Heat Wave

Today’s medical spa-goers often expect all gain and no pain when it comes to rejuvenating facial treatments. And they want immediate improvement to keep up appearances for social media and the widespread selfie. According to the latest statistics from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), selfies have increased the demand for plastic surgery by 33 percent since 2013. Because selfies are taken up close, they tend to exaggerate flaws and signs of aging, such as a sagging jawline, wrinkles, and uneven skintone. High-tech devices can help you address clients’ concerns and fix those imperfections without surgery. Radiofrequency (RF) is one appealing offering, and it has become a hot commodity. RF has proven that both the technology and results have staying power. Here’s what doctors and medical spa professionals have to say about RF and the treatments that help clients achieve a youthful-looking face. —Jennifer Nied


Thermage David Alessi, M.D., founder of the Alessi Institute and Face Forward Foundation (Beverly Hills, CA)

How it works: Combined with gentle vibrations and interspersed cooling for comfort, a specially designed treatment tip directs RF energy into the skin to heat the tissue and remodel collagen.

Ideal client: It’s beneficial for clients who have sagging but aren’t yet ready for surgery.

Conditions and concerns addressed: It addresses wrinkles and sagging skin.

Recommended course of treatment: Thermage is an intense RF device, so it only requires one treatment before producing results that can be seen instantly. A full face and eyes can take two-and-a-half hours.

What are the results?

This treatment encourages collagen and elastin remodeling that will tighten the skin. During a session, we do one half of the face first so the patient can compare it with the other side.  There is always a “wow.” The effect continues to improve during the next six months.

How long have you been using this facial technology?

We have been doing RF for five years and Thermage for one year. 

What innovations and changes have you noticed?

Thermage has undergone several improvements in the past several years.  When I looked at it eight years ago, I couldn’t tell the difference in  the pre- and post-treatment pictures.  Now it has different energy algorithms that allow more energy to go to the subcutaneous tissues for tightening with less heat and burning risk and pain on the skin.


Ellman International Pellevé System Yael Halaas, M.D., FACS, facial plastic surgeon and member of AAFPRS

How it works: A facial handpiece delivers sustained RF energy deep into the skin causing heat to build up where the skin and fat layer meet. That heat modifies the collagen within the skin and stimulates new collagen growth over time.

Ideal client: It is ideal for younger patients in their 40s who want to maximize the noninvasive treatments they can do to improve the texture of their skin. It is a good adjunct treatment for clients who already do Botox, fillers, and peels.

Conditions and concerns addressed: It treats subtle skintone imperfections and fine lines.

Recommended course of treatment: I suggest a series of five sessions, with each treatment three weeks apart. It allows the collagen stimulation to develop maximally before treating the skin again to help further that process along.

What are the results?

Immediately after the service, skin looks smoother and more even, and you can see a little bit of a brow lift. The pores might look a bit tighter, as well, which is hard to achieve with other devices.

How long have you been using this facial technology?

I started using Pellevé two years ago, and it was the first RF device in my practice. It introduced the idea of gently heating the skin so that you can safely bring the skin to the goal temperature of 107 degrees to get the heat and collagen stimulation and production.

What innovations and changes have you noticed?

The technology continues to improve. The RF power increases while the delivery gets safer.


InMode Forma (Invasix Fractora Firm) Mark Meyers, M.D., owner of New Leaf  Dermatology (Scottsdale, AZ)

How it works: RF current flows between the bipolar electrodes with built-in temperature controls to achieve optimal heating and comfort.

Ideal client: The ideal patient is one who is beginning to show signs of skin laxity, jowling, and loose neck and chest skin. It is not for people who have advanced facial aging with large jowls and a neck wattle.

Conditions and concerns addressed: It addresses laxity, fine textural issues such as fine lines and wrinkles, and a dull appearance. It’s best to start the treatments as soon as one notices the signs of aging, and with maintenance, more invasive procedures and surgery can be delayed for some time.

Recommended course of treatment:  The face and neck take about 45 minutes for one session. To start, I recommend six treatments once a week, and for maintenance, I  recommend one treatment four times a year.

What are  the results?

Skin tightening can be seen immediately after the procedure. Over time with more treatments, the skin looks smoother, fine lines and wrinkles are diminished, and the forehead is tightened with lifting of the brows and cheeks. The neck may also be tightened. The skin surface takes on a more radiant appearance.

How long have you been using this  facial technology?

We have been using RF devices for three  years and InMode Forma for two years.

What innovations and changes have  you noticed?

The devices have become more automatic. The temperature of the skin is maintained at a constant therapeutic level by sensors on the handpiece, which eliminates the need to stop and start to avoid too much heat. This makes the treatment more effective and decreases  the treatment time.


EndyMed Pro Neil Sadick, M.D., clinical professor of dermatology for Weill Cornell Medical  College and owner of Sadick Dermatology (New York City)

How it works: This multifunctional device can be used with interchangeable handpieces that transfer optimized 3Deep RF for treating specific areas. The 3Deep technology, a multipolar RF, ensures controlled delivery of heat into the skin while minimizing the energy flow and heat on the skin’s surface.

Ideal client: RF facials are safe for all skin types. Most of our patients start these treatments in their early 30s to address lax skin, scars, or wrinkles.

Conditions and concerns addressed: The range of conditions that can be addressed are facial and neck tightening and acne scar and wrinkle reduction.   

Recommended course of treatment: I recommend a series of six to eight treatments performed two to three weeks apart for a reduction in wrinkles, smoother skin, and some tightening of the face and neck as  collagen regeneration takes place. Each treatment lasts from 30 minutes to one hour.

What are the results?

Patients will notice some transient erythema and mild edema that lasts about 24 to 48 hours. This immediate reaction adds a nice supple fullness to the face that patients really like.

How long have you been using this  facial technology?

We have been incorporating RF into facials for six years and using this device since November 2010.

What innovations and changes have you noticed in that time?

The technology has advanced dramatically, and EndyMed now incorporates a microneedling applicator called the Intensif, which is a non-ablative fractional skin remodeling treatment that treats acne scars, fine lines, elasticity, tone, and texture more effectively than before. The handpieces are also more user friendly, which in turn results in a better treatment for our patients.

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