Charlotte Ophthalmology Center for Facial Plastic Surgery is proud to announce the addition of the Thermage system to its practice!

The Thermage system was recently featured on the Oprah Winfrey show and the Good Morning America show!

Why choose Dr. Briggs Cook for your Thermage procedure:

• Dr. Cook is the only surgeon performing Thermage in the Charlotte and Lake Norman area specifically trained in eye and facial plastic surgery
• Dr. Cook is the only surgeon performing Thermage in the Charlotte and Lake Norman area specifically trained and certified by Thermage in the use of its equipment
• Dr. Cook was one of the first surgeons to use the new Thermage "fast tip"
• Dr. Cook has lectured nationally and internationally on Thermage. In 2005, he travelled to SouthEast Asia, Germany and Switzerland where he trained other physicians in the use of Thermage.  He is considered a Thermage Ambassador.

Our next Thermage seminar will be held soon! Please call (704) 895-8200 for reservations! Charlotte Ophthalmology Center for Facial Plastic Surgery has now been designated a Center of Excellence by Thermage!

Celebrate Spring with a new you!

$500 Off Of Any Thermage Procedure in 2006!

Schedule A Complimentary Consultation Here!

Thermage

Thermage (Also known as Thermacool/Thermalift) is a radio frequency device developed by Thermage, Inc. (Hayward, CA, www.thermage.com). This device uses a new form of delivery of radio frequency energy so that the energy is transmitted through larger areas of the skin. During delivery of this radio frequency pulse the upper layer of the skin – the epidermis – is protected by cool cryogen spray. Thus, the radio frequency energy can heat deeper tissue without inducing a superficial skin burn. This controlled heating of deeper layers of skin and other tissue causes skin contraction and tightening and is referred to as volumetric tissue heating. An immediate effect of volumetric tissue heating is collagen contraction or shrinkage. A secondary or later effect is collagen remodeling and production of new collagen as well as continued tightening over time as the skin heals.

How does the Thermage unit work?

With each pulse Thermage delivers controlled, uniform, and sustained heat in the tissue underneath the surface of the skin. The heat is applied approximately 4 mm underneath the skin surface, into the dermis (the epidermis is the top layer of skin). This produces bulk or volumetric tissue heating that may result in contraction and tightening of flaccid or loose skin, tightening of the collagen underneath the skin, and the generation of new and tighter collagen. The upper layer of the skin (the epidermis) is protected from this heating by cryogen cooling of the treatment tip which keeps the temperature of the epidermis constant while deeper tissues are heated.

How does the Thermage Procedure change your skin?

This magnified picture of skin (before image) depicts diminished collagen density and a thinning epidermis (top layer of skin) which is typical of aging skin. Four months after the Thermage Procedure there is new and denser collagen and an appreciable increase in the thickness of the epidermis (after image).

   
Before                    After

Where on the face or body is Thermage applied?

Tightening skin in certain key areas of the face can be advantageous for cosmetic improvement. Treating the skin of the forehead can lift the eyebrows and enhance the appearance of the eyes, making the eyes look more open, less tired, and more alert.  The skin of the cheeks can also be treated to reduce the appearance of the deep folds (nasolabial folds) that appear next to the nose with increasing age. Thermage can also be used to treat the loose skin along the jaw line to reduce the appearance of jowls that appear with icreasing age. Other applications are currently being tested and include the neck, chest, elbows, knees, and loose skin of the abdomen. The only current FDA approved application of Thermage is the forehead and eye area; however, other areas are commonly treated (treatment of areas other than the forehead and eye area would be a non- FDA approved use of the device).

Before                    After
Patient treated and photos provided by Neil Sadick

Is Thermage Painful?

Each time the machine is fired, there is a sensation of heat in the area. Fortunately, this heat sensation lasts only fractions of a second and is preceded and followed by a cool sensation, which also helps reduce discomfort. Initial treatments with Thermage were done with the use of a topical anesthetic cream; however, more experience has shown that this is not helpful and may even increase pain because it numbs the cooling sensation from the cryogen spray, which is delivered before, during and after the application of heat. Most patients experience at least moderate pain during the treatment. Some areas are more sensitive than others (jaw line and temples for example). Nerve blocks (injections) may be used in the forehead to reduce pain; however, these injections may change the resistence of your skin and make the Thermage treatment less effective. Charlotte Ophthalmology Center for Facial Plastic Surgery typically uses both oral pain medications and oral ralxing medications prior to your treatment. Use of these medications requires that you have transportation home after your treatment as you will be unable to drive. Pain after treatment is infrequent and typically consists of mild soreness. This discomfort goes away very quickly.    

How long does the procedure last?

Treatment times depend on the size of the area to be treated and the number of passes planned. Typical treatment times for the cheeks and forehead is 30- 45 minutes each area. Other areas may require more time to treat.  

Is there any special preparation?

No special preparation is required. All makeup and creams will be completely removed prior to the start of your treatment. Use of skin care products such as Obagi skin care that promote collagen production and remodeling will enhance the results of your procedure.  

When can I return to my normal activities?

You may return to your activities immediately, as there is usually no down time.  Minimal redness is seen in some patients but it disappears within an hour.  Swelling and pain are uncommon after the procedure.  Occasionally there is significant swelling that may be noticeable and typically lasts 24 hours up to several days. There is no special care needed afterwards unless you develop crusting which can occur rarely.  If crusting is seen, then Bacitracin or Polysporin ointment should be applied twice daily.  
 

What results can I expect and when will they be seen?

Although in some patients the results are seen immediately, in most patients they will appear gradually over 2 to 6 months.  Since the effects are so gradual, you may not be aware of the extent of the changes. Visual comparison with pre-operative photographs usually will demonstrate the changes. Results however remain variable so that some patients get much better results than others. It is possible that the results you achieve may not be as great as you would like or expect. Treatment with Thermage is not as predictable as surgery. We try to maximize your potential for a great outcome by using as high an energy as indicated by skin type and thickness, and by careful placement of treatment grids. Studies have shown that greater than 70% of patients feel that get improvement from Thermage.  

How many treatments will I need?

For many patients one treatment will suffice.  Repeat treatments may be beneficial. You will probably reach your maximum improvement in 3 – 6 months. At that time if you wish to achieve greater improvement, another treatment may be considered. For significant skin laxity, it is very likely that more than one treatment will be required to achieve the best results. Current studies indicate that results from Thermage last approximately 3-6 years.  

When can I have another treatment?

A decision regarding further treatment can be made as early as one month; however, since benefits are delayed, further treatment may be postponed for several months. 
 

How long will the effects last?

The studies to date demonstrate that there may be a variable response. It is likely that any tightening you achieve will be maintained for one year to as long as several years, but this is not currently know because the technology is so new. The few patients initially treated about 2 years ago appear to have maintained their results.  

How safe is it?

It is extremely safe.  Although this is a relatively new procedure and a new technology, great effort has been made to make is as safe as possible. The number of adverse events is extraordinarily small. Small, superficial burns have been reported in a few patients. These burns appear to have occurred by not completely removing topical numbing creams (which are currently not used by most practitioners).  Some patients have experienced temporary nerve injury in superficial sensory nerves resulting in mild numbness that recovered with time. A very small number of patients have had small depressions in the skin over the treated area. This correlates to use of too high a energy, so we carefully choose an energy appropriate to the area being treated.

Please click here for before and after photos of Thermage patients  

Charlotte Ophthalmology Center for Facial Plastic Surgery currently has two locations: 

• Charlotte (Cotswold): (704) 364-7400
• Huntersville (Birkdale): (704) 895-8200

Please feel free to contact us to arrange a complimentary Thermage consultation or to receive a informational brochure.

For more information, contact the Charlotte Ophthalmology Center for Facial Plastic Surgery or visit one of our two locations.