After trying over 150 Thermage procedures, I felt guilty in taking patients' money for essentially no result. I sold my machine several months ago. Why the FDA ever improved this is beyond me.

Re Titan, it is the same joke, as is YAG laser "tightening" or "toning" and contour threading (or whatever).

As a facial plastic surgeon, there are certain things that still require surgery to give the patient the result they bargan for. The Quicklift (UpLift) is one damn nice procedure. So are blepharoplasty and erbium resurfacing.

One further caution: Fraxel. Expensive machine, multiple, painful procedures. Can do a better job for a lot less $$ with the er:YAG.

Don't be sold by salesmen/women!!!

I'm not a surgeon, but I do agree with what you are saying. I've seen great results with Er-Yag. Very safe as well.

I think the perfect combination of equipment for a Non-Surgical Medical Spa would be the following:

IPL skin rejuvenation
Laser and in some parts of the country an IPL for hair removal.

Microderm

Er-Yag for wrinkles.

I've seen good results with some threat lifts.

and yes, the phone number to a good plastic surgeon to refer the patients you can't or should not treat.

This is fantastic. I'm grateful to have such a frank discussion about this stuff as it's usually sales reps who's opinion is suspect.

I've been holding off of Thermage since it's received such negative press. It's obvious that there's a market and I suspect that the technology will improve until it reaches a point where everyone jumps on board.

Thanks for being honest Dr. Mindell. Wish I had found this site and your post above before being burned at Dermacare.

Having read this site for the last six months with a great deal of interest, I've found myself changing my position regarding some of these newer nonsurgical technologies like Thermage. A year ago I thought this was mostly smoke and mirrors.I can see that I was mistaken and that there really is some movement towards treatments that could replace me as a surgeon. I'll continue to watch with interest, and with some sense of trepidation.

ID,

I do not think these will replace you. There will always be individuals that want or need more than the noninvasive procedures can deliver.