Thermage Before and After: What Studies Measured at 1, 3 and 6 Months

Cheeks, jowls and neck: pictures at 1, 3, 4 and 6 months

Alster and Tanzi treated 50 people once with the ThermaCool system, an earlier Thermage generation: 30 for mild to moderate cheek laxity and 20 for the neck. The cheek treatment covered skin from the nasolabial folds out to the front of the ear and down to the jawline, and the neck treatment ran from the jaw to mid neck. Three masked assessors compared photographs taken at baseline, immediately after treatment, at 1 week and at 1, 3 and 6 months, on a quartile scale from under 25% to over 75% improvement. The authors reported improvement in most patients, with tightening still evident 6 months after the single treatment, and wrote that the longevity of results had yet to be determined.

Fritz and colleagues randomly assigned 20 people with mild to moderate laxity of the middle and lower face to one ThermaCool TC treatment or two treatments a month apart. Four blinded physicians rated standardized photographs taken before treatment and 1 and 4 months after the last session, scoring the nasolabial folds, marionette lines, jowls, laxity under the chin and overall appearance. Both groups improved further between the 1-month and 4-month assessments, two treatments scored higher for the nasolabial folds, and the authors described the overall change as modest in most patients.

A 2019 split-face trial treated 20 people with monopolar capacitive radiofrequency on one side of the face and microfocused ultrasound on the other; its abstract names the technology rather than the device. Laxity scores for the face and upper neck had improved significantly on both sides by day 30 and remained improved through days 90 and 180. A 2025 randomized study from Beijing used Thermage CPT as the comparison arm for a different monopolar device and photographed its 40 participants, including with Antera 3D imaging, at baseline and at 1, 3 and 6 months, measuring the depression volume of the nasolabial folds.

Eyes and eyelids: from 8 weeks to 6 months

In Fitzpatrick's six-month study of 86 people treated around the eyes with the ThermaCool TC System, independent reviewers scoring blinded photographs found at least a one-point wrinkle-score improvement in 83.2% of treated areas, while treating physicians working without the pre-treatment photographs noted improvement in 28.9%.

Biesman and colleagues treated the eyelids of 72 people once with a 0.25 cm² monopolar RF tip and followed them on a serial basis for 6 months, with masked physician observers rating the photographs taken at each visit. Upper eyelid tightening and less hooding were noted in 88% and 86% of participants and lower eyelid tightening in 71–74%. Most achieved "at least up to 25% improvement", and a smaller share showed larger change.

A 2025 Korean study of 50 people treated the upper eyelids once with a Thermage 450 REP 0.25 cm² eye tip, at 0.25–0.45 joules per pulse and about 200 pulses per eyelid. Photographs were taken at baseline and at 8 weeks, an interval the authors chose to capture early change while noting that collagen remodeling can continue for 3–6 months. Five board-certified dermatologists rated each pair blind, and those ratings trained an automated scoring model. For the eye-specific procedure, see the Eye Thermage guide.

How to read a before-and-after pair

A before-and-after pair compresses months into two frames. Between them, the cited studies held five things constant: a set interval after treatment; the lighting, which was cross-polarized in the eyelid scoring study; a fixed distance with identical aperture, exposure and ISO; a neutral expression with the eyes in primary gaze; and raters who were masked or blinded. The gap between blinded photo reviewers and treating physicians in the periorbital study shows how far the rating method can move the result.

A photograph you take before your session is most useful if you can repeat it the same way at the later visit. In the lower-face study, every participant had mild swelling and mild to moderate redness right after treatment; the aftercare and downtime guide covers those first days.

Questions for clinic photographs

Delight Dermatology Clinic's before-and-after photographs show one pair from a combined plan that also included Ultherapy. When a clinic shows you a pair, ask:

• Which device, tip and areas were treated, and was anything else part of the plan?
• How long after treatment was the second photograph taken?
• Were both photographs taken with the same light, distance, camera settings and expression?

Who tends to suit the treatment is covered in the candidates guide, and the XTherma and Thermage records guide explains how to confirm which device a clinic is offering.