Many changes occur to the skin as we age, wrinkles and frown lines and are some of the most noticeable signs of facial aging. We can target these changes by focusing on the muscles and nerves that can promote their formation. Many of the options available to reduce the development of frown lines and wrinkles involve injection of medicines like Botox/Dysport/Xeomin into the offending muscles. Relaxation of the muscles helps to reduce the formation of the animation lines and wrinkles. Although effective, the results of Botox/Dysport/Xeomin are short-lived. Patient’s typically require repeat treatments 3-4 times a year.
As we age, in addition to the characteristic changes seen in the skin, there are also characteristic changes which occur in the neck muscles. The changes seen in the appearance of the neck muscles also act as tell-tale signs of aging. With time, the connections of the platysma muscles in the neck can loosen producing what are called platysmal bands. These bands can be treated with Botox which relaxes the muscles but on a temporary basis. The bands are often also addressed in a neck or face lift with a procedure called a platysmaplasty.
See the difference in wrinkles and fine lines, before and after the treatment:
Luckily, a technique has been developed that can address the aging changes seen with years of facial and neck muscular contraction without surgery or repeated injections of Botox/Dysport/Xeomin. It is possible to very specifically locate the individual nerves that supply the muscles that produce the animation lines or platysmal bands. Once identified, a fine radiofrequency (RF) probe can be used to weaken the nerve with radiofrequency energy. The radiofrequency energy will halt activity in the nerve leading to relaxation of the targeted muscle. The procedure is very specific to the individual nerves and their target muscles and is designed to be permanent.
The procedure is called ThermiRase and we are the only practice in Iowa that provides the treatment.
How do we find which nerves to pinpoint?
During your ThermiRase procedure Dr. Andrews and his staff at Dr. Andrews Plastic Surgery in Cedar Rapids, will very specifically map the nerves to the target muscles. They will also map the nerves to muscles that are not to be treated so they are identified and protected.
Watch Dr. Andrews having his nerve mapped out when he had his treatment:
The treatment is performed in our office with local anesthetia. Patients can drive themselves to our office and drive themselves home if no oral sedatives are used. The patient is placed in a comfortable position on our procedure chair. The nerves are then mapped and marked on the skin, local anesthetic is injected and small access punctures are made. We then pass a small RF probe under the skin. The probe is also used to stimulate the nerves to again pinpoint their location. We then deliver more local anesthetic directly around the nerve. Radiofrequency energy is then used to heat and weaken the nerves. During the RF treatment, the nerve and tissue is heated. Dr. Andrews and his staff use a cold-air chiller device to cool the area during the treatment, increasing the patient’s comfort during the procedure. Periodically, the patient is asked to animate to test the progress of the treatment. We continue treating the nerve until there is no residual motion in the targeted muscle. One gratifying facet of the procedure is that the results are maximal at the end of the procedure, unlike Botox/Dysport/Xeomin where one must wait 3-4 days to determine whether the treatment was effective.
What areas can be treated?
Currently, we can treat the frown lines between the eyebrows, the so-called “elevens,” and the platysmal bands in the neck.
Is there downtime?
*After the procedure, there typically is not a significant amount of pain. There is actually often numbness in the treated area which is expected to improve with time. Bruising can be seen but is usually minimal. Swelling does occur. We have a protocol to address the swelling which includes: ice, head elevation, anti-inflammatories and arnica montana/bromelain. You can expect to have swelling in the areas treated for about 1-2 weeks.
How do I prepare for the procedure?
It is important that you stop all supplements and medicines that can increase the risk of bleeding including aspirin, Plavix, Xarelto, Eliquis, Coumadin/Warfarin, NSAID’s/anti-inflammatories and fish oil.
How much does the procedure cost?
The procedure costs between $2500-3000 depending on the area treated. We do have various financing options that we would be happy to discuss with you.
How long does the procedure take?
Most procedures take 1-2 hours to perform. The length of the procedure is influenced by a patient’s individual nerve anatomy and the response of the nerves to the RF energy.
How long will a ThermiRase treatment last?
Although results of the treatments can vary based on an individual’s particular anatomy, the treatment is intended to be permanent. If nerve activity is regained, a repeat treatment can be performed.
Why choose ThermiRase over Botox, Dysport, and Xeomin?
Botox, Dysport and Xeomin are highly effective for many patients. However, there are some patients who do not respond to “neurotoxins”- the so-called “non-responders.” ThermiRase is a great option for the neurotoxin non-responders. ThermiRase is also ideal for anyone who wants to avoid the inconvenience and cost associated with repeat Botox/Dysport/Xeomin treatments. ThermiRase is designed to be a permanent solution to frown lines and platysmal bands.