Key summary Thermage is a non-surgical lifting procedure that uses radiofrequency heat to tighten fine wrinkles and mild skin laxity by delivering heat broadly to the dermis and deeper layers of the skin. Research showed improvement observed during 1~6 months after the procedure, and differences in effectiveness compared to Ultherapy were not evident, though pain was relatively less. It is worth first comparing for those concerned with reduced skin elasticity or fine wrinkles around the eyes and lower face rather than those with severe jawline sagging.
01 How does Thermage tighten skin?
Thermage cools and protects the skin surface while delivering radiofrequency heat broadly to the dermis and deeper layers. Rather than pulling a single point, it works by heating loose skin broadly to induce collagen contraction and remodeling, making it better suited for fine wrinkles around the eyes and lower face or mild elasticity loss rather than significant jawline descent. In Korea, Thermage FLX is registered as medical device approval 18-245.
02 When do effects appear and how long were they maintained?
| Item | Confirmed findings | Source |
|---|---|---|
| Overall efficacy | Literature review of 23 radiofrequency devices (monopolar and bipolar) reported measurable improvement in facial and whole-body skin sagging | PMID 35877937 |
| Safety (all RF modalities) | Adverse events were mostly mild and transient. Monopolar equipment reported higher rates of major adverse events than bipolar equipment | PMID 35877937 |
| Thermage efficacy alone (nasolabial folds) | In an RCT vs. newer device, Thermage (CPT) showed significant improvement in nasolabial fold depth at 1, 3, and 6 months, with no difference from newer device and no serious adverse events | PMID 39957006 |
| Thermage efficacy alone (wrinkles) | In a 230-person multi-center non-inferiority RCT, Thermage group achieved GAIS improvement rate of 98.1% at 90 days (new device group 100%, no statistical difference), with 0 serious adverse events | PMID 41758257 |
| vs. Ultherapy | In 2 direct-comparison RCTs, no differences in efficacy, satisfaction, or adverse events; procedural pain was greater with ultrasound (Ultherapy) | PMID 30531187, PMID 28902019 (see reference document 2) |
Research showed improvement in nasolabial fold depth and facial wrinkles between 1~6 months after the procedure. However, both trials used Thermage as a comparator to confirm that new equipment was not significantly inferior to Thermage, so these were not independent trials specifically validating Thermage alone.
In a 212-person study, 98.1% of the Thermage group received an improvement rating at 90 days; however, this rating was based on physician subjective assessment viewing photographs, and approximately 94% of participants were female. Even though the percentage appears high, it does not mean results would be the same across all genders and skin conditions.
03 What should you verify before treatment?
| Verification item | Why it matters | How to verify |
|---|---|---|
| Equipment registration | Whether it is officially registered equipment | Check MFDS UDI database, medical device approval 18-245 |
| Practitioner qualifications | Board certification status and experience | Hospital information + HIRA public data |
| Basis for efficacy claims | Whether claims are exaggerated | Terms like "permanent" or "surgical-grade results" are warning signs exceeding the research scope (6 months follow-up, etc.) |
| Safety information | Monopolar devices reported higher major complication rates | Whether risks like burns and hyperpigmentation and preventive measures are explained |
| Pain management | Degree of procedural pain | Whether cooling and anesthesia methods are explained beforehand |
The fact that it is officially registered equipment is only the starting point for equipment verification and does not guarantee procedural results. Consultation is considered concrete only when the specific treatment area, energy settings, skin cooling methods, and procedures for contacting if adverse reactions occur are all explained.
04 When should you compare Thermage with other lifting options?
If you are concerned with fine wrinkles around the eyes and lower face or reduced skin elasticity and want overall tightening without incisions, Thermage is worth comparing. While efficacy differences with Ultherapy were not evident, pain was relatively less, which could be significant for those who prioritize pain management. If you have significant jawline descent requiring definite improvement, it is better to compare surgical face lift alongside non-surgical options rather than deciding on non-surgical equipment alone.
05 What are the pain and side effects like?
After radiofrequency procedures, redness, swelling, and tenderness when pressed may occur, and most have been reported as mild and temporary. Monopolar radiofrequency has been reported with more major complications such as burns compared to bipolar devices, but in two recent comparative studies involving Thermage, there were no serious adverse events. Since different research findings exist alongside one another, equipment settings, skin cooling, and burn management methods should be confirmed before the procedure.
06 Common misconceptions
The two recent studies did not both validate Thermage itself. The two trials used Thermage as a comparison standard while evaluating new devices, and in one of the studies, the new device manufacturer provided equipment for research.
It is not accurate to interpret monopolar radiofrequency as inherently dangerous. In the overall radiofrequency literature, most complications were mild and temporary, but when compared to bipolar devices, major complications such as burns were reported more frequently.
Less pain compared to Ultherapy does not necessarily mean better results. In head-to-head comparison studies, Thermage showed relatively less pain, but there were no significant differences in sagging improvement and satisfaction.
07 In summary
Conclusion Thermage is worth considering when you want to tighten fine lines and mild loss of elasticity without incisions, and when reducing pain burden compared to Ultherapy is important. The period in which changes were observed in studies was 1 to 6 months, and this is not data showing surgical-grade changes in cases of significant facial sagging. If you have decided on the procedure, you should also verify that it uses properly registered equipment and confirm skin cooling and burn prevention methods.
08 Frequently Asked Questions
Does Thermage work?
Improvement in fine lines and mild sagging has been confirmed in studies. Hollowing in the nasolabial fold area improved in 1 to 6 months, and facial wrinkles improved after 90 days, but both studies are trials comparing new equipment, so they are not the most recent studies independently validating Thermage alone.
Is Thermage safe?
Most side effects have been reported as mild and temporary, but this does not mean there is no burn risk. Monopolar radiofrequency has been reported with more major complications compared to bipolar devices, and in two recent comparative studies involving Thermage, there were no serious adverse events.
Which is better, Thermage or Ultherapy?
In small-scale head-to-head comparison studies, there were no significant differences in efficacy and satisfaction. If visualization of skin layers and depth control is important, consider Ultherapy; if you want to reduce pain burden while addressing fine lines and mild loss of elasticity, Thermage can be compared first. Detailed information is organized in Ultherapy and Thermage comparison.
How do I verify that the Thermage equipment is authentic?
Thermage FLX is registered in the MFDS UDI as Approval 18-245 number. The search results only show whether the model is registered, so the hospital must separately verify whether the actual treatment equipment is the same model.
09 Pre-consultation checklist
- □ I verified the equipment name and its registration status with MFDS (
Approval 18-245 number) - □ I verified the credentials of the healthcare provider who will actually perform the procedure
- □ I verified that efficacy explanations do not exceed the study scope (e.g., 6 month follow-up)
- □ I received guidance on monopolar radiofrequency-specific risks such as burns and prevention measures
- □ I received explanation of pain management methods (cooling, anesthesia)
10 Glossary of Terms
- RCT (Randomized Controlled Trial): A relatively high-confidence research method that randomly divides participants into groups for comparison.
- Controlled Group Study: Research that separates the treated group and a comparison group (control group). Without a control group, it is difficult to determine whether improvements are due to the procedure or other factors.
- Non-Inferiority Trial: A research design that confirms whether a new treatment is not worse than an existing treatment beyond a predetermined acceptable margin. It proves "not inferior" rather than "superior."
11 Source, Verification Date
- PMID 18940540, verified 2026-09-18. 2008 narrative review (not a systematic literature review, used only as an overview reference material).
- PMID 35877937, verified 2026-09-18. Monopolar and bipolar radiofrequency systematic review, 23 articles.
- PMID 39957006, verified 2026-09-18. New device vs Thermage CPT randomized controlled trial (RCT), 40 participants.
- PMID 41758257, verified 2026-09-18. New device vs Thermage CPT multicenter randomized controlled trial (RCT), 212 participants. The source directly states limitations: the new device manufacturer provided research equipment, evaluations were primarily subjective measures, and 94% of participants were female.
- Korea Medicines and Medical Devices Safety Evaluation (MFDS) UDI lookup, Thermage FLX
approval number 18-245, verified 2026-09-17 - The above research is reference material for understanding procedure principles and effects; it does not endorse any specific clinic, practitioner, or outcomes.
12 Editorial Responsibility, Conflicts of Interest
- Authored by: Korea Beauty Report Editorial Team, Editorial responsibility: Korea Beauty Report Editorial Team
- Review scope: The editorial team prepared this content from published research and public data. It was not separately reviewed by a medical professional and does not replace individual diagnosis or treatment.
- Conflicts of interest: No contracted or advertising-related clinics in this article
- First published: 2026-09-18, Final source verification: 2026-09-18