Post from: Laser Clinic MD

Featherlift + Threadlift

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Thermage is FDA approved for tightening and thickening skin without surgery. This non-invasive choice is particularly attractive for patients who don’t want to undergo the more drastic effects of a traditional surgical facelift and its associated recovery period.

Thermage uses a radiofrequency (RF) technology to heat the deep layers of the skin while protecting the skin’s outer layers with a cooling cryogen spray. This deep heating promotes immediate collagen contraction beneath the skins surface and generates new collagen growth over time.

Thermage: Key Points

• Thermage is approved by the FDA for skin tightening and collagen growth.
• Thermage provides an alternative to traditional surgical face lifts.
• Thermage not only treats existing conditions, but is also a preventative treatment for future problems including wrinkles, loose skin and collagen loss.
• Thermage can treat any area of the body but is most commonly used on the face, around the eyes and forehead, cheeks and jowls, and the neck. Results actually increase over time. With maximum results usually achieved up to 6 months after the treatment.
• Thermage “Vectoring” can be used for more specific results. Vectoring uses a second, double row of pulses to tighten skin along specific lines or “vectors”. In this way we can perform eyelifts, neck lifts, bags around the eyes, crows feet, or any part of the face where loose skin is unwanted.

Thermage: Key Benefits

• Thermage tightens skin and stimulates new collagen growth.
• Thermage can be performed in 2-3 hours under local anesthetic.
• Thermage actually “tightens” skin rather than stretching skin.
• The results look completely natural
• The cost is less than traditional, surgical facelifts
• The results are very long lasting or permanent.
• Additional treatments can maximize the effects or just maintain results.

Thermage: Benefits in comparison to traditional surgical face lifts

• No cutting. No stretching. No stitches. No scars.
• Thermage requires no physical recovery time.
• The skin is tightened rather than stretched, eliminating the pulled look that can happen with traditional face lifts.
• The chance of complications or infection is almost nil.
• Thermage can be combined with other treatments like filler injections and Pointé Lifts for more dramatic effects.

Possible Complications with Thermage Treatments:

Thermage complications are very rare. The device contains three computers that constantly monitor the amount of energy being delivered. However, as with any medical treatment there exists the possibility of other results, including:

• Burns; in clinical trials for Thermage less than 1% of patients received any burns. (There were only two that healed completely and without complication). At Surface, we have never seen a burn.
• The effect is less dramatic than the client wants: However, Thermage can be used as a treatment more than once. Results can be improved or enhanced with additional treatments like Botox or Surface Pointé Lifts.

NOTE: Thermage has received mixed reviews from both patients and physicians. In our opinion this is because of the way that Thermage has been marketed to physicians as an “add-on” to their practice. Thermage results are highly dependant upon the treatment you receive. While Thermage is now widely available, our recommendation is that you only have a Thermage treatment from a physician who specializes in non-surgical cosmetic medicine and has a laser clinic, skin clinic, or laser treatment center with experience with this treatment.

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Post from: Laser Clinic MD

Thermage Skin Tighening

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Although this chapter from the Advanced Medical Aesthetics Training Manual wasn’t actually requested in the training manual I wrote for the academy students, I felt it was extremely important for the entire medical spa staff, especially for medical estheticians, to know the difference amongst the various treatments used to alleviate the appearance of wrinkles and folds, and the difference between dynamic and static lines.

Medical estheticians have the most “face time” with clients, examining it with magnifying lenses, treating it with exfolliants, moisturizers, galvanic current, high frequency, various acids, etc. They understand the realm of fine lines and wrinkles and know what can be alleviated with topical treatments such as facials, peels, microdermabrasion and laser resurfacing, and what cannot.

I cannot tell you how many patients call or come into our office with no knowledge of the difference between paralyzing agents such as Botox and Dysport, and dermal fillers. We take it for granted that we know the difference, but injectable products can be very confusing to the lay person. Because the aesthetician works with the client’s skin, they should be well versed in the differences in the two categories of injectables and the products that lie within. Estheticians become your most powerful education source for your clients which ultimately leads to an upsell for them (with possible commission).

Many people think all fillers products are the same, nor do they care to understand the difference between hyaluronic acid or calcium hydroxylapetite. All they truly care about is “how long will it last” and will the “results look fake”. Only with proper education can the medical esthetician effectively and intelligently discuss the differences in the filler products, educate the patient about the effects and lasting results, and help lead the patient to the right product, or combination of products, for their expected outcome.

This information in this chapter is very important for your medical spa front desk/phone people as well!

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Post from: Laser Clinic MD

Medical Esthetician Training from Medical Spa MD

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Non Surgical Facelift is the nomenclature that many medical technology companies, skin clinics, plastic surgeons and med spas are using to market laser and radio based skin tightening treatments like Thermage, Fraxel, ActiveFX, DeepFX, and CO2 laser resurfacing. So, what’s the difference?

The non surgical facelift has been the holy grail of cosmetic medical technology. Themage, DeepFX, ActiveFX, Fraxel, laser skin tightening… all have some promise and effects but a surgical face lift will always be the most dramatic. (Of course surgical facelifts have more potential downside; scarring and that overly ’stretched’ look among them.)

Non surgical facelift technologies have come a long way and there is a tremendous amount of research being conducted that goes beyond the current base of Fraxel and Thermage and into bioengineering and potentially even nano-technology that reverses the aging process on a cellular level.

Thermage: Radiofrequency energy is directed just below the surface of the skin into the collagen with no surgery, injections, or incisions. The process heats and contracts the existing collagen and thereby stimulates the production of new collagen.

Fraxel: Fraxel treatments use thousands of tiny beams of light to establish microscopic treatment zones that treat only a predetermined percentage of skin while leaving normal surrounding skin to help with the healing process. This “fractional” treatment allows the skin to heal much faster than if the entire surface of the skin were treated at once. Using microscopic treatment zones also allows certain Fraxel® Lasers to penetrate more deeply into the dermis than traditional lasers. This deeper penetration helps to stimulate collagen production helping to make the skin appear more youthful and counteract the effects of aging. Generally, 3 – 5 treatments spaced 2 – 4 weeks apart are recommended.

DeepFX: Fractional DeepFX laser treatments involve treating only a fraction of the skinʼs surface, leaving bridges of untouched skin to aid in the regeneration process. (similar to Fraxel) Each laser pulse removes a narrow column of tissue while simultaneously treating surrounding skin. This deep heating causes immediate collagen remodeling. The result is softening and smoothing of wrinkles and scars, and improved skin texture.

ActiveFX: Active FX laser treatments cover about 80% of the skin’s surface. (Fraxel treats only about 20% of the skin’s surface at a time.) The 80% coverage by Active FX seems to provide a good balance of desired results with amount of down-time. (ActiveFX and DeepFX are cosmetic lasers that are offered by the same company.)

Thermage, ActiveFX, DeepFX, and Fraxel Laser skin resurfacing results are both immediate and progressive. If you respond well, you will see some improvement within days of the procedure as your skin begins to heal. Good skin care can extend the benefits of  your Themage or Fraxel non surgical facelift.

CO2 Laser Resurfacing: CO2 lasers are generally older and only recommended in the hands of the most specialized plastic surgeon or cosmetic dermatologist that ’specializes’ in these treatments. CO2 laser resurfacing burns away the entire top layers of the dermis and has significant disadvantages compared to Thermage, Fraxel, ActiveFX and DeepFX.

Medical Spa MD has more information about Thermage vs Fraxel as well as ActiveFX, DeepFX & CO2 laser resurfacing.

Post from: Laser Clinic MD

Non Surgical Facelift: Thermage, Fraxel, DeepFX & CO2 Laser Resurfacing

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Skin Tightening: Thermage & Laser Treatments

Skin tightening treatments are usually performed in a med spa or laser clinic by an aesthetician under the direct supervision of a physician skin tightening treatments don’t require much down time for the patient. While devices used for skin tightening do vary in their modality; the procedures do not require topical anesthetics. These procedures are typically performed in monthly intervals and results can be seen gradually over several months. Because of the gradual improvement, it is important to obtain before photos of the intended treatment area(s) before the procedure, with subsequent photos taken immediately prior to performing each consecutive treatment. A final results photo should be taken one month after the last treatment. This photo journal can show the patient their improvement.

Nonsurgical Skin Tightening Devices

The source of energy used to produce thermal damage can be either radio waves, infrared light, lower wavelength laser or any combination of the three. The intention is to stimulate increased collagen production.

Light wavelengths, specifically in the infrared spectrum, are successfully used to promote tightening of the skin by heating the dermis. This in turn initiates the body’s natural healing response. This type of treatment is called “selective thermal damage”. When the dermis becomes “damaged”, the body will begin to heal itself by encouraging additional collagen production and the rebuilding of the collagen that already exists in the tissue. As the layer of collagen builds upon itself, the underlying tissues of the skin contract, resulting in a tighter appearance to the skin. Most infrared devices deliver their light source in a single grid. This results in a large area of controlled thermal damage. The Palomar LuxDeepIR Fractional is one device on the market that delivers light in an array of columns into the target area of tissue and leaves the surrounding areas untouched. The company says that this type of technology reduces patients’ pain and also promotes quicker healing time as the new developing areas of collagen can attach to and build upon the untouched areas. When using the radio frequency devices, there also is a variance from one source of energy to bipolar devices constituting two wavelengths.

Why is collagen important to Laser Skin Tightening?

Collagen is an important protein and structural component of skin. Large amounts of collagen are contained in the dermis. Collagen fibers build a strong mesh responsible for maintaining the texture, strength and resilience of skin. As we get older, our collagen fibers start to break down and the epidermal layer thins. The results are visible sagging, wrinkles and folds. Even though fibroblasts can produce more collagen fibers, the human body’s ability to do so decreases as we age.

Skin Tightening Results

Although not comparable to plastic surgery, on average, the most dramatic results of laser skin tightening treatments are seen in the neck and jaw line where the dermal layer is thinner. However, results are not seen until months after one treatment or more. Results are also varied depending on differences in skin texture and thickness and a patient’s lifestyle (alcohol, smoking, sleep patterns). Each device states different claims of how painful the procedure is, so some patients may choose to use a topical anesthetic or an analgesic to decrease pain. Side effects may include edema, erythema, or skin blanching immediately following treatment. Rarer side effects of laser skin tightening may include blistering, skin depressions and even slight pigment changes. Post treatment skin care can greatly affect the recovery time from skin tightening.

Post from: Laser Clinic MD

Skin Tightening

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Plastic Surgery & Cosmetic Dermatology: Used Thermage Tips.

Thermage Skin Tightening treatments from Solta Medical have ushered in a new type of anti-aging and skin laxity treatments for cosmetic dermatologists, plastic surgeons and medical spas that adds another nonsurgical treatment to a cosmetic medical practice Radio Frequency Skin Tightening.

Thermage has implemented a change in cosmetic medicine.

Pricing strategies that charge the plastic surgeon or cosmetic dermatologist for each Thermage treatment by ‘killing’ the Thermage tip after a preset number of treatment pulses or predetermined length of time, even if the Thermage tip could still be used for additional pulses. This leaves the plastic surgeon or cosmetic dermatologist (and patient) in the position of paying for a Thermage treatment tip that would still work, except that they’ve been turned off by Thermage.

With tips costing up to $800 for a single treatment and medical practices under increasing pressure to maintain profitability, many doctors are turning to third parties to ‘reactivate’ these Thermage tips for additional use by bypassing the counter inside the chip and effectively resetting the device to allow for continued use.

According to Thermage, tips are disabled only to ensure patient safety.

The Thermage position on reactivating  used Thermage tips:

“The largest study we know of involving Thermage is a four year study conducted by Weiss,1 and it only involved 600 patients. In addition, the claims in the Stevens publication are also wildly inconsistent with immense quantities of Thermage quality and reliability data we have compiled on our own products over the years. We know for a fact the dielectric membrane on our treatment tip will break down when subjected to a tiny fraction of the repeated use this publication alleges can be done. Dielectric breakdown can result in patient harm.”

Potential complications can arise from treating patients with damaged Thermage tips that can include burns or the destruction of underlying fat that can leave permanent depressions in the skin. But, with more and more cosmetic dermatologists and plastic surgeons looking to squeeze out a profit wherever they can and grey-market suppliers able to sell a reactivated Thermage tip for hundreds of dollars below the retail price, refurbishing or reusing Thermage tips may be used in an increasing number of cosmetic practices and medical spas.

Post from: Laser Clinic MD

Is Your Local Laser Clinic Reusing Thermage Tips?

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