Review: Skin Tightening Without Surgery Thermage FLX- Five Months After

I had my first Thermage treatment for a loose neckline in 2009, as I was a long way away from any surgery.  Ouch!  The treatment was not only very painful, I saw no results.

So when Dr. Vic Narurkar , San Francisco dermatologist and Laser King asked if I’d like to try the new Thermage treatment for training purposes, I said yes.  For years, Thermage has been called “the gold standard” for skin tightening.

Thermage FLX  delivers radio-frequency energy deep below the surface of the skin were the collagen is produced. The energy heats and smooths out the existing  collagen and creates  new collagen. It also heats up the skin faster. FLX  is the newest version and a big game changer as it produces more predictable results.  The tips are 33% larger so larger treatment surface areas can be treated, allowing for faster treatment times.  A face and neck can be done under 60 minutes, making all the treatment areas more comfortable.  You will see immediate off the table results but optimal results are generally at the 3 to 6 month mark . Retreatment is done every 1 to 3 years.

I’m always a little skeptical about skin tightening devices. Patient selection is key, as not everyone will benefit.  Since my last Thermage in 2009, I’ve had a face and neck lift. However, my neck was never tight enough, so I was willing to give this a try.

I expected to get numbing cream before the treatment, even though I knew it could not hurt as much as the first time.  I was told that I did not need  numbing cream and that it would not hurt. My anxiety level went up 100%. However, I put my faith into Dr. Narurkar’s  skilled hands and trusted him.   Once we started the treatment, I was incredibly surprised to feel almost nothing.  I was dozing off. Amazing!

Dr. Narurkar used a setting of 2.5 to 3.5 on my face and 1.5 to 2 on submentum and 0.5 to 1 on my neck.  900 count tip.  About 4 to 6 passes per anatomic area.



Right after my treatment, my face had a nice glow and I could see it looked tighter.

It’s been five months since my treatments. I see a little lifting around my jaw line. My brows do look elevated. It’s hard to tell if there is any improvement in my neck, but I was not expecting much.

In conclusion, Thermage FLX is extremely comfortable. As results improve over time, you have to be patient. It’s not a quick fix.  Results take 3-6 months. The treatment is a great adjunct after a facelift. If I had a Thermage treatment soon after my facelift, my  facelift may have lasted longer than it did.  As I said, patient selection is important and you have to manage your expectations.   Combining Thermage FLX  with Botox and Fillers helps in maintaining a youthful appearance.   Keep in mind, if  you really need a facelift and have lots of loose, sagging skin you may not be happy with the results. Results are different with each person.  Before you decide, please seek the advise of a Board Certified Dermatologist or Plastic Surgeon who has a lot of experience in treating patients of all age groups with Thermage.







What To Know Before You Get Fillers This Holiday Season

You’ve heard about new facial fillers such as Juvederm Volbella® or Restylane Refyne®. Your doctor or nurse injector has many fillers in their tool box. How do they know which ones to use?  What fillers are the longest lasting  and what  should you know about each facial filler. When you’re planning on getting fillers for your lips, smile lines, temples or cheek area its important to be well informed. 

The most common fillers are Hyaluronic acid HA is a natural substance found in your body. These fillers are easily dissolved with Hyaluronidase if you are overfilled, have complications or don’t like the way it looks. However, it’s important your injector knows how to use this product, as too much can dissolve your natural tissue, this is not permanent.

I’ve tried all the Hyaluronic acid  fillers on the market today. I’ve been injected by the most skilled plastic surgeons, dermatologists and nurse injectors.  I still experience swelling, bruising and have had fillers dissolved.  Recently, I tried newer fillers like  Juvederm Vollure ®,  Juvederm Volbella® as well as Restylane Refyne® and Restylane Defyne®. My body breaks down fillers rapidly, therefore some fillers have a shorter duration.  Due to different technologies and your body’s chemistry some fillers  may cause more swelling and bruising than other fillers. Expect swelling and bruising especially with lip and under the eye fillers.


Keeping Your Smile Young: The Effects of Aging

When people talk about physical aging, the main topics of discussion tend to be specific issues like wrinkling or graying hair. These tend to be the most noticeable effects of aging, are very specifically linked to growing older. However, they are not the only physical changes to look out for. In fact, one of the most commonly overlooked but very prevalent physical effects of aging is that many people find their smiles beginning to look “old.” This can be due partially to changing facial structure, but in most cases it is due to declining oral health, which can cause your teeth and gums to look like they are poorly cared for, and ultimately make your smile old and unattractive. Here are a few specific issues to keep an eye out for.

•           Stained Teeth – Over the years, even people who take consistently good care of their teeth often find that the surfaces of their teeth become stained anyway. This can be due to a number of different factors, from smoking, to coffee consumption, to many others. Fortunately, there are several ways to address this sort of problem and keep your teeth looking bright, healthy, and therefore young. You have numerous options with store-bought products or dental procedures, and most are very effective at whitening your teeth.

•           Receding Gums – A very common byproduct of the aging process, receding gums can be hard to notice at first, but if they become more severe they can give your smile an unhealthy, unkempt appearance that can age your smile and face significantly. This is a harder issue to treat on your own, but if you visit a site like

you can find a dentist in your area and consult about cosmetic dental procedures designed to restore your gums. It’s a bit more involved, but the results will contribute to making you look young and healthy.

•           Lost Teeth – Occasionally, people lose teeth as they begin to age, though if you brush and floss regularly throughout your life there will be far less risk of a problem like this. Still, having a tooth or two that needs to be removed due to decay is not uncommon, which is why it is a good idea to be aware of dental implant procedures. These days, there are numerous different ways for fully functional and realistic looking dental implants to be put in, and in most cases they blend in seamlessly with your mouth, helping you to avoid glaring gaps or silver teeth, as people used to have. This too can help you to keep your smile young and vibrant.