Gwyneth Paltrow's Cosmetic Tips: Botox, No; Thermage, Yes

by Michele R. Berman, MD April 12, 2013

Thermage is the brand name of one of several non-invasive cosmetic procedures which uses radiofrequency technology.

A few words about skin aging: As we age, our skin becomes subject to photodamage -- a process known as solar (or actinic) elastosis. Clinically, this is seen as fine lines, rhytides (wrinkles), skin laxity, skin discoloration and the formation of telangiectasias.

At the microscopic level, one sees an accumulation of elastic fibers in the dermis and mid-dermis. The collagen fiber matrix becomes increasingly disorganized. It is also prone to increased breakdown, with decreased synthesis of new collagen to replace it.

The traditional method of surgical repair with procedures such as blepharoplasty, brow or chin lifts is being replaced by less invasive procedures as the demand for cosmetic procedures has increased.

Ablative laser resurfacing uses intense pulsed light to treat and remove wrinkles arising from photo-aging. The process induces controlled wounds on the skin, prompting it to heal itself by creating new cells. The main disadvantages include downtime that can last 4 to 6 weeks and complications that include oozing, bleeding, and infection.

Non-ablative lasers were developed to address these problems. However, because they create less energy penetration than ablative procedures, they are better suited for mild to moderate photo-aging, and may require more treatments (typically four to six) to get the desired effects. Recovery time is decreased -- only about 3 days after each session.