Thermage Around the Eyes: Questions and Answers

Yes. Thermage FLX has a small Eye Tip designed for the upper and lower eyelids and the skin around the eyes. In the United States, Thermage is cleared for non-invasive treatment of wrinkles, including those around the eyes and on the eyelids. Before the Eye Tip is used, numbing drops go into the eyes and protective shields are placed over the eyeballs. The larger face tips are not used over the eye itself.

It is a small single-use radiofrequency tip with a treatment surface of 0.25 cm², far smaller than the 3.0 and 4.0 cm² tips used on the face. Its size lets it follow the curves of the eyelids and the area around the eyes, and it delivers shallower heating suited to thin eyelid skin. Like other Thermage tips, it uses surface cooling with each pulse. It is planned and counted separately from the face tip.

Eyelid skin is among the thinnest skin on the body, and it sits directly over the eye and the delicate tissues around it. A large tip would not sit evenly on the curved lid, and deeper heating is not appropriate there. The smaller Eye Tip delivers shallower heat in small steps, allowing even coverage of thin skin. The difference in tip is one reason the eye area is planned as its own part of the treatment.

The heat makes existing collagen in the thin eyelid skin contract and starts a healing response that builds new collagen over the following months. The aim is skin that looks slightly firmer and smoother, with fine lines and crepey texture softened. It works only on the skin layer. It does not remove skin, move the brow, reduce fat bags or strengthen the muscle that opens the eyelid, which are separate causes of a tired look.

The principle is the same: monopolar radiofrequency heats the skin while the surface is cooled. The differences are the small Eye Tip, the shallower heating, the eye shields and numbing drops, and the energy settings chosen for very thin skin. The eye area is often treated in the same visit as the face, but it has its own plan and pulse count. Some people have only the eyes treated, and some only the face. Which suits you depends on where the thin, loose skin actually is.

The number varies with the size of the area, whether both upper and lower lids are included, and how loose or crepey the skin is. Eye Tip pulses are counted separately from face pulses, so an eye treatment is usually described with its own number. As with the face, the total says less than how the pulses are spread across the upper lids, lower lids and outer corners. Ask how your pulses will be distributed.

Most people feel a brief warm sensation with each pulse, followed by cooling, and the eyelid can feel more sensitive than the cheek. The numbing drops make the shields comfortable, and numbing cream on the skin is usually used too. Energy is adjusted from your feedback during the treatment. Some people find the pressure of the shields under the lids the strangest part, rather than the heat. The sensation stops as soon as the treatment ends, and most people describe the eye area as warm and slightly tight for a few hours.

The eye area itself usually takes a shorter time than a full face, often well under an hour, but numbing, placing the shields and removing them add time. When the eyes are treated in the same visit as the face, the whole appointment is longer. Plan for the whole visit, including a short rest after the shields are removed, rather than only the time spent with the tip on the skin.

The eyelid skin is thin, it moves with every blink and expression, and the tissues beneath it change in several ways with age. The orbicularis muscle, the membrane that holds back the eye socket fat, the fat itself, the brow above and the bone around the eye all change over time. A tired look can come from any of these. Only changes in the skin are within the reach of a skin-tightening treatment.

Yes. In the United States, Thermage is cleared for non-invasive treatment of wrinkles around the eyes, including the upper and lower eyelids. That clearance covers the use of the device with the proper tip and eye protection. It does not mean every eyelid concern will respond, because many are caused by excess skin, a dropped brow, fat bags or a weak eyelid-opening muscle, which a skin treatment does not correct.

Numbing drops are placed in the eyes, and then smooth plastic shields are placed over the eyeballs, under the eyelids. The shields protect the eye while the Eye Tip treats the eyelid skin above them. They are removed at the end of the eye treatment. The larger face tips are not used over the eye itself. This protection is a standard part of eyelid treatment with Thermage.

Most people find them strange rather than painful, especially because numbing drops are used first. You may feel pressure and an urge to blink while they are in place. Afterwards, the eyes can feel slightly gritty or watery for a short time. Tell the practitioner straight away if you feel sharp pain in the eye during or after the treatment, so it can be checked. Breathing slowly and keeping the face relaxed makes the time with the shields in place easier.

Yes. Contact lenses are removed before the numbing drops and shields are placed, and it is wise to bring glasses and a lens case. Many people wait until the next day before wearing lenses again, because the eyes may be slightly dry or irritated after the drops and shields. Follow the clinic's advice, and wait longer if your eyes feel uncomfortable. If you wear lenses for long hours, plan a day with glasses so you are not tempted to put them in early.

Tell the clinic in advance. The shields sit under the eyelids and the tip treats the lid skin near the lash line, so extensions and their glue can get in the way of even contact or be affected by the cooling spray. Some practitioners treat around them, and some ask for them to be removed. Planning the appointment and any lash appointments around each other avoids problems. If you have just had extensions applied, mention it when booking so the timing can be adjusted.

Yes. Eye makeup, mascara and eyeliner are removed so the skin is clean and the tip can sit evenly on the eyelid. Clean skin also lowers the chance of product getting into the eye when the shields are placed. Come without eye makeup if you can, and bring something to cover your eyes, such as sunglasses, for the trip home. Waterproof mascara in particular can leave residue along the lash line, so removing it carefully the night before or at the clinic saves time.

Serious eye injury is rare when proper shields are used and the Eye Tip is used correctly. Temporary irritation, dryness, watering or blurred vision from the drops can happen and usually settles quickly. The shields can occasionally irritate the surface of the eye. Any eye pain that persists, a red eye or a change in vision after treatment needs prompt review rather than waiting to see if it settles.

Tell the clinic about any eye surgery, including LASIK, lens surgery and cataract surgery, and when it was done. Recent eye surgery is generally a reason to wait until your eye doctor confirms full healing, because numbing drops and shields touch the surface of the eye. Older, fully healed laser vision correction is not usually a problem, but the decision is made case by case.

Often yes, but tell the clinic first. The numbing drops and shields can make dry eyes feel more irritated for a short time afterwards. Using your usual lubricating drops after treatment, as advised, may help. If your dry eye is severe, or you have another condition affecting the surface of the eye, the practitioner may suggest treating only the skin around the eyes and not the eyelids themselves.

Yes, both the upper and lower lids, and the skin at the outer corners, are often treated in one session with the Eye Tip. Whether both are included depends on where the crepey skin and fine lines are. Some people mainly need the upper lids, others the lower lids. The plan follows the concern rather than a fixed package, and it affects the number of pulses used.

Yes, and it often is. The face is treated with the larger tip and the eye area with the Eye Tip, each with its own pulse count. Treating both in one visit means one recovery period, which suits people visiting Seoul for a short time. Keep in mind that swelling around the eyes is usually more visible than on the rest of the face, so allow a day or two before any event.

Only for mild skin changes. When the eyelid skin is crepey or slightly loose, Thermage may be enough. When there is excess skin resting on the lashes, fat bags, or a drooping eyelid muscle, blepharoplasty or ptosis correction deals with the cause in a way radiofrequency cannot. As a plastic surgeon trained in facial surgery, Dr. Kim can tell which situation applies and will say so, though he does not perform surgery at Violacell.

Some signs point to surgery: upper lid skin that rests on the lashes or blocks your side vision, a lid edge that sits low over the pupil, raising your brows to see, or prominent fat bags under the eyes. These come from excess skin, the eyelid muscle or fat, not the quality of the skin. Thin, crepey skin with fine lines is the situation where Thermage is more likely to help. See Heavy upper eyelids: upper blepharoplasty or forehead lift?

Often yes, once healing is complete, but tell the clinic about the surgery and when it was done. Waiting until your surgeon confirms the eyelids have fully healed, often several months, is the usual approach. After surgery, Thermage may help the quality of the remaining eyelid skin, but it does not change the result of the surgery itself. Scar tissue and any changes in sensation are taken into account when planning energy.

It cannot stop the eyelid from aging, and it cannot prevent excess skin, fat bags or a weak eyelid muscle from developing. For someone with mild, crepey skin, it may improve the look of the skin enough that surgery is not on their mind for now. Whether that holds depends on how the brow, the eyelid and the surrounding tissues change over time, which differs from person to person.

Thermage uses the small Eye Tip on the eyelid skin itself, with eye shields, to firm thin skin and soften fine lines. Ulthera is cleared in the United States to lift the eyebrow and works deeper in the brow and forehead area, but it is not used over the eyelids. So Thermage addresses the skin of the lids, while Ulthera addresses brow position in mild cases. Some faces benefit from both, each on its own layer.

Yes. Muscle-relaxing injections soften lines caused by movement, such as crow's feet when smiling, while Thermage works on the quality and firmness of the skin. They address different causes and are often used together. They can be given at the same visit or on different days, depending on the clinic's preference and your schedule. Ask in which order they will be done, because injection points can affect contact with the tip.

It can, but timing and order matter. When injections are given on the same day, the device treatment is usually done first and the injections afterwards, so that the injected material is not heated or pressed by the tip. Injections under the eyes need care with depth and technique, and not every under-eye concern is suited to them. Tell the clinic about any filler or booster already placed near the eyes.

Tell the clinic what was injected, where and when. Studies in this area are small, but they have generally not found that radiofrequency at usual settings breaks down hyaluronic acid filler. Practitioners still take filler into account when planning energy near it, and some prefer to wait a few weeks after recent injections. If filler under the eyes has caused swelling or lumps, that is assessed before any device treatment.

Because the brow and the eyelid are easy to confuse. When the brow has dropped, it pushes skin down onto the lid, and treating only the eyelid skin, or removing eyelid skin, can leave the real cause untouched. Dr. Kim writes that lifting should start by looking at every layer to find the cause. Around the eyes, that means checking the brow, the eyelid skin, the eyelid muscle and the fat before choosing a treatment.