Thermage is a technology that uses radiofrequency waves (similar to a microwave) to heat the deeper layers of the skin. A cooling device at the tip of the application probe keeps the surface of the skin from heating up. By causing controlled thermal damage to the deeper layers of the skin and sparing the top layers, the machine seeks to cause tightening of the skin. I have had Thermage in my office for over four years. My experience has been that there is some firming of the skin but if patients view the treatment as an alternative to a facelift, then they will be disappointed. However, patients that are not interested in ANY operative interventions have expressed satisfaction with the improvement seen from Thermage treatments. I have seen fine wrinkling under the eyes improved by staggered treatments of Thermage and Fraxel, avoiding the more involved lower lid surgery. My master aestheticians administer this treatment and have several years of experience with it. As long as patients have realistic expectations, they have been pleased with the results of Thermage.