:18 am

Great results?!?! At best, they are mediocre...at worst, extensive damage...but the usual with Thermage--no results at all. To spend money on a procedure with less than a 25% satisfaction rate is nuts. RF is used in surgery to ablate tonsils, and other organs. So for it to superheat and 'melt' fat is not unusual at all. The first couple of days you'll look great (due to the minimal immediate swelling--just enough to 'puff out' the wrinkles, yet not look 'swollen')...when that goes away, you'd be hardpressed to see any significant or lasting results. I really think this is an 'emporer's new clothes' procedure....some people are easily swayed. For example, when I had mine, and said that there was no difference...the aesthetician tried to tell my my 'eyebrows were lifted a couple of millimeters' and I 'looked fabulous'.....until I washed off my 'temporary lift' serum that I use...then she couldn't say anything at all. My opinion is that if you spend money on something, you want results, are hopeful, and are easily swayed.
LookinUp
 
Posts: 4425
Joined: Wed Jul 13, 2005 4:38 am

Postby lollipop » Sat Jan 20, 2007 3:59 pm

I dont know why the whole thermage thing is not shut down someone with 60 minutes should do an expose'. The titan another huge ripoff!!!Whatever tightening effect you get is temporary-you can get the same effect with egg whites for 10cents.
lollipop
 
Posts: 1257
Joined: Thu Jun 02, 2005 6:49 pm
Location: san diego area



Postby LookinUp » Sat Jan 20, 2007 4:50 pm

I absolutely agree with you on the 'egg white' (albumen) trick! Works like a charm!
LookinUp
 
Posts: 4425
Joined: Wed Jul 13, 2005 4:38 am

Re: Thermage- Why some have fat loss and other great results

Postby MissJ521@aol.com » Tue Jan 30, 2007 4:20 pm

I don't have the citations for them but I have seen studies that have discussed it. More over, I have seen cases where there is clearly soft tissue loss from the thermage and reports by docs that it does not have a high enough success rate for them to justify using it anymore.

I'm not so sure that it results in "fat loss" though. I mean, I've seen VOLUME missing in some cases from it but I suspect it's probably collagen loss or shrinkage (which cosmetically, would give the same bad 'look' as fat loss). Given that the device operates on the principle of 're-modeling' the collagen as to 'tighten' that act would be equivilent to SHRINKING collagen. Hence the volume loss people report from it even if they call it "fat loss".





wineaux wrote:I was scheduled to get Thermage done next week. Now I am totally freaking out due to the posts about fat loss. I called the Doctor in a panic and he assured me he has done thousands of the procedures and has NEVER had had a problem with fat loss. I called 2 of his prior patients who gave him and the thermage procedure glowing reviews.

Does anyone know if there have been any studies by Doctor's or Themage to determine the cause of the fat loss. Are certain individual's more susceptible to the problem. Ie: thin skin , or low body fat to start with?

Trying to reconcile why some have great results and others are devastated.

Would really appreciate feedback.
User avatar
MissJ521@aol.com
 
Posts: 3029
Joined: Fri Jun 09, 2006 3:35 pm



Postby MissJ521@aol.com » Tue Jan 30, 2007 5:09 pm

I agree with you but have a different take on why it does not work:

The thermage device is one that ABLATES the collagen layer under the skin without burning off the skin as does a Co2 laser. A CO2 laser will 'shrink' or ablate the collagen layer under the skin but it also 'burns' off the surface of the skin and hence also REDUCES the SURFACE AREA of the skin to accommodate the volume loss from the ablation under the skin.

Ablation of collagen is similar to what happens to an egg white when you cook it. So it basically 'cooks' the collagen under the skin in the hopes that it will 'remodel' itself. Well, ya, the collagen layer can 'remodel' itself but if the remodeling is a 'tighter' 'denser' layer of collagen UNDER the skin but the skin itself does not also tighten over that (which it might not because the skin is not ablated or burned with the device). That said, a 'tighter' 'denser' 'new layer' of collagen UNDER the skin is going to be one of LESS VOLUME for the surface area of skin over it. That physical phenomena ALONE veers toward having 'too much' surface area of skin over the volume underneath which very well could make the skin look more droopy given the reduced volume underneath it. Hence, it is HIGHLY PROBABLE that people would see some kind of apparent or relative VOLUME LOSS after getting the thermage.

The total fallacy with the 'information' they give you on it is that it "tightens the skin". Well, it does NOT tighten the skin. To tighten the skin itself, you actually have to do DAMAGE to the skin--like burn it with a controlled burn from say a CO2 laser or phenol peel. Yet they tell you it "does not damage the skin". Can't have both but they MARKET both. For example, they tell you it does not damage the skin but it tightens the skin. If you want to tighten the skin, you've got to reduce it's surface area by some kind of controlled "damage' to it whether it be a controlled burn or a controlled CUT (excision).

Hate to phrase it this way, but most of PS procedures are really the art of some kind of CONTROLLED DAMAGE to the tissues with the objective of kicking up a better cosmetic effect from the damage.

Well, if your not damaging the skin itself (in the sense of a highly controlled BURN), than the skin is NOT being "tightened". What's being 'tightened' is the collagen layer underneath the skin via an ostensibly 'controlled' sort of damage. That's where the discrepancy people see comes from: A tightened layer underneath with a loose layer (skin) over it.

Let me put it this way: Say you got a face lift where they only 'tightened' the tissue UNDER the skin but did not tighten the skin over it (like removing some of--REDUCING THE SURFACE AREA of skin). Guess what it would look like: VOLUME LOSS.

Very young skin with very good 'elasticity' can remodel itself over volume loss underneath, as in liposuction to younger people, but I would say that most people going for the thermage don't have that 'snap back' to the skin layer going on and the loose skin is just going to 'sit there' over the volume shrinkage of the collagen layer below it. It's not going to tighten up with the volume loss underneath.

That's my THEORY as to why, for the most part, Thermage does not give good results. Add to that the fact that many docs just do the procedure and DON'T really follow up the patients to see if it did much.


LookinUp wrote:Great results?!?! At best, they are mediocre...at worst, extensive damage...but the usual with Thermage--no results at all. To spend money on a procedure with less than a 25% satisfaction rate is nuts. RF is used in surgery to ablate tonsils, and other organs. So for it to superheat and 'melt' fat is not unusual at all. The first couple of days you'll look great (due to the minimal immediate swelling--just enough to 'puff out' the wrinkles, yet not look 'swollen')...when that goes away, you'd be hardpressed to see any significant or lasting results. I really think this is an 'emporer's new clothes' procedure....some people are easily swayed. For example, when I had mine, and said that there was no difference...the aesthetician tried to tell my my 'eyebrows were lifted a couple of millimeters' and I 'looked fabulous'.....until I washed off my 'temporary lift' serum that I use...then she couldn't say anything at all. My opinion is that if you spend money on something, you want results, are hopeful, and are easily swayed.
User avatar
MissJ521@aol.com
 
Posts: 3029
Joined: Fri Jun 09, 2006 3:35 pm



Postby LookinUp » Thu Feb 01, 2007 5:01 pm

The theory behind radiofrequency waves in thermage is NOT to ablate the collagen, but to damage it in order to stimulate it to repair the damage and ultimtely create more collagen. Also in theory, by creating more collagen, the skin will plump up and stretch taut to accomodate the extra volume. It does not damage the surface skin at all. And it has been scientifically shown to cause fat loss.
LookinUp
 
Posts: 4425
Joined: Wed Jul 13, 2005 4:38 am

Postby MissJ521@aol.com » Thu Feb 01, 2007 5:16 pm

Ablation is how it's damaged, (the collagen layer). The theory is to damage/ablate, YES to make new collagen but the new collagen may not be more 'fluffy' or volumetric. It can be denser (not thicker but more compacted). I know i does not damage the surface of the skin.

Thermage can result in VOLUME DEFECT of the face. More likely from shrinking the collagen. However, the appearance is definitely that of fat loss and the correction is f/gs to the area to restore the volume loss.


LookinUp wrote:The theory behind radiofrequency waves in thermage is NOT to ablate the collagen, but to damage it in order to stimulate it to repair the damage and ultimtely create more collagen. Also in theory, by creating more collagen, the skin will plump up and stretch taut to accomodate the extra volume. It does not damage the surface skin at all. And it has been scientifically shown to cause fat loss.
User avatar
MissJ521@aol.com
 
Posts: 3029
Joined: Fri Jun 09, 2006 3:35 pm



Postby LookinUp » Fri Feb 02, 2007 6:37 am

Ablation, by definition is surgical removal. We use RF tissue ablation in our practice for tonsils, uvula, etc. (You can google somnoplasty for more info) Ablation means to remove, not simply to damage. You aren't trying to ablate the collagen (if you did, there would be nothing to repair). You are simply trying to cause damage to it (by 'poking into it' essentially)to stimulate reparations and hence create additional collagen to that which is needed for repair. Using RF surgically is in my field of expertise. I can tell you without a doubt it is not a muscular or tissue degeneration (the strength of the Thermage-type RF units is far below the power of the surgical unit we use)...but I agree, it is a volume defect, caused by fat loss...it is easily measureable and confirmable. The tissue remains the same, but the fat loss is highly apparent. Just curious...where are you getting your info?
LookinUp
 
Posts: 4425
Joined: Wed Jul 13, 2005 4:38 am

Postby MissJ521@aol.com » Fri Feb 02, 2007 9:16 am

Yes, I am familiar with the ablation process pertaining to removing layers from the SURFACE of something. With regard to what's under the skin (collagen layers), Jeffrey Dover MD ('Grand Wazoo' in cosmetic laser medicine--consultant for many of the laser companies), when describing the CO2 laser, in his papers and lectures, used the term "ablation", not only to the surface of the skin but to the underlayer and likened it to an egg white being 'cooked'. Subsequent damage (of both skin and under layer of skin) resulting in repair and collagen remodeling.

I know that in the field of 'materials', the word "ablation" is used just to remove the surface of something and in some ENT applications (like the one you cite), it refers to removing the surface of something as is true for removing just the surface of the cornea. However, Dover's use of the term, in the context of how he was describing the CO2 laser, both to his audience and in his paper, was that of a CONTROLLED DAMAGE, not only to the skin but the collagen layer underneath.

Semantics should not play too much here as we can agree to use the term or concept of "controlled damage". After all, we both agree that what is trying to be achieved by the Thermage is a type of "controlled damage" to the collagen layer with no damage to the skin. Basically what the device is attempting to do is affect controlled burning to the collagen layer underneath, a type of controlled 'cooking' as the basic mechanism is THERMAL DAMAGE.

CO2 also acts on thermal damage but to both skin and collagen layer. Radio frequency device selectively targets collagen layer for it's thermal damage.

The problem with the thermage is that they CAN'T CONTROL the thermal damage to the collagen layer as much as they would like to. A frequent problem with laser type devices is "collateral damage". Selective thermal damage is the goal of many laser type devices (radio frequency included). However, when you are heating something up to the temperature you need to damage it, if the HEAT does not DISSIPATE quickly enough from the area you wanted to thermally damage with it, it can thermally damage surrounding areas you don't want to damage. This is a phenomenon described as 'collateral damage '.

That would describe what the problem with thermage would most likely be: Collateral damage where the thermal damage to a 'selected' part can't be controlled enough to prevent it from thermally damaging non selected parts.

You asked about my 'info'. Well, for a lot of the cosmetic laser info, I've attended things by Jeff Dover and also read his papers. However, interest in lasers stems from actually having helped (but in small way) to build them over 25 years ago. One of my professors (Eziekial at MIT) was a pioneer in the laser design and research. So, most of my stuff is on 'academic' side, either in building the things or with having to know the scientific phenomena describing them.

The real scary thing about lasers and laser devices, in my opinion, is that the people they sell them to for use, for the most part know extremely little about the science or principles behind them and why they work. It's just something they turn on and off with some adjustments to levels of strength.

That's why getting laser device things is risky for patients. They can rely on their MD to have studied some important concepts relating to "medicine" or surgery but there are no such quality control levels in action in which a person using a laser device needs to know the principles behind them. Docs are sold lasers but don't really study laser theory. Then you get the doc letting some assistant use the laser and ENTER problems with laser devices in the patient population.




LookinUp wrote:Ablation, by definition is surgical removal. We use RF tissue ablation in our practice for tonsils, uvula, etc. (You can google somnoplasty for more info) Ablation means to remove, not simply to damage. You aren't trying to ablate the collagen (if you did, there would be nothing to repair). You are simply trying to cause damage to it (by 'poking into it' essentially)to stimulate reparations and hence create additional collagen to that which is needed for repair. Using RF surgically is in my field of expertise. I can tell you without a doubt it is not a muscular or tissue degeneration (the strength of the Thermage-type RF units is far below the power of the surgical unit we use)...but I agree, it is a volume defect, caused by fat loss...it is easily measureable and confirmable. The tissue remains the same, but the fat loss is highly apparent. Just curious...where are you getting your info?
User avatar
MissJ521@aol.com
 
Posts: 3029
Joined: Fri Jun 09, 2006 3:35 pm



Postby LookinUp » Fri Feb 02, 2007 10:31 am

Thermage is not a laser, nor a laser device. They work in totally different ways.. That would be like equating an x-ray with an ultrasound. They are apples and oranges--not apples and apples! And removing a layer of skin is definitely ablation, as you are destroying it as it is removed, not merely damaging it. Just because a physician employs a PR firm (as the doctor you cite does), and hits the media does not make him the 'grand wazoo' of anything. I'm not criticizing him, but I've seen fab physicians who do things quietly behind the scenes, and those that are 'out there'....on Oprah, supposed pioneers, blah blah blah.....one PS in Chicago comes to mind....talk about a media hound--from his TV appearances and ads, you'd think he was the father of aesthetics and antiaging-very charismatic....but then you find out he isn't even board certified, has numerous cases decided against him, and has been disciplined on many occassions...but the lay person would say he was 'the man'. I've spend many CME hours in lectures as well....and I agree there is damage to areas that aren't meant to be damaged, such as the fat layer! But again, it has been proven that it is fat that is 'melted'.
LookinUp
 
Posts: 4425
Joined: Wed Jul 13, 2005 4:38 am

Postby MissJ521@aol.com » Fri Feb 02, 2007 11:26 am

Yes, I know thermage is not a laser. Sometimes these things are referred to a 'laser like devices' with reference to lasers being recognized on a consumer market level. It's more of a term relating to how consumers perceive the devices (as like a laser somehow). They put them in the category of a 'laser like thing'. Hence the term. Although I admit it's far from accurate with reference to the type of waves and mechanism of action.

As to Dover, he has 2 aspects to him. On one hand he is somewhat of a pioneer in laser research in the cosmetic realm and has contributed a lot of information to that. On the other hand, yes, he does have publicists who get him 'out there' on a consumer level. The papers I refer to reading of his were not aimed at consumers but to people in the field. The type of info he shares with patients is watered down and very little like he shares on an academic level. For example, on an academic level, he has shared with his colleagues, that cryogen (freezing something off) is more effective for a large distinct brown spot than any laser. However, if a patient goes in there, drawn by the 'intrigue' of a laser, he will treat the brown spot with that and not share the same info with the patient that the cryogen is actually more effective for a large brown spot. This is just one example. There are other discrepancies. He is a good source of info on an academic level but not totally reliable on a 'consumer' level. For example (and this is just one of many), he suggested a C02 Ebrium combo for the wrinkles to my lower lids. When I asked him if I had a higher risk for scleral show from that, (because I had congenital scleral show to begin with) due to the tightening pulling my lid down a tad more, his answer was: "Well the gal last week who had scleral show chose to do it". That type of answer was enough for me to choose not to do it.

How do they demonstrate the damage is to the fat and not to the unwanted destruction of collagen like material which also would produce a volume loss to the face? Like how do they differentiate that? I mean, I agree it could be to the fat layer but boy, that's a lot of collateral damage.

I did have some citings from some docs who said it was fat layer but lost them in computer change when I wanted to fine tooth comb them for how they differentiated the fat layer from too much collagen destruction. I guess the histology of it is not that important given I have seen the deformities the device has kicked up in which volume loss is very apparent and needs to be corrected with f/gs.

I agree that it's actions include being useless and also detrimental. I'm just trying to differentiate how they determine where the unfavorable damage actually occurs.


LookinUp wrote:Thermage is not a laser, nor a laser device. They work in totally different ways.. That would be like equating an x-ray with an ultrasound. They are apples and oranges--not apples and apples! And removing a layer of skin is definitely ablation, as you are destroying it as it is removed, not merely damaging it. Just because a physician employs a PR firm (as the doctor you cite does), and hits the media does not make him the 'grand wazoo' of anything. I'm not criticizing him, but I've seen fab physicians who do things quietly behind the scenes, and those that are 'out there'....on Oprah, supposed pioneers, blah blah blah.....one PS in Chicago comes to mind....talk about a media hound--from his TV appearances and ads, you'd think he was the father of aesthetics and antiaging-very charismatic....but then you find out he isn't even board certified, has numerous cases decided against him, and has been disciplined on many occassions...but the lay person would say he was 'the man'. I've spend many CME hours in lectures as well....and I agree there is damage to areas that aren't meant to be damaged, such as the fat layer! But again, it has been proven that it is fat that is 'melted'.
User avatar
MissJ521@aol.com
 
Posts: 3029
Joined: Fri Jun 09, 2006 3:35 pm



Recently received Thermage

Postby dmae » Thu Feb 15, 2007 3:53 pm

I'd like to take a moment to post a response to all the posting about Thermage on this website.

First, I had Thermage myself recently and have had no issues or problems so far. I suffered mild redness (like a mild sunburn) and NO burning, and no dimpling. The technician was very knowledgeable about the procedure and because I had read all the horror stories on this website, I made a pre-appointment to discuss with him all the "possible" complications. I was satisfied with his explanation and his level of knowledge and I did make and keep my appointment for Thermage of my full face, neck AND eye area.

He did tell me that in the early days of Thermage, Physicians would use anesthetic creams to deaden the area and then crank up the machine for better results. He told me that they NO LONGER do this. Use of creams is NOT recommended. He also told me that alot of physicians still keep the machine turned up a little too much even though Thermage discourages this.

In Thermage, the technician constantly asks you about what you are feeling and if they need to adjust the level up or down. If your Thermage technician or physician burned you perhaps it was due to a lack of feedback or the use of anesthetic creams prior to the procedure.

During my procedure, the technician told me when he was getting close to a 'hot spot' (tender area near a nerve) and he would turn the machine down or adjust it to MY comfort level. On most of my face, I felt a heating sensation surrounded by the cold sensation and it got very warm but not burning warm during each of the 2 1/2 second blasts from the Thermage tool. In a couple of places on my face that were sensitive near the nerves at the corners of my mouth, I did feel a momentary SLIGHT discomfort at the end of the blast but NOTHING to compare to what everyone on this site is listing.

I am thrilled with the results so far. PERHAPS if you are considering Thermage you should make an appointment with the technician or physician doing the procedure and talk to them about the concerns and problems that have been listed on this website and if your not comfortable with the answers or knowledge of the person performing the Thermage, you should just find someone else.

If you stop and think about it, most of the people who post complaints to these types of sites are the ones who have had problems. Most of the ones who are satisfied never post.

This isn't 'voodoo' medicine. Your physician or technician just didn't know what they were doing, or didn't care.
dmae
 
Posts: 1
Joined: Thu Feb 15, 2007 3:16 pm



Thermage

Postby frewtloop » Thu Feb 15, 2007 7:55 pm

Thank you previous posters on this topic. Even with the disagreements, its obvious this procedure does not live up to its hype and worse, may be detrimental. I'm cancelling my appointment.
frewtloop
 
Posts: 37
Joined: Thu Feb 15, 2007 7:26 pm



Postby frank_mass » Sun Feb 25, 2007 1:02 pm

Hi I had it done, no results and a lot of pain

Frank
frank_mass
 
Posts: 99
Joined: Sun Feb 25, 2007 12:52 pm



Next

Return to Non-Surgical Cosmetic Procedures

 

Featured Specialists









Top Cleveland Plastic Surgeon
Look Young Again!
Experienced & Compassionate
www.DrBramKaufman.com

Miami Plastic Surgery
Board Certified Surgeons
Breast Augmentation $2800
coralgablescosmetic.com