Why Thermage Has No Effect

— When the shot count is under 600

The real reason it ends with just a temporary glow

Last Tuesday, in the consultation room,

a corporate employee in their late 50s came in.

"Doctor, I had Thermage done somewhere else last year,

and at first it looked a little brighter, but

it went back to how it was in less than a month.

Does that mean this procedure just doesn’t suit me?"

Looking at the chart, they had received 400 shots.

It wasn’t that it didn’t suit them; it just wasn’t enough.

Thermage is not all the same Thermage

Thermage is a lifting procedure that uses radiofrequency (RF) energy to

heat the deep layers of the dermis

and contract and regenerate collagen.

Unlike Ulthera, which shoots ultrasound in dots,

Thermage

lays down heat across a surface.

That’s why it helps with tone, firmness, and fine wrinkles too.

That part is something everyone already knows.

But even though it’s the same Thermage FLX, some people see results that last a year,

while for others it goes back to normal in just a month.

Why does that happen? Let me explain today.

If the shot count is under 600

why doesn’t it work?

For 70% of customers who feel

that Thermage doesn’t work, the cause is too few shots.

If the whole face gets fewer than 600 shots,

it often doesn’t pass the collagen contraction threshold,

so it ends with just 1 to 2 weeks of glow.

— Director Wi Young-jin (Hongdae Beautystone Clinic)

Thermage is similar to ironing clothes.

If you run the iron over once, the wrinkles won’t smooth out.

Only when enough time,

and enough heat

are applied to the same area do the fibers rearrange. Collagen is the same.

Collagen fibers in the dermis

begin to contract at around 65°C,

but a single heating pass only causes partial denaturation.

For this to lead to meaningful lifting,

a certain density or more of

heat stimulation must accumulate across the entire face.

If the whole face gets fewer than 600 shots, honestly,

it often ends with just a brief glow.

Just the other day, a 49-year-old client

came in saying, "I didn’t expect much

because it didn’t work last year."

Looking at the chart, it was again in the 400-shot range.

This time we proceeded with 900 shots.

At the 2-week follow-up, they were the first to say,

"Oh, wait—so this is what it was supposed to be?"

It’s the same Thermage, but just the difference in shot count

makes the results split like this.

So how many shots do I need?

When people hear Thermage 1200 shots,

they worry about the pain first.

But that doesn’t mean you just have to endure it.

We offer three pain-control options:

topical numbing cream, nerve block (injection anesthesia),

and light sedation for sleep.

However, when anesthesia gets deeper,

feedback during the procedure becomes dulled,

so the practitioner has to adjust the intensity more carefully.

Three things clients

ask about most often

Q1. When does the effect reach its peak?

For the first 1 to 2 weeks after the procedure,

you get a primary glow effect from the heat.

The real result is around 2 to 3 months later,

when the newly formed collagen settles in place.

Q2. Can I just do it once a year?

What about the cost?

If someone in their late 40s with progressing sagging gets

1200 shots,

doing it once every 9 to 12 months

gives better cumulative results.

Q3. What about side effects?

I heard it makes you lose facial fat—is that true?

Hollowing of the cheeks is sometimes seen when someone with a lean body type and little fat

gets treated at the maximum output

without exception.

That’s why it’s important for the practitioner to look at the distribution of fat in your face

and adjust the output.

If you take just one thing away today,

— when you feel Thermage didn’t work,

don’t suspect the procedure;

check the shot count you received first.

If it didn’t reach 600,

it wasn’t that the procedure didn’t suit you,

it just wasn’t delivered enough.

In the next post,

we’ll break down 'what output settings to use

if you want to prevent cheek hollowing after Thermage.'

This has been Wi Young-jin.

Read also

• "Thermage doesn’t work?" An honest lifting story from the consultation room - Hongdae Thermage

• Dark circle effects: why no treatment seemed to work

• "It didn’t work anywhere else..." Why people from Hongdae and Hapjeong especially come to our clinic

Frequently asked questions

Q. When does the effect reach its peak?

A. For 1 to 2 weeks immediately after the procedure, there is an initial gloss effect caused by heat.

Q. Can I get it once a year? How much does it cost?

A. If sagging has progressed in your late 40s, and you receive 1,200 shots, getting treatment once every 9 to 12 months produces a better cumulative effect.

Q. What about side effects? I heard it makes you lose weight—is that true?

A. Sunken cheeks are sometimes seen when someone with a slim build and little body fat receives it at "maximum output".

Q. I’m worried that I won't be able to handle the pain of a Thermage 1200-shot treatment. Are there anesthesia options available?

A. We offer three different pain control options to ensure your comfort: numbing cream, nerve blocks, and twilight sedation. However, deeper anesthesia can reduce your responsiveness, which requires us to be even more meticulous when adjusting the treatment intensity. If we have to lower the number of shots due to pain, it can be difficult to achieve the desired results.