Thermage explained: what it does, who it suits, what it costs

What is Thermage, and what does it actually do?

Most people arrive at Thermage with the same two worries: will it do anything at all, and will it hurt. Both are fair. It is not a small amount of money, and the internet is full of reviews that say little more than "my skin felt tight afterwards".

I am Dr. Won Woo Choi, one of the chief directors at Wells in Apgujeong. I trained and completed my dermatology board certification at Seoul National University Hospital, and I have spent a long time trying to answer that first question with something better than a feeling.

Mechanically, Thermage FLX is a monopolar radiofrequency device. It delivers RF energy into the skin, that energy becomes heat in the dermis, and the heat stimulates the collagen you already have while prompting your skin to build more. That is the whole idea: tightening from within the dermis, with no incision.

What it is not is a facelift. Thermage works on skin quality and firmness, not on deep structural sagging — that belongs to ultrasound at the SMAS layer or to surgery. When someone asks me for a jawline that has genuinely dropped, I talk about Ultherapy Prime FIT as well, not Thermage alone.

Who is Thermage treatment for — and who should skip it?

At Wells, the Collagen Booster Thermage FLX and Thermage MAX protocols are aimed at loose skin on the cheeks, jawline and neck, at fine lines, and at a general loss of firmness. If you have had standard Thermage before and felt the result was inconsistent, that is also a reason to come in and talk.

• Skin that has softened rather than collapsed — early to moderate laxity
• Fine lines and a crepey texture on the cheeks
• A jawline that is blurring but has not yet fallen
• Anyone who wants firmness without incision or downtime

I would steer some people away. If the main problem is volume loss — hollow temples, a flattened upper face — heat alone will not restore structure, and Sculptra Lifting is the more honest answer. If the problem is a heavy lower face with fat under the chin, I would talk about InMode first.

What does the research say about Thermage FLX?

This is the part I care about most. We ran a joint study with CutisBio using skin microbiome analysis, because I wanted a measure of ageing that was not a photo or a satisfaction score. Skin ageing is not only wrinkles and sagging; it is also a weakened barrier, more frequent inflammation and a shifting microbial environment.

The study covered 480 patients, 16 men and 464 women, from their 30s to their 70s. Each had 3D photography and a skin microbiome sample on the day of treatment, then the same again 28 days later. A control group received standard Thermage FLX at an average of 42 kJ over the full face; the Thermage MAX group received high-intensity Thermage FLX with AQmax IV pre-treatment at an average of 54 kJ.

In a follow-up analysis published in the journal of the Korean Association of Dermatologists in February 2026, the high-intensity group also showed a statistically significant rise in Cutibacterium acnes — the organism that dominates healthy young skin — and the skin inflammation vulnerability index fell by about 62%. The low-intensity group showed none of this, which tells me treatment intensity is not a detail.

Microbiome-based age prediction carries an error margin of about 3.8 years, considerably tighter than oral or gut models, and an AI classification model separated ageing groups with about 96% accuracy. That is why I trust it more than a before-and-after impression.

How is Thermage done at Wells, step by step?

The visit starts with a consultation and 3D skin analysis. Before Thermage MAX, we also take a skin microbiome sample, so that when you come back a year later we can compare and see how fast your skin is actually ageing.

What happens during the session

Two bottles of AQ MAX (alanyl-glutamine) are infused before the RF energy goes in. The purpose is simple: protect the collagen-producing fibroblasts so they survive the heat of the pulses rather than dying and only partly recovering.

During treatment, a collagen-peptide serum is applied as the FLX handpiece works. It adjusts the skin's electrical conductivity so the sting is reduced, and its peptides penetrate to support collagen synthesis.

In lab tests, fibroblasts treated with AQ at 40 mM resisted cell death under 43 °C and 55 °C heat for five minutes, and Western blot analysis showed collagen synthesis held up after an hour at 43 °C — with the protective effect increasing as AQ concentration rose from 0 to 20 to 40 mM.

Bad Thermage side effects: what should I actually worry about?

Let me be direct. Every procedure can carry side effects, and they vary from person to person — that is why the decision should follow a full consultation, not a price list.

Thermage delivers heat. The risks people search for — burns, uneven results — trace back to how much energy is delivered, where, and by whom. This is a treatment where the hand on the handpiece matters as much as the machine.

Three things that reduce risk

• A board-certified dermatologist performs the treatment from consultation to last shot, not a nurse or an aesthetician.
• Genuine Thermage FLX tips only. If a tip is ever found not to be genuine, we refund ten times the treatment price.
• No sleep sedation. We use Air NOX, a controlled oxygen and nitrous-oxide mix, with local anesthetic.

That last point is not a comfort feature, it is a safety one. Awake, you can give feedback while energy is being delivered, and you can see the tip and the shot count yourself. Under sedation, neither is possible. You also need no fasting, recover in a minute or two and can drive afterwards.

Air NOX is not suitable in early pregnancy, in respiratory conditions, in panic disorder or with vitamin B12 deficiency — tell us at consultation and we plan around it.

How much does Thermage cost in Korea?

Here are our listed Thermage MAX prices. They are in Korean won and exclude 10% VAT, and the dermatologist confirms your plan and the final figure at consultation before anything starts.

Both options include the skin microbiome test, the two-bottle AQ MAX infusion and the collagen booster serum — that is what separates this from a plain shot count. For Collagen Booster Thermage FLX on its own, the price is confirmed at consultation.

Whether 600 or 900 shots fits you depends on the area being treated, and the dermatologist decides that in the room. I will not quote a shot count from a photo alone, though a photo is a very good place for the conversation to start.

On timing: with Collagen Booster Thermage FLX, effects appear from about two weeks and last six to fourteen months. So if you are flying in for it, plan the trip knowing the visible change arrives after you are home.

Thermage, Ultherapy or something else — how do I decide?

They are not competitors; they work at different depths. Thermage heats the dermis for firmness and skin quality. Ultherapy delivers focused ultrasound to the SMAS layer — the layer a surgical facelift tightens — for lifting from depth.

If your concern is texture, crepiness and a softening of the face, Thermage is the better first move. If the jawline has genuinely dropped, read our Ultherapy explainer and expect me to suggest ultrasound. For a brow and eyelid that have fallen, 3X Upper Face Lifting combines Eye Thermage, EMFACE and Eye Ultherapy in one visit.

Where the skin also needs texture and pore work, Genius RF uses microneedle RF to place energy precisely where collagen is made. Combinations are common; the order and timing are planned at consultation.

What a visit from abroad looks like

Message us on WhatsApp with your concern, a photo if you like, and your travel dates. You get a reply in English with which treatment fits and available times, before you book a flight.

We are on the 8th floor of the Apgujeong Building, 842 Nonhyeon-ro, Gangnam-gu — about five minutes on foot from Apgujeong Station, Line 3, Exit 3. Hours are Monday to Friday 10:00–20:00 and Saturday 10:00–17:00, with lunch 13:00–14:00; we are closed Sundays and Korean public holidays.

At the clinic a dermatologist examines your skin, runs the 3D analysis and the microbiome test where the protocol calls for it, and confirms the plan and the price. Treatment follows on the same floor, and you leave with written aftercare and a WhatsApp line you can use once you are home.

Results and recovery vary by individual. Every treatment carries possible side effects, which are explained at the consultation. Prices are in Korean won, VAT excluded, and confirmed at your consultation. This article is general information from the clinic, not a diagnosis.

Written by

Dr. Won Woo Choi

Chief Director · M.D., Ph.D. · Wells Clinic, Apgujeong

• Board-certified dermatologist, Seoul National University Hospital
• Residency & board certification in dermatology, Seoul National University Hospital
• Ph.D. in Dermatology, Seoul National University
• Former clinical instructor, Seoul National University Hospital
• Adjunct professor, Department of Dermatology, Seoul National University Hospital

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