Thermage side effects: what is normal, and what is not
Medically reviewed by Dr Sin Yong · Last reviewed · 3 min read
After Thermage FLX, most people have redness and mild swelling that settle within hours to a day, sometimes with a faint grid pattern from the treatment tip. Uncommon problems include small burns or blisters, and contour changes when heat affects the fat beneath the skin. They are uncommon because the surface is cooled during each pulse and energy is set area by area; when they do happen, early review matters.
Illustrative image. Radiofrequency is often used where skin quality, not depth, is the main issue.
Key facts
Common, settles
Redness, mild swelling, a faint grid pattern, tenderness
How long
Hours to a day or two
Uncommon
Small burns or blisters, contour changes from fat loss, temporary altered sensation
Lower risk with
Correct cooling, coupling, energy per area and avoiding overlapping passes on thin tissue
See a doctor if
Blistering, crusting, a growing dent, or pain that worsens
Thermage heats the dermis as a layer while the surface is cooled with cryogen spray. Redness and mild swelling are expected for a few hours, and around the eyes swelling can last a day or two. Some people see a faint grid or the outline of the tip for a short time. Tenderness is usually mild.
Less common problems and why they happen
Small burns or blisters can occur if cooling or contact is incomplete for a pulse, or if energy is too high for that area. Contour changes, such as a small dent, can follow if heat affects the fat beneath the skin; this is more of a concern in lean faces. Altered sensation is uncommon and usually temporary.
Energy is set per area and adjusted by feedback during treatment, which is why Thermage is done by a doctor who plans the passes for each face. A heavy face after filler is a different problem altogether and is assessed separately; see pillow face.
What to do if something is not settling
Swelling and redness that are improving can be watched. Send a photograph if a mark has not faded after a few days, if a blister appears, or if you notice a dent forming. Burns are managed like any superficial burn, with wound care and sun avoidance, and are reviewed until healed.
Questions after treatment come back through WhatsApp at +65 8023 7170 during clinic hours (Monday to Friday 10am to 8pm, Saturday 11am to 3pm, Singapore time). Anything that is getting worse rather than better, a blister or open area, or fever needs to be seen the same day, wherever you are.
“Radiofrequency is forgiving when it is planned for the face in front of you, and less forgiving when one setting is used for everyone.”
Dr Sin YongOn Thermage safety
Frequently Asked Questions
Usually a few hours. Swelling around the eyes can last a day or two.
Uncommonly, contour changes can follow if heat affects fat beneath the skin, more of a concern in lean faces. Energy is planned per area to reduce this.
Small burns or blisters are uncommon and are linked to incomplete cooling or contact, or to energy that is too high for the area.
Radiofrequency is not absorbed by pigment in the way some lasers are, so skin colour is less of a factor; the main planning points are tissue thickness and energy per area.
It can be assessed. Bring the date, the areas and the tip used if known.
