Thermage FLX: Three Changes from the Earlier System

There are moments after cleansing when you run your fingers over your face and it no longer feels as springy as it used to, but somehow thinner and slacker.

Skin ageing does not arrive only as fine lines around the eyes and mouth. It also progresses as a loss of strength in the foundation of the skin itself, as the density of collagen fibres making up the dermal layer decreases. Looking into radiofrequency lifting at this stage brings you to Thermage FLX, and many people want to know what has changed from earlier versions.

Put simply, Thermage FLX is the fourth-generation Thermage system. Three things have changed compared with the previous generation. It automatically measures skin resistance (impedance) by area with every shot and adjusts the energy accordingly, it lowers the burden of discomfort with micro-vibration and cooling gas, and the tip area has increased from 3.0cm² to 4.0cm², covering a wider area at the same shot count.

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Why does skin resilience decline?

The key to maintaining skin resilience is the collagen fibres that make up more than 80% of the dermal layer.

From the late twenties onwards, the body’s capacity to produce collagen begins to decline, while existing fibres also degrade and loosen, so the skin gradually thins. Because cosmetics and home care struggle to deliver ingredients as far as the dermal layer, many people run into a limit. In other words, a loss of resilience is not a surface problem but a structural change in which the collagen density of the dermal layer decreases.

How does Thermage FLX work?

Thermage FLX works by delivering 6.78MHz monopolar radiofrequency evenly into the dermal layer of the skin.

When the thermal energy reaches the dermal layer, the loosened collagen fibres contract and resilience follows. Remodelling then continues over the following months as the skin produces new collagen of its own, and in this process the thinned dermal layer is filled back in. In other words, it is not a treatment that pulls the skin but a tightening method that fills in the density of the dermal layer. How much you notice, and when, varies from person to person.

What does automatic resistance measurement do?

Automatic resistance measurement is a function that reads the impedance of an area in real time each time the tip is placed on the skin and a shot is delivered.

Impedance is the value describing how much tissue blocks the flow of current. It varies with moisture content and tissue composition, so the heat actually generated differs by area even at the same output. The fourth-generation system measures this value and matches the target energy to it automatically.

What has changed from before?

Three things in particular have changed from the earlier Thermage.

Technology	How it works	What changes
Automatic impedance measurement	Measures resistance by area in real time with every shot	Reduces energy variation between areas
Vibration and gas cooling	Applies micro-vibration and cooling gas at the moment of each shot	Lowers the burden of discomfort
4.0cm² total tip	Area increased from the previous 3.0cm²	Covers a wider area at the same shot count

To sum up, the fourth-generation change is less about raising the output than about delivering the same energy more evenly and more comfortably.

Is Thermage all right with little cheek fat?

Thermage FLX works in the direction of filling in the density of the dermal layer rather than contracting the fat layer.

So it is a treatment that those with less facial fat, who are concerned about cheek hollowing, can consider. That said, excessive energy applied without regard to your conditions is a burden whatever the method, so values are set after checking skin thickness.

To sum up, Thermage FLX suits those who want to fill in the density of thinned skin rather than lift sagging upwards.

What should be checked at the consultation?

There are two things to check quite apart from the device itself.

The first is whether a genuine single-use tip is used. A Thermage tip is a single-use medical device to be used on one person only, within a set time after opening. Reprocessed or illegally distributed tips deliver output unevenly, so problems such as burns to the epidermis may come with them.

The second is individual energy planning. Even where automatic measurement corrects variation between areas, which area is treated and to what extent has to be decided by a person. However much the device is upgraded, confirming a genuine tip and planning for the individual remain things a person has to take care of.

What should be observed afterwards?

Heat has been delivered to the dermal layer, so it is worth reducing stimulation for a few days.

• Redness and warmth — these may appear slightly straight afterwards and usually ease within two to three hours.
• Cleansing and make-up — both are possible from the same day, but give scrubs, peels and active products such as vitamin C and retinol a rest for about a week. Washing gently with lukewarm water over the same period is best.
• Moisturising and sun protection — apply plenty of soothing cream and use SPF 30 or higher when going out.
• Alcohol, smoking and hot environments — please avoid these along with saunas, steam rooms and vigorous exercise for two to three days.

The principle of aftercare is to add no further stimulation while the heat left in the dermal layer turns into collagen synthesis. If your skin no longer feels as resilient as it did, this may be the point at which refilling the support in the dermal layer matters more than covering the surface. Rather than deciding on price alone, we would suggest checking your skin’s thickness, moisture density and stage of ageing. You can also see how it compares with the other lifting options in our lifting guide, and we will go through it together at the consultation.

Healthy, resilient skin comes together when accurate information and consistent care are added to the treatment itself. NUWA Clinic Gangnam, which proposes a direction suited to your skin through one-to-one diagnosis, is located directly in front of Exit 7 of Gangnam Station, on the 3rd and 4th floors at 385 Gangnam-daero, Seocho-gu, Seoul.

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Frequently asked questions

Q. How is Thermage FLX different from before?

A. It is the fourth-generation system, measuring resistance by area automatically with every shot and adjusting the energy. Micro-vibration and cooling gas lower the burden of discomfort, and the tip area has increased from 3.0cm² to 4.0cm², covering a wider area at the same shot count.

Q. What is impedance?

A. It is the resistance value describing how much tissue blocks the flow of current. It varies with moisture content and tissue composition, so the heat actually generated differs by area even at the same output. This is why a function that measures and corrects it with every shot is built in.

Q. Is Thermage very painful?

A. Micro-vibration and cooling gas work together at the moment the shot is delivered, which lowers the burden of discomfort. How much is felt varies from person to person, and adjustments can be made as we go.

Q. How do I check the tip is genuine?

A. A Thermage tip is a single-use medical device to be used on one person only, within a set time after opening. You are welcome to watch the tip being opened before the treatment, or to ask at the consultation. It is not an awkward request but a perfectly reasonable check.

Q. When do the changes start to show?

A. A firmer feel from collagen contraction may be noticeable straight afterwards, while new collagen formation continues over the following months. When and how much you notice varies from person to person with age and skin condition.

Q. Can I wear make-up on the day?

A. Gentle cleansing and make-up are possible from the same day. Please avoid scrubs and peels, though, and give active products such as vitamin C and retinol a rest for about a week.