Non-surgical tightening
Thermage
Radiofrequency that heats the full thickness of the dermis in one pass, while the surface is cooled. One appointment, no downtime, and a result you judge in months rather than days.
- Minutes
- 60–90
- Session
- 1
- Downtime
- None
What it does
Thermage passes monopolar radiofrequency current through the skin. Tissue resists that current and the resistance makes heat — not at a single depth, but through the whole thickness of the dermis and into the fibrous strands that run down through the fat beneath it. Collagen contracts as it heats, which is the small tightening some people notice early, and then the heated tissue repairs itself over the following months. That repair is the part that matters, and it is why the result is judged at three to six months rather than on the day.
The tip cools the surface before, during and after each pulse, and vibrates while it fires. Both exist for the same reason: the treatment works by heating the layer under the skin without cooking the layer you can see, and the margin between those two is not wide. Every tip is also counted — it is loaded with a set number of pulses and stops when they are spent — so the size of the area and the number of pulses are decided before anything begins, not adjusted mid-treatment to fill the time.
This is not the same treatment as focused ultrasound and it is not a replacement for it. Ultrasound places discrete points of coagulation at a set depth, including the SMAS; radiofrequency heats a volume of tissue broadly and more shallowly. Which one suits you depends on what is loose and how deep it sits, and that is an assessment question rather than a menu question. At our North Vancouver clinic the assessment comes first, and sometimes the answer is neither.
Heats a volume, not a line
The whole dermis in the treated area, rather than points at one depth.
The surface is protected
Cooling before, during and after each pulse, which is what keeps the heat below.
Nothing to recover from
Most people go back to work the same afternoon.
Skin tone does not change the settings
Radiofrequency is not absorbed by pigment the way light is, so it is not a device that has to be dialled back for darker skin.
Usually a good fit
- Mild to moderate laxity of the face, jawline, eyelids or abdomen
- Skin quality and crepiness you would like improved as much as contour
- You would rather not have surgery, or are not ready for it
- You can wait three to six months to judge the result
- You are in your thirties to sixties, which is where the tissue still answers well
- You want one appointment rather than a course
Usually not
- A pacemaker, defibrillator or any implanted electronic device — radiofrequency current and implanted electronics do not mix, and this is a hard no rather than a caution
- Metal implants or permanent metallic material in the treatment field
- Significant loose skin — a surgical consultation is the honest answer
- Pregnancy or breastfeeding
- Open wounds, active infection or active inflammatory acne in the area
- You need to look different by next week
- You are unwilling to have the area assessed first
Before
- Come with clean skin and no makeup if you can
- Tell us about any implanted device — pacemaker, defibrillator, neurostimulator — before the appointment, not on the day
- Tell us about any recent fillers, threads or neuromodulator in the area
- Eat beforehand; the treatment is easier on a full stomach
- Book it at least two weeks clear of any event
On the day
- 01MappingA treatment grid is drawn on the area so the pulses are placed evenly and counted, not estimated.
- 02TreatmentThe tip cools, fires and vibrates in turn. Each pulse is a brief deep heat; you tell the practitioner what you feel, because that feedback sets the level.
- 03FinishThe grid is cleaned off. Skin may look flushed or slightly swollen. You leave without a dressing.
- 04PhotographsStandardised photographs before you leave, so the review compares like with like rather than memory.
After
- Redness and mild swelling for a few hours to a couple of days is normal
- Sunscreen, as always
- Normal skincare and makeup the same day — there is no barrier to protect
- Changes build over 3–6 months; we photograph at your review so you can compare
- Tell us promptly about a blister, a burn, a lasting dent or numbness that is not improving — those are not part of the ordinary course
- A review at three months, which is the earliest point the result is worth judging
$3,200 – $3,600
per area
The range reflects the area treated and the number of pulses it takes to cover it — eyelids sit at the lower end, full face and neck at the upper. It is priced per treatment rather than per session of a course, because this is usually one appointment. You will have an exact quote before anything begins.
What can go wrong
Thermage is non-invasive. Non-invasive does not mean without risk, and the risks here come from heat. Most of what follows settles on its own; the last two are uncommon and are the reason the settings are set by feedback rather than by a default.
- Redness, mild swelling and a bruised feeling for hours to a few days
- Tenderness or a lumpy feeling under the skin for a few weeks
- Numbness or tingling in the treated area for days to weeks
- Blistering, burns or a change in skin colour where heat has been excessive. Uncommon, and it is the reason you are asked throughout what the heat feels like
- Loss of fat in the treated area, producing a dent or hollow rather than tightening. This can take months to appear and does not always fully resolve; it is why an assessment decides whether you have enough support to treat at all
Questions we get
Does it hurt?
Each pulse is a brief deep heat, sharper over bone. Most people manage without medication. Say so if a pulse is too hot — that is not stoicism being tested, it is the feedback the settings are based on.
When will I see something?
Sometimes a little tightening early, then gradual change over three to six months as the heated tissue repairs. It is not an overnight treatment.
How long does it last?
Commonly one to two years, varying with age, skin quality and sun exposure. Your skin continues to age; the treatment does not stop that.
Is this instead of a facelift?
No. It tightens and improves skin quality but removes nothing. If you have significant laxity, a surgical consultation is the more honest conversation, and we will say so.
How is it different from Ultherapy?
Ultrasound places discrete points of coagulation at a set depth, including the layer a surgeon lifts. Radiofrequency heats a volume of tissue more broadly and less deeply, and tends to do more for skin quality and crepiness. Neither is the better device in the abstract — they suit different problems, and which one is right is decided at the assessment.
Can I have it if I have a pacemaker?
No. Radiofrequency current can interfere with implanted electronic devices. Tell us before you book rather than on the day, and we will talk about what else there is.
How many treatments will I need?
Usually one, then a review at three months. Some people repeat after a year or two. Anyone who tells you the number before seeing your tissue is guessing.
Does it work on darker skin?
Yes, and the settings are the same. Radiofrequency is not absorbed by pigment the way light-based energy is, so the risk of burns or pigment change that comes with some laser treatments does not apply here in the same way. The heat-related risks above still do.
I have filler already. Does that matter?
Tell us what you have had and when. Heat can affect some products. It is usually a question of sequence and interval rather than a reason not to treat — but it needs to be known before, not discovered during.
What if I do not see a change?
Bring it to the three-month review with the before photographs. Response varies with age, skin quality and how much laxity was there to begin with, and some people get little from it. We would rather say that at the review than have you book another on hope.
Book an assessment
Book onlineWho does this
Assessments and treatments at the Lonsdale Avenue clinic in North Vancouver are carried out by MMC’s own clinicians. Who they are, what they trained in and which treatments each of them does is on the team page.
Other treatments here
Everything listed here is offered at the Lonsdale Avenue address in North Vancouver. Names, durations and prices come from the clinic’s live schedule rather than from this page, so what you see is what is bookable today.
- Dermal Filler
- HarmonyCa
- IV TherapyConsultation first
- Injectable Consultation
- Neuromodulator Treatment
- Skin Booster
- Ultherapy
Other places people start
These are sorted by what is bothering you rather than by treatment name. Each page says what actually helps, what does not, and when the honest answer is that nothing here is needed.
- Loose Skin After Weight LossLosing the weight is the hard part and you have done it. What is left is usually a skin problem rather than a fat problem, and those have completely different answers.
- Fatigue & Low EnergyThis is the concern where we are least likely to sell you anything, and we would rather say that at the top of the page than at the end of a consultation.
- Dullness & Uneven ToneDullness and dehydration are a texture problem, not a shape problem. That distinction decides which half of the menu is even relevant.
- Volume Loss & HollowsVolume loss is the change people describe as looking tired or gaunt without being able to name a line. It is also the one where over-treatment is most visible from across a room.
- Forehead & Frown LinesForehead and frown lines are muscle before they are skin. The question that decides your result is not the dose — it is whether the line is still only there when you move.
- Hooded Upper LidsThe line where this stops being an injectable question and becomes a surgical one is unusually clear, and you are entitled to be told which side of it you are on.
- Jawline & Contour LossThe most common reason people book here, and the one where the honest answer changes most with age. In your forties a device usually does it. In your sixties it usually does not.
- Nasolabial FoldsNasolabial folds are usually a symptom. Filling the fold itself is the most common way to end up looking heavy in the lower face.
- Stubborn Body FatA pocket that stays the same size while the rest of you changes. Usually the flanks, the lower abdomen, or under the chin. The useful question is not which machine to use — it is whether what you are looking at is fat at all.
- Under-Eye Hollows & ShadowsThe most common request here, and the one where the answer is most often no. Under-eye shadow has at least four causes and filler helps exactly one of them.