Skin tightening for 40-45 and under


What is your recommended treatment for skin tightening for a 40 year old? I read that Thermage and the like cause loss of fat which causes a hollow look. What is your view?

It’s amazing isn’t it how much our brains respond to 1 person’s report, even when we know that we can’t tell much from that. We all do it.  It’s human to do it.

In thousands of cases that we’ve done over the years, we have not seen a single case of fat loss with Thermage.  And I’ve not seen any studies where this was reported, with the correct settings. I did hear of one case in Portland years ago, by a certain doctor who was known for turning the energy up past the recommended on all his devices.  If the parameters are respected on the device, it doesn’t cause fat loss.

Most 40-45 and under will get a good result with Thermage, Ultherapy, or Exilis all if done correctly.  Some skin tightening, no downtime and good collagen building.  Over 40-45 you’ll still get good collagen, jawline maintenance, and no downtime. But, you’ll usually not see as much tightening.  A deeper RF procedure like Profound would be better.

How to keep yourself safe:

  1. Ask who is doing the treatment?  Ideally the person doing the treatment has medical training! Are they a doctor, a midlevel like an ARNP or PA-C, or RN?  Medical training helps with judgment, correct assessment of the skin type, and how to avoid problems.
  2. Ask them to stay well within safe zones when they are treating.  I know this might feel awkward at first. But when you arrive and being set up, think about saying something like this.  “I know you’re very experienced with this, but I’d like to make sure we stay within the safe and recommended settings for this device.”  And then make sure the answer reassures you.
  3. Do they have experience?  At your consult, ask “How many of these treatments do you do in a week?” “How long have you worked here?”
  4. You can leave. Fortunately, you’re not under anesthesia and can leave if something isn’t going well.  Bait and switch?  Suddenly a different provider? Asking for more money or too discounted?  Might be a good time to reassess and not go ahead with the treatment.

Hope this helps,

Dr. Brandith


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