Thank you for your question
You submitted a question without a photo and you state in your question that you had a
Thermi procedure and you didn’t see a huge difference but you understand it takes 3 to
4 sessions to see a difference, but at the same time you became aware of course there
was a cost difference between Thermi and Pelleve and you want to know if these are same technologies
or what’s the difference.
I can certainly give you some guidance into this type of concern and question that people
have.
A little bit background, I’m Board-certified cosmetic surgeon, and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years and I have been part
of this continuous evolution of thermal energy devices for the past 20 plus years, beginning
with the original CO2 lasers back in the early to mid 90s.
So you raise a very very good question and it’s certainly actually brings into focus
a broader issue that I certainly have some opinion about.
So to begin with let’s understand what Thermi and Pelleve are.
They are both radiofrequency technology devices that induce a certain amount of heat to create
skin changes what is essentially collagen remodeling.
If you actually watch the procedures being demonstrated, they look exactly the same.
And essentially for all intents and purposes, they are the same.
From a scientific perspective they’re both handheld devices that apply energy to the
skin through radiofrequency technology to generate heat to a target temperature.
Because the science behind these devices is essentially is the same from the way the heat
is generated and the goal of the tissue response.
There’s basically a core concept that when skin is heated up to a certain level, there
is a response the generation something called heat shock proteins and a process of collagen
breakdown and remodeling that results in a favorable response such as the improvement
of fine lines and wrinkles.
Now the challenge is for the consumer is that unfortunately there is a real race between
companies to dominate and create brand awareness rather than educating the public about what
the science is and letting the physician be the person who actually guides you as to what
any of these particular devices can do.
From my perspective as a practicing doctor these devices are tools and the patient comes
to me with a particular problem and I don’t have to be locked in just to using one tool.
I can use a combination of approaches.
So in principle you are looking at essentially similar devices doing similar things.
When I look at someone who wants improvement of wrinkles let’s say the under eye area
I don’t just say ok there is only one device.
Essentially I will combine it with other modalities because typically there a lot of things that
can be improved at the same time.
I always say the whole is greater than the sum of its parts.
So it’s not unusual to have issues to have pigmentation, issues with the surface of the
skin, issues with volume loss.
So to solve those issues we also include a modality such use of PRP or platelet-rich
plasma.
Platelet-rich plasma is derived from your blood and is used to stimulate collagen and
create this remodeling of skin, without inducing heat.
And one of the things I should point out is although the skin can be heated to a certain
temperature the response of the skin is not consistent between people.
It’s like going to the gym, everyone goes to the gym and may do exactly the same workout
but everyone will develop a different degree of muscle growth.
The same thing with skin- multiple factors whether age, ethnicity, tissue type, just
too many factors to really articulate altogether when you don’t look at the whole global
picture.
The patient’s medical background, their sun exposure history, their smoking history,
there are a lot of things so a lot of times people get really disappointed when they see
a device on television promoted aggressively and it’s the next miracle and then they
go have these procedures and they don’t get results.
And a lot of times it’s because there’s basically a commoditization where in many
situations the physician actually isn’t involved in the planning of the whole procedure.
The patient comes to a spa of some kind and a non-physician does says okay this is the
device we use for that what kind of package would you like.
I look at things a little bit more globally.
I look at the patient as I said I would consider using platelet-rich plasma, I use possibly
a hyaluronic acid filler such as Restylane, to help with tear trough area or I maybe use
neurotoxin, like Botox® to help with fine lines and wrinkles and I put into perspective
for the patient the realistic potential benefits of these devices.
In our practice we have Pelleve and I should disclose that we have Pelleve we don’t have
Thermi at this time, we also have a 1064 YAG laser, Q switch laser, fractional CO2 laser,
Erbium laser we have a lot of technology, and so there is no limitation in providing
solutions for our patients and what we don’t do just jump on whatever is new and exciting
for that moment because I’ve seen a lot of hype for devices and really it’s more
about the devices and the manufacturer’s interest in selling and leasing those devices
to doctors and then within another year or so they are selling or leasing a different
version of device making the previous device obsolete.
So it creates this kind of tension between the patient the consumer and the physician.
But remember if the physician is the one most qualified to give you guidance and give you
a whole plan.
At least I feel that’s the role of physician and that’s what I do in my practice.
So even though there may be a price difference between the two devices coming from the different
potential of practitioners.
Get a good understanding as to what a good outcome you’re looking for and what is realistic
with either device and also understand what your other options are.
But as far as answering the question about the technology and the outcomes these devices
are as far as I am concerned, are pretty much the same.
And although manufacturers will always try to differentiate one from another in ways
that might be significant from a sales point of view, for a physician from a instrument
point of view as a tool I would say that it would be no difference for me which of these
radiofrequency devices I would use to accomplish a particular target heating goal to generate
collagen.
So I think you should actually before you continue doing more packages or looking at
more brands, either seek the attention of the physician you’re going to for this device
or this treatment or find a physician who can guide you and have a more global plan,
otherwise you’ll be like many people bouncing from one practitioner to another reacting
to these strong messaging for one miracle device to another.
So I hope that was helpful I wish you the best of luck and thank you for your question.