Ask a Dermatologist: What is Thermage?

Thermage is a non-invasive radiofrequency therapy that applies heat to the deeper layers of your skin to stimulate collagen growth, which in turn helps smooth and tighten your skin for a more youthful and refreshed look

In this series, we explore cosmetic procedures that can help us look (and feel) refreshed as we prepare to emerge from pandemic life

This past year has been one of the toughest times in our lives. And while that toll is felt mentally, it also manifests physically. Many of us haven’t been eating or sleeping well, and our usual activities have been severely limited due to government restrictions. At this point, it seems like those frown and worry lines have become permanent fixtures on our faces (and every single flaw seems to be amplified on Zoom).

With vaccines rolling out, there is an end in sight. And we know that when we look good, we do feel better. So we caught up with cosmetic dermatologist, Dr. Marcie Ulmer from Vancouver’s Pacific Derm to discuss some popular anti-aging treatments and how to achieve the best results after this taxing year.

Whether you’re looking to improve fine lines, wrinkles or volume loss, there really is a solution to address every skin-care concern. If you’re worried about sagging skin, here’s everything you should know about Thermage.

BCL: What is Thermage and what are the benefits?

Dr. Ulmer: Thermage is a non-invasive radiofrequency therapy that applies heat to the deeper layers of your skin to stimulate collagen growth, which in turn helps smooth and tighten your skin for a more youthful and refreshed look.

BCL: When do you see results from Thermage?

Dr. Ulmer: Patients will see a difference immediately after their procedure, but the best part? Results continue to improve over the next six months as healthy new collagen grows.

BCL: How dramatic are the results from what you’ve observed and does everyone respond the same?

Dr. Ulmer: Thermage treatment results are truly individual and dependent upon each patient’s ability to produce new collagen. While many patients strengthen their existing collagen and dramatically produce new collagen in response to this radiofrequency therapy, we know that some patients may not make the same collagen in response to the same treatment. Everyone’s skin is as unique as they are. The benefit of skin tightening with Thermage results from collagen contraction and new collagen production.

Consultation, prior to treatment, allows us to fully evaluate what our patients are hoping to achieve. For example, a patient with extreme skin laxity would not be the best candidate for Thermage and may be better suited for a surgical approach and this is a critical discussion to have prior to embarking on treatment. Clear communication and exploring expectations prior to treatment is the key to us achieving best outcomes and a high degree of patient satisfaction. Thermage is often used in combination with other therapies. The results of one treatment complement the results of the other treatments, providing a balanced and natural aesthetic outcome. All of the treatments we perform work a bit differently (neuromodulators for wrinkles resulting from facial muscle movement, fillers for volume loss and Thermage for skin tightening) which is why they work so well concurrently.

Before and after Thermage. Photos have not been retouched. Individual results may vary.

BCL: What specific areas can be treated to improve what? And where do you typically see the best results?

Dr. Ulmer: Thermage skin tightening is used for the face (improves sagging, wrinkles, lines), neck (tightens the neck and defines the jawline), eyelids (reduces laxity, lifts the brows and provides a more open-eye appearance by reducing saggy upper eyelids). In the appropriately selected patient, Thermage also provides benefit in tightening and helping smooth crepey skin on the limbs and abdomen. In my experience, results are most impactful on the face and upper neck.

BCL: What does the procedure involve?

Dr. Ulmer: Plan to be at the clinic for approximately two to three hours. A clinician is with you for your entire appointment and starts by placing a grounding pad on your back. They then transfer a temporary grid onto your skin (don’t worry—it comes off!), which is used as a guide throughout the procedure. Then it’s time for the Thermage machine to work its magic.

The technician uses a hand-held device, which not only provides heat for collagen stimulation, but also a cooling sensation to help keep you as comfortable as possible. In some areas, the treatment feels like a warm vibration, whereas towards the chin and neck, you will experience more of a pinching sensation. If you’re treating the face and neck area, the machine passes over your skin multiple times on one side and then the other.

BCL: Is there any post-procedure care you recommend?

Dr. Ulmer: Any minor redness or puffiness you may experience will go away with a day and makeup can be applied immediately following the treatment. Proper skin care will help maintain results, including using a topical Vitamin C antioxidant (see below for our top picks). Click here for more information on Thermage pre- and post-care. 

BCL: What is the cost?

Dr. Ulmer: The cost is dependent upon the area that is being treated. If you are interested in skin tightening, a consultation with your cosmetic specialist will help to determine if this is the right treatment for you. A detailed quote will be provided after your physician assesses the area you are hoping to improve.

BCL: Is there any follow up to the treatment?

Dr. Ulmer: Patients typically come in annually or biannually for Thermage. Many of our patients come in for a six-month follow-up treatment (vectors) to target specific areas but everyone responds differently, so the length of time between treatments will vary. An annual Thermage treatment is part of many patient’s holistic skin maintenance program.

BCL: Who would you recommend this procedure to?

Dr. Ulmer: Because we start to observe the effects of collagen loss in our 30s and 40s, this is often when our patients begin incorporating Thermage into their treatment programs. Collagen is one of the foundational elements of the skin. Strengthening existing collagen and building new collagen is complementary to the other treatments we routinely perform at Pacific Derm. Patients come to see a cosmetic dermatologist, at various life stages, wondering how they can tighten the skin without surgical approaches. Thermage is one of our most commonly used non-invasive skin tightening treatment options whether you are 30 or 70 years of age. We use it as a tool on the face to maintain definition along the jawline and to help tighten the skin of the eyelids, cheeks and neck.Before and after Thermage. Photos have not been retouched. Individual results may vary.

BCL: Have you ever done this procedure yourself?

Dr. Ulmer: Thermage is part of my personalized self-care program and has been for several years. I am a proponent of conservative and natural results and Thermage is a treatment that reflects this approach. It incorporates so easily into my routine and I love that there is no downtime.

On the subject of aging, we know that this past year of life has been incredibly challenging. Now, more than ever, I feel truly grateful to be here, reflecting on a renewed appreciation for the gift of life. If there is one thing I am certain of, in this time of uncertainty, it’s that aging is truly a privilege. Each day I strive to give my patients new opportunities to feel positive and confident about themselves, and their aging process, by supporting their personal commitments to self-care and enhanced well-being. Being a part of their journey is a sincere pleasure. ?



A powerful antioxidant, vitamin C is an important ingredient to incorporate into your skin-care routine, especially if you want to maintain and enhance your cosmetic procedures. Here are three serums we love from SkinCeuticals…

SkinCeuticals Silymarin CF

The newest in SkinCeutical’s vitamin C collection, Silymarin CF is formulated for oily and blemish-prone skin. This product is clinically proven to improve texture, reduce signs of aging and neutralize free radicals. Apply in the morning after cleansing and toning to a dry face, neck and chest before other skin care products.
$166, Available at SkinCeuticals and dermatologists nationwide

SkinCeuticals C E Ferulic

CE Ferulic works hard to neutralize free radicals, help build collagen and provide antioxidant protection to give you a more youthful complexion. Apply in the morning immediately after cleansing and toning.
Price: $166, Available at SkinCeuticals and dermatologists nationwide

SkinCeuticals Phloretin CF

In addition to preventing photodamage, Phloretin CF corrects existing damage by stimulating the synthesis of essential proteins and fibres and accelerating cell turnover. Apply in the morning immediately after cleansing and toning for more youthful, firm and glowing skin.
Price: $166, Available at SkinCeuticals and dermatologists nationwide