The Aesthetic Guide is part of the Informa Markets Division of Informa PLC

This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC's registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.

RF-based system addresses skin concerns pre- and post-procedure

Article-RF-based system addresses skin concerns pre- and post-procedure


Providers and patients alike continue to reap the benefits of utilizing radiofrequency (RF)-based energy for non-surgical, no-downtime body shaping and skin rejuvenation procedures. As a versatile example of this trend, the Thermi250® device from Thermi, an Almirall Company (Dallas, Texas) employs temperature-controlled RF that delivers a tailored treatment for non-invasive, non-ablative body rejuvenation for people of all skin types.

With both monopolar and bipolar capabilities, the Thermi250 platform can be used to improve fine lines, wrinkles and crêpey skin laxity of the eyelids; upper and lower lips; and front of the neck; as well as address the appearance of cellulite. The ThermiSmooth procedure can also serve as an adjunctive therapy performed prior to or after another treatment, to address lax skin and other skin-related concerns.

“Some fat reduction treatments using other devices can be painful, so I prefer using the Thermi250 for the ThermiSmooth body procedures,” expressed Paul S. Nassif, M.D., a facial plastic and reconstructive surgeon in Beverly Hills, Calif. “I’ll use it after a fat reduction procedure, but overall I like using it before, just to stimulate the collagen. It offers a comfortable procedure where you don’t have to use anesthesia.”

As reported by Dr. Nassif, heating tissues directly via RF after a fat loss treatment causes a contraction resulting in tighter skin. 

“Studies have shown immediate heating facilitates collagen denaturation with resulting fibril contraction and tissue thickening,” Dr. Nassif explained. “An inflammatory wound healing response ensues with long-term neocollagenesis and further tissue contraction. Selective heating and tightening of fibrous septae within the subcutaneous layer likely accounts for immediate contour changes in the skin after treatment.”

ThermiSmooth post-procedure treatments can be combined with other fat reduction modalities, such as cryolipolysis. “Any time you actually do a fat reduction treatment there is a fear you’ll have a little loose skin,” Dr. Nassif shared. “Wait a few weeks before you do ThermiSmooth. It does seem to result in a better outcome.”

In preparing patients for fat reduction, followed by a ThermiSmooth procedure, Dr. Nassif recommends beginning the regimen with tight, taught skin. “I suggest a preparatory application of ThermiSmooth to create a tight tissue foundation. Following the fat loss procedure, do a final ThermiSmooth skin tightening treatment to ensure that the result will be smooth, tight and with reduced fat,” he said.

ThermiSmooth also works on different body areas, according to Jason D. Bloom, M.D., a facial plastic and reconstructive surgeon in Ardmore, Pa. “For instance, a ThermiSmooth procedure around the eyes. The device is about the size of a marking pen and literally lets you get in close to the eye.”

You can really see a change in the wrinkles especially in the periorbital region, Dr. Bloom added. “It tightens up that area. In some patients I’ll do the whole face and the neck, too. Usually, I will sell them a series of three treatments, around six to eight months apart. If you consider collagen generation, it is about six weeks before you see collagen production. I do two to three treatments and then after two months I’ll take pictures and see a difference.”

Dr. Bloom utilizes the ThermiTight for fat reduction, which is powered by the ThermiRF platform. “I’ll use ThermiTight on the jowls and neck, which is going to give you the best skin tightening in those areas. Years later, I ask them to come back in for a series of ThermiSmooth sessions, which allows them to maintain their results.”

The nice thing is patients like the feel of it, added Dr. Bloom. “The ThermiSmooth procedure feels like a hot stone  massage. Also, it is safe so the treatments can be delegated, meaning it is not something that the physician necessarily has to do.”

Patient selection is always up to the physician’s discretion, noted Dr. Nassif. “We recommend treating areas with good skin quality or turgor, and texture, without excessive weight fluctuation or excessive photodamage, and in patient populations capable of collagen regeneration.”

As reported by Dr. Bloom, “The idea of percutaneous RF has been hugely popular in my practice among the patients that I call the ‘tweeners.’ This would be the mid-40s to early-50s patient that is not ready for a surgical face- or neck-lift procedure. RF and even topical or transcutaneous RF, where you’re actually massaging the skin, has always been the gold standard for tightening without surgery.”

ThermiSmooth is a go-to therapy for Millennials, as well, Dr. Bloom continued, “Because they don’t have as much skin laxity as someone who is older. I will treat Millennial necks with ThermiTight. It is perfect for them. First I’ll do a little microliposuction and then tighten the skin.”

Patient satisfaction is very high, stated Dr. Nassif. “Our customers are happy. Remember what is important about this is expectations. We have to make sure the patient knows that this is not a face-lift, and that this procedure will achieve a nice tightening with minimal discomfort. However, you do have to wait for that collagen contraction to see the full effects.”

In Dr. Bloom’s experience, the lack of downtime is another big selling point with ThermiSmooth. “People can go back to work immediately,” he said. “Many of them say it is relaxing, that it feels warm and they like it. And it actually produces real results. You can see tightening after as few as one or two treatments.”

Return on investment (ROI) is high because there are no disposable costs, Dr. Bloom pointed out. “The Thermi250 system is one of the best pieces of equipment I’ve ever bought. There’s a low overhead and no disposable. With a lot of devices, you pay for the tip or some disposable, but with Thermi250 you clean the handpiece and you’re ready to go to the next patient. In addition, patients also save on the cost of procedures.”