ThermiTight™ and ThermiSmooth™

*individual results may vary

Why Radiofrequency?

Surgery will remove excess skin, stretch skin, re-position skin, but it will not tighten skin*. What if there was a magic wand that could change the nature of human tissue and tighten it? Imagine all the applications there would be for this technology! Maybe you have some neck laxity and are either not ready for a facelift, or maybe you just do not want a facelift? Maybe you are willing to accept a somewhat less than surgical result if you can do so with little to no downtime and far less expense?? Do you see where I am going with this?

Is this far from a reality? Definitely not!!. How do we do achieve tightening of tissue without surgery? The secret is radiofrequency energy.

What is radiofrequency energy?

Radiofrequency energy is essentially radiowaves. We all know how a microwave oven can heat food. Microwaves are ultra high frequency radiowaves that when contacting a water containing substance will result in the production of heat within. When applied to living tissue, the production of this heat will cause the tissue to tighten. Not immediately, but over time. ThermiRF™ uses radiofrequency, but instead of ultrahigh frequencies as used in a microwave oven, ThermiRF™ uses low frequency radiowaves. The end result is the heating of tissue and contraction of that tissue over time*. Furthermore, we know that when the tissue is heated to about 44 degrees C, human tissue, mainly skin, can reliably undergo progressive tightening over approximately twelve to eighteen months. We also know that skin will burn if it reaches a surface temperature of about 52 degrees or so.

How is Thermi RF™ energy applied to human tissue?

There are two ways in which ThermiRF™ energy is applied to human tissue:

1. Non-invasive: A treatment is said to be non-invasive when there is no break in the skin whatsoever. With this method, a probe with a flat surface is applied to your skin and radiofrequency energy leaves the probe and enters the skin. Ultrasound gel is placed over the skin to lubricate it and ensure even heating. The skin gradually warms until a set "target temperature" is reached. The probe actually monitors the skin surface temperature and that temperature reading is continually displayed on a readout for the person performing the treatment. This is a safety feature to prevent a burn from occurring. Many describe the feeling as resembling a "hot-stone massage". It is not at all painful or unpleasant*. Actually, it can feel quite good. Usually several treatments at time intervals of a few weeks are required to achieve the desired therapeutic effect. The non-invasive arm of ThermiRF™ is called "ThermiSmooth™."

2. Microinvasive: A treatment is said to be micro-invasive when the only break in the skin is a small pinhole, usually made by a needle. There is no need for stitches and no visible scarring. In this case a few tiny holes are made in the skin with a hypodermic needle. Next, a thin blunt tipped hollow instrument called a cannula is placed through those tiny holes in the skin so that a local anesthetic can be introduced under the skin to numb the area being treated. Next, a thin probe is placed through those same needle holes and introduced under the skin being treated. The tip of the probe emits radiofrequency energy while the probe also records the temperature inside the skin to the operator, four times each second. Again, this is a safety feature to prevent a burn from occurring. Lastly, a special infrared camera is aimed at the treatment area and an infrared temperature map of that area is displayed on a monitor continually, so that the operator knows the surface temperature at all times, again to prevent a burn from occurring. With both inside tissue and external surface temperature monitoring in place, the procedure is very safe as well as effective because the temperature of the tissue can be safely brought up to the level that will stimulate tissue contraction. The microinvasive arm of ThermiRF™ is called "ThermiTight™", also nicknamed "injectable RF" because the radiofrequency energy is being "injected" under the skin.

Review the video below for a brief introduction to ThermiSmooth:

Tighten your eyes, thighs and tummy with ThermiSmooth


Surgical lifting procedures have value that has been proven over decades of performance. However, new trends in aesthetic medicine have more people leaning toward non-surgical rejuvenating procedures. Because the skin is in a continual state of flux, the loss of elasticity can be difficult to manage. Patients of our Long Island cosmetic surgery office may discover that their best option to manage skin tightness is completely non-invasive. ThermiSmooth™ is an innovative skin tightening procedure that we are pleased to offer.

What is ThermiSmooth™?

ThermiSmooth™ is an innovative extension of the ThermiRF platform. This treatment is intended for the non-invasive tightening of superficial tissues. It is based on radio frequency and the ability of this energy to induce ongoing collagen production.

How ThermiSmooth™ Works

Science has discovered that, when tissue in the dermis reaches certain temperatures, there is a constrictive response. This information has been used by numerous manufacturers to develop skin-tightening devices. Using radio frequency, ThermiSmooth™ targets existing collagen fibers, as well as the fibroblasts in deeper tissue to increase the future production of collagen.
The goal-temperature for ThermiSmooth™ treatment is only 108 ºF. That is only a few degrees higher than normal body temperature, sufficient enough to cause collagen to shrink but not so much that treatment is uncomfortable. In addition to shrinking the collagen that is in place to support the skin, the heat absorbed by radio frequency elicits an inflammatory response that results in greater collagen stores months down the line.

Common Treatment Areas

ThermiSmooth™ is intended as a facial rejuvenating procedure. It is appropriate for treating thin, loose skin under the eyes, and is also an excellent therapy for reducing jowls. Additional treatment areas include the neck, lower face, eyelids, and forehead.

ThermiSmooth™ Treatment

Prior to ThermiSmooth™ treatment, we conduct a thorough consultation and skin assessment in our comfortable Stony Brook office. It is important that we have a clear understanding of the desired outcome, so that we may develop a treatment plan to achieve that. ThermiSmooth™ is one of a few options patients have to improve the appearance of their skin.
ThermiSmooth™ treatment begins with skin cleansing and the application of cool gel. This is similar to ultrasound gel, and facilitates the transfer of energy through the skin. The device is set for our target temperature, which warms the skin through a small hand piece. A circular or sweeping motion is used to pass the hand piece over the skin. As tissue absorbs energy, a warming sensation is likely. Most patients do not describe this as uncomfortable. In fact, many of them find it relaxing! To promote the greatest possible comfort, the ThermiSmooth™ device has built-in temperature adjustment technology that responds to feedback from the skin.

How many ThermiSmooth™ applications are needed?

One of the most common questions regarding non-invasive skin tightening is how many treatments will be necessary to achieve the desired outcome. This can only be answered after a face-to-face consultation. According to research, younger patients (who have more viable collagen to begin with) may be able to reach their objective with just one ThermiSmooth™ treatment. The more sun damage and signs of aging a patient has, the more treatment sessions he or she may need to restructure the surface of their skin.


What to expect after treatment

There is no recovery to speak of after ThermiSmooth™ treatment. This is one of the most notable benefits! For a short time following the procedure, skin may appear slightly pink, due to the absorption of energy. Skin may feel tighter due to the constriction of collagen strands, as well, but this is a temporary sensation that will fade over a day or two.

ThermiSmooth™ Results

It is important to be patient with the onset of results from non-invasive skin tightening. Generally, the collagen-rebuilding process takes place over several months, and sometimes through multiple radio frequency sessions.
We pride ourselves on staying at the forefront of surgical and non-surgical treatments. Learn more about the benefits of ThermiSmooth™. Call 631-689-1100 to schedule your visit with our friendly team.

ThermiTight™

See the video below for an explanation as to how tissue tightening with ThermiTight™ "Injectable RF" process occurs:

See the video below for a brief introduction to ThermiTight™:

For more information on ThermiTight™ and some case studies:

How long does it take to see results from thermitight™?

Although in isolated cases I have seen results in a couple of weeks, it usually takes 6 - 12 weeks to appreciate results. Results continue to improve for up to twelve to eighteen months.

How long do Thermitight™ results last?

Unlike Botox or fillers which do wear off, ThermiTight™ changes the nature of the tissue, thus setting the clock back. Of course you will continue to age, but with the your tissue more rejuvenated, you will enjoy longlasting results.

What is the downtime after thermitight™?

There is minimal discomfort, easily managed with regular Tylenol™. Bruising is rare. There is some swelling for a few days. You may experience some temporary numbness in the skin. You can go about your normal activities immediately.

How many thermitight™ treatments will I need?

While it is anticipated in most cases that only one procedure will be needed, ThermiTight™ can be repeated again and again if needed. It is recommended to wait at least nine to twelve months so that you can get an idea as to how much improvement you will attain from a given treatment before undergoing a second treatment.

thermirf™ Case Studies

Case study 1 - Abdominal rejuvenation:

50 year old female, no children desires improvement in the contour of her abdomen. She works out several times a week, but cannot tighten her abdominal skin. She complains of loose skin around her umbilicus, lax and excess lower abdominal skin. She does not want the downtime and expense associated with a surgical procedure. Solution: ThermiTight™.

She is shown below both before and six weeks after a single treatment of ThermiTight™ performed under local anesthesia:

Thermitight in long island | Mark Epstein M.D.

Notice the elimination of the wrinkles in the lower abdomen. The skin around the umbilicus has tightened and the hooding is all but eliminated. As the procedure was performed through needle punctures in the skin, there is no visible scar anywhere! No surgery? Local anesthesia? No downtime? No pain? No scars? Yes, it is all possible with ThermiTight™!

Case study 2 - Neck rejuvenation

59 year old female who complains of lax skin, deep "necklace lines" around her neck and deep creases on the sides of her neck (worse on the right side). She does not want surgery! Solution: ThermiTight™.

She is shown below both before and six weeks after a treatment of ThermiTight™; performed under local anesthesia:

Thermitight in long island | Mark Epstein M.D.

Thermitight in long island | Mark Epstein M.D.

Thermitight in long island | Mark Epstein M.D.

Note the tightening of the skin on the neck, the smoothing of the skin, the softening of the etched "necklace lines" in the front as well as the near elimination of the posterior creases on the sides of the neck!

Case study 3 - Repair of contour deformities in the skin

59 year old female who underwent liposuction of the outer arms by another surgeon some years ago. She developed severe contour deformities of both outer arms that resulted in complete reluctance to wear a sleeveless top, even during the hot summer months! The deformity is worse on the left arm. The right arm has arrows to indicate the site of the two "bumps" that resulted after liposuction. Solution: ThermiTight™.

She is shown six weeks following a single ThermiTight™ treatment to her arms, performed under local anesthesia:

Thermitight in long island | Mark Epstein M.D.

Thermitight in long island | Mark Epstein M.D.

Notice how the contours have been smoothed and the deformities are no longer present.

Schedule a consultation

If you think that ThermiTight™ is right for you, contact our Long Island office today! Call (631) 689-1100 to schedule a consultation.

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