Benefits and Risks of Facelifts Without Surgery

Comparing the Thermage and Titan Procedures

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Of the new crop of skin tightening ​procedures, the two that are best known are the proprietary procedures Thermage and Titan. While these two treatments utilize different proprietary technology, the idea is essentially the same, in that they both aim to heat the deeper layer of the skin (the dermis) in order to stimulate collagen production.

The increased collagen production and remodeling of existing collagen results in improved skin contracture and this tighter skin.

Plastic surgeon consulting female patient
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Both Thermage and Titan treatments have been used with success on the face and areas of the body. Some of the most dramatic results have been seen in the area of the neck and jawline. However, these treatments have also shown promise in reducing the appearance of cellulite and tightening sagging skin on the abdomen, upper arms, butt, and thighs.

Unlike ablative lasers or chemical peels, there is no peeling of the top layer of skin. Therefore, the procedures are more suitable for people with darker skin tones because no pigmentation changes are involved. The cost is also considerably less than a facelift since there is no cutting is involved.

Skin-tightening procedures seem to work best in people with thin faces who don’t quite need or want a facelift. The procedure may have little or no discernible effect on those with loose skin, a lot of wrinkles, or excess facial fat.

Although many people do experience dramatic improvement after undergoing a Thermage or Titan procedure, there is no guarantee of a noticeable difference.


The basic difference between Thermage and Titan is the mechanism by which the dermis is heated. Thermage employs radiofrequency energy, while Titan uses infrared.

The field has burgeoned since 2007 and now there are technologies that use a variety of radiofrequency, ultrasound, and infrared devices. All of them have the mechanism of heating the dermis and subdermal areas while not damaging the epidermis.

Which technology is best for you will depend on the site being treated and individual factors. The good news is that a 2014 review published in the journal Dermatologic Clinics found them to be incredibly safe with minimal to no recovery times. Success rates vary by the appropriate use of the technology.

Costs run from $500 to $5,000, depending on the size of the area being treated. Thermage tends to be costlier, although one treatment is usually needed. Titan requires one to three treatments based on your specific needs and goals.

Possible Side Effects

Pain management is hardly an issue, as some of these procedures require the use of local anesthetic or over-the-counter painkillers, while some use nothing at all. All incorporate some sort of means of cooling the skin during the treatment.

For most people, there is no downtime, although a few may have excessive swelling, redness, or temporary skin blanching (whiteness) immediately following treatment. Complications such as bumps, blistering, permanent pigment changes, or skin depressions are rare. Extremely rare incidences of scarring or infection have been reported.

Keep in mind that these procedures are not meant to deliver the same results as a surgical facelift. You cannot expect to erase 15 to 20 years with non-invasive tissue tightening.

It is also important to remember is that results vary from person to person due to differences in skin thickness and texture, healing response, and lifestyle factors (such as smoking and sun exposure).

The Thermage and Titan procedures are probably best suited for younger people to stave off more invasive procedures or those for whom surgery is not an option.

Tips and Considerations

Operator technique is of paramount importance to obtain a good result with these procedures, so make sure to do your research regarding the experience and training of the person who will be performing your procedure. And don’t forget to get and check references.

While you may be offered these technologies, with rapid developments in this field there may be superior devices and methods available. Discuss your options with your clinic to help determine which is best for you.

Keep in mind that since dermal collagen remodeling takes place over time, you cannot expect to see the final result until up to six months following your final session. This means that people may be able to expect to see some immediate effects with improvements continuing for up to six months following the procedure.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Update on tissue tighteningJ Clin Aesthet Dermatol. 2010;3(5):36–41.

  2. Beasley KL, Weiss RA. Radiofrequency in cosmetic dermatology. Dermatol Clin. 2014;32(1):79-90. doi:10.1016/j.det.2013.09.010

Additional Reading
  • Beasley KL, Weiss RA. Radiofrequency in Cosmetic Dermatology. Dermatologic Clinics. 2014;32(1):79-90. doi:10.1016/j.det.2013.09.010.

  • Gold MH, ed. Update on Tissue TighteningThe Journal of Clinical and Aesthetic Dermatology. 2010;3(5):36-41.