Radiofrequency  (RF) is a worldwide validated, accepted and recognized technology for skin tightening. Biological effects of RF depends on  two complementary but independent mechanisms: 1) Hyperthermia problably the most known and 2) Non-thermal or, more strictly, "subthermal" (electrical) which are clearly depending on the frequency (or wavelenght) of the used technology.

However, in science the only way to provide objective assessments is by an accurate analysis of  avalaible clinical data and research.

Unfortunately , to do this analysis is not easy due to the next factors: 1) Non consensuated identification of the keywords need for an exhaustive search: radiofrequency, diathermia, hyperthermia, CRET, capacitive / resitive transfer...2) Different technologies according the way to apply the RF: monopolar, bi, tri and "more" polar, basically different according to their penetration level on the biological tissues, 3) Equipments working in a wide range of "frequency" values, without assuming that some of their actions are only present at one value but not another even been  closer one and 4) The lack of research rigour in many medical device publications differently from what happens with the drugs, where to reproduce the Material and Methods of a paper (power and wavelenghts of the device, number of and interval session, temperature, application vehicles.... is objectively  impossible.

Without forgetting the relevance of the training  and skills of the applicators who has a significant impact of final results. and which could explain "surprising" results depending oo the authors.

As conclusions: 1) Again, as what happens with  the drugs, any interested in these technology should to consider the  concept  of"bioquivalence" or "biounequivalence"  due to its impact over the final results , 2) there still more to exploit in RF, according to the available evidences  and the studies or research in course, and .  3) it provide and excellent relation profit / risk, justified  also for many years in the market..

Hope that view was useful  for you.

Best reards.

I have had experience with Thermage early versions.  Even though the published data suggested it might be effective, the clinical outcomes were disappointing in that a significant number of our patients did not demonstrate photographable improvement in facial laxity.  The procedure was extremely painful and in our hands did not deliver enough improvement to cover the cost or pain of the procedure.  The company kept providing upgrades claiming that they would improve outcomes, we bought a few but eventually gave up.   The single use tips were expensive and a significant component of the charges making it difficult to refund unhappy patients.  Even now they say the newer versions are more effective but "once bitten twice shy".  I do however speak with international colleagues that I respect who are happier with the procedure than I was.  

Having quite a long experience in radio-frequency skin rejuvenation, I can confirm the technique provides satisfying results, an the outcome is definitly operator-dependant. Equipment makers have constantly been improving their technology, to correct main downfalls, but hand piece high price remains unjustified.

Agree with all above, especially about the early Thermage procedures. Recent improvements in the technology have led to better response in SOME patients. The problem I have seen is that some patients do well and get a great result while others do not respond. It may be operator dependent but in our experience it is idiosyncratic or the factors that contribute to excellent skin tightening in the individual patient are unknown so results are not guaranteed.

Why do alternative treatments when you could do percutaneous collagen induction by skin needling and get better results?