@DrBermant :thermage therapy ,is it effective?
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
I have never been a fan feeling that there was mostly hype and poor documentation. During my practice, I saw many unhappy patients after failed various laser "skin tightening" experiences from other surgeons. There were many techniques represented and different practitioners responsible for the bad results. This sampling is not sufficient for an effective evaluation since happy patients would not be coming to me.
In looking at their website today, I saw, for the first time in many years actual before and after pictures that were not completely misleading and unethical. However, I do not understand their statement:
represent patients who have had significant results.
and would have preferred to be seeing typical results as the ASPS ethics guidelines mandates.
Still missing are adequate standard views to prove that a technique has actually worked. I also have not found anyone using the standard videos show how the tissues move. Tighter tissues just doe not bounce as much and hug the body better.
Documenting Loose Skin
This is the problem about documenting loose skin and theoretical treatments for this condition. The failure is in methodology in our industry. Nobody has come up with a great method to demonstrate just how much loose skin there is and then after treatment, how tight is the skin after treatment.
This has been the goal of my efforts through the years of evolving my various Standard Picture and Movies for various parts of the body. I use gravity pulling the tissues away from the body and how the body moves to demonstrate the contours of the tissues and the tightening process. One such example would be my Standard Tummy Tuck Pictures
to evaluate loose skin of the stomach and abdomen. Different parts of the body need different methods to show this process as seen in another set for loose skin of the male chest: Standard Pictures for Male Mastopexy and Evaluation Loose Skin Male Chest
My method does not quantitative the problem nor change. I was never a fan of a theoretical concept of putting the tissue so that gravity was directly behind the skin pull. That means for stomach, the patient would be on their back. For under chin, the patient would be standing upright. Then attaching some tension measuring device like a force gauge to the skin. I see no practical way to do this. Then measure the force to pull the tissue specific distances. There are theoretical issues here also as you are also measuring the weight of the tissue involved. How are you separating out the process of tightness vs tissue weight?
I have started posting various resources like How to Evaluate Tummy Tuck Pictures
which takes a critical look at this process of documentation.
My various standard picture and videos system is the best effort I have seen to date of anybody to document this issue. I would be happy to learn more and see other methods or examples. For that matter, I would be interested in seeing others take what I started and go the next step and further refine the process.
Back on point, the Laser Skin Tightening pictures seen today still are only scattered views, not a complete set as I demonstrate for my Skin Tightening Operations. Therefore, I still feel that the "proof" that they work is not sufficient. To evaluate that the results shown should be Typical and more complete.
Here is an open invitation to others who have such documentation. Use this forum to show it, prove it, and demonstrate it. Start with my standard pictures / videos and do as much or better. Let us analyze such pictures videos and learn.
Hope this helps,
Michael Bermant, MDLearn More About Plastic Surgery