Apr 5

We are often asked what is the difference between the various "non surgical" and "minimally invasive/ lunch time/ threadlifts/ lifestyle" facelifts?

In order to explain all the differences we need to first differentiate between those procedures which are “non surgical” and the others which are “minimally invasive.” The “non surgical” options include Botox, Thermage, and the various lasers. For the purposes of this blog we will avoid lasers which are can serve as facial rejuvenation tools but are not really intended to give the effects of a facelift. (We will of course blog on all the various lasers in the near future.)  The minimally invasive options will be discussed over the rest of the week.

“Non surgical” facelift options are intended for those patients who wish to improve the appearance of their facial features without undergoing any downtime whatsoever. Some of these non surgical options are more invasive than others, each have there own risks and benefits, and all require different fees.

Perhaps the most popular “non surgical” facelift procedure is Botox. More than two million people underwent a Botox “non surgical” facelift procedure in 2003 alone. Botox can be used on all skin types and colors, has really no downtime, and has minimal associated pain and complications. However, in point of fact, while Botox works great at doing its job when used by appropriately trained physicians, it really has very little correlation with a true facelift. The results are far less dramatic than a surgical facelift and generally last three to four months. (Please link to our Botox page to read much more about the appropriate uses for Botox)

Perhaps the next step in “non surgical facelift” is Thermage.

Thermage

Thermage is a patented radiofrequency device that uses deep heating to tighten skin and renew facial contours. In conjunction with deep heating, the Thermage device also cools the skin. This combination of deep heating and contact cooling in theory protects the outer skin while breaking down the underlying collagen. The theory is that as the collagen rebuilds the skin tightens and renews facial contours. Unlike lasers, Thermage works on all skin types and colors, is touted as requiring only one treatment, and has no downtime.

For those of you who have heard of Thermage, it has undergone a number of changes since first being touted by Oprah in 2003in a segment entitled, THE AGE DEFYING WOMAN: HOW TO STOP THE CLOCK ON AGING. At that time millions of Oprah Winfrey fans came face-to-face with the Thermage procedure.

http://www.thermage.com/vids/page45_Stretching.html
In fact, Oprah was key to introducing Thermage to the general population. After this non-surgical “facelift” was touted on her show, sales of the machine and treatments skyrocketed. Unfortunately, in the years since that initial segment was aired, there have been numerous reports of patients who have had what appears to be significant damage from the Thermage treatments, especially when the machine was used at its higher settings. Patients have exhibited a progressive gauntness of the face, in addition to dents and stripe-like linear depressions. Some have speculated that the fat underneath the skin can become affected and even cause scar tissue to develop. Not many people know about the possible risks of this popular treatment, and it is operated by many people who are not board-certified plastic surgeons or dermatologists. Moreover, and perhaps just as importantly, the benefits of Thermage are often difficult to see.

On the positive end, Thermage has undergone a number of changes in the way it is performed. Using the original treatment algorithm, 45% found the procedure too painful, and 68% of patients found the treatment results met their expectations. With the newest algorithm and with better explanations of what you can truly expect with these treatments, only 5% found the procedure too painful, while 94% found the treatment results met their expectations. How long these treatment results last is still not clearly understood with at least one study showing that the demonstrated improvements diminished with time.

At PROFILES, our conclusion is that Thermage currently should not be intended to replace the more dramatic effects of surgical techniques. Results are always subtle and are not remotely as dramatic or reliably produced as those obtained from surgery. The skin contraction achieved is in the order of 3 mm at best in the face. Radiofrequency can impart mild tightening in patients with minimal facial laxity. In addition, it may help acne scars and acne. With further refinement of the technology and treatment algorithms, Thermage may represent a tool of growing importance to the future of facial rejuvenation procedures. There is, however, a need for more studies.

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