Treatment Of The Week: The Jawline-Tightening Thermage FLX

For two years, I went on air at QVC®, representing a skincare brand that I personally use and truly believe in. One evening, before a “hit” (an on-air appearance), I was chatting with one of the network’s hosts, in awe of another brand’s product that had just sold out in record time. “That’s because it’s a firming cream,” he told me. “When we say the word ‘firming,’ the product flies out the door.” 

Until pretty recently, the need to firm just wasn’t on my radar. My religious regimen of sunscreen, retinol, and more products had kept my skin pretty darn perky, thank you very much. But around age 45, my skin started to head south. I noticed it most along my once razor-sharp jawline: there was a hint of a jowl, a wisp of a waddle. I added a little extra bronzer around the offending area and tried to ignore it.

EDITOR’S NOTE: Retinol shouldn’t be used by women who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.

Then last fall, in the backseat of a cab (or an UberTM, or, probably a Lyft®), I caught my reflection in the driver’s rear view mirror. I nearly keeled over (thank goodness I was wearing a seat belt). The lovely afternoon light streaming through the window cast a shadow across my face that made me look like I was wearing jowl enhancer. I told the driver that I was changing my destination: “Take me to Marmur Medical®, 87th and Fifth Avenue,” I demanded. Okay, fine, it didn’t happen quite like that. But I had just read that  Thermage®, leaders in tightening technology, had come out with a faster version called Thermage FLX®, and that one of my go-to dermatologists, Dr. Ellen Marmur, had the new machine in her office. I booked a consultation, post-haste.

EDITOR’S NOTE: As always, talk to your doctor before starting any new treatment, medication, or supplement.


“You have what I’d call ‘early jowls,’” Dr. Marmur told me, “and you’re a great candidate for Thermage FLX.” The device uses radiofrequency — not be confused with lasers, which use higher frequency light waves. “Thermage delivers heat to the skin,” explained Dr. Marmur. “But not to the top of the skin — below the skin’s surface — to the deep collagen-rich level called the dermis. And when we get the heat to a certain temperature, it causes heat-shock protein to be released from the collagen. This triggers a cascade of events to create more collagen and elasticity and contraction of the skin.”

She told me I could expect to see some results in the short-term thanks to initial collagen that can grow in just a few months. But the real improvement would take about six months to show, as the collagen matures and grows stronger and more robust. Marmur uses Thermage from “hairline to collarbone,” so I’d see results under my eyes, to my nasolabial folds, to the emerging waddle under my chin and, yes, to my baby jowls. Maybe minor redness, but little to no downtime. Let’s do this thing.


I’d love to tell you how the procedure went . . . but I can’t. The heat that Thermage creates can be uncomfortable for some, so some patients are given sedatives and painkillers before the procedure. Let’s just say my little cocktail had me deeply, deeply relaxed. I do have some vague recollections of my skin feeling hot while it was happening, and thinking, Are we done yet?, but it’s mostly a blur. Luckily, SpotlyteTM was filming parts of the treatment for social media. Here’s what the video reveals: 

  • I am full of naughty innuendo when under the influence.
  • I had a grid transferred onto my face, which served as a guide to where the tip of the Thermage handpiece should go.
  • I was covered in goo, ostensibly a cooling gel.
  • I must have requested a Band-Aid®, because one shows up on my upper lip mid-video.
  • I look sexy as hell in a surgical hairnet. 

EDITOR’S NOTE: As always, talk to your doctor before starting any new medication.

After the procedure, I waited, patiently, for the collagen to kick in. For someone who’s used to the faster gratification, six months of waiting felt like an eternity. I made it five before I showed up again in Dr. Marmur’s office, eager to see my before and after shots.


They were, in a word, stunning. My jawline was more defined, my waddle was smaller, my cheekbones more contoured, and my brow, lifted — like, five millimeters! But boy, am I glad that I saw the before and afters, because if you had asked me before I saw them if Thermage had made a difference, I would have said . . . maybe? It’s hard to see those tiny, incremental changes in the mirror every day. “It’s like trying to watch your hair grow,” says Marmur. “You don’t notice until it’s long.” 

Marmur recommends an annual Thermage treatment to maintain the tightening. “You can even do a half-treatment booster at the six-month point,” she says, and Thermage can be used all over your body. The mind spins at the tightening possibilities. “Come back around Thanksgiving,” Dr. Marmur says on her way out of the treatment room. “We’ll get that wattle just in time for Turkey Day.”

Dr. Ellen Marmur is a paid Allergan® consultant.

Complimentary treatment was provided to the author for the purpose of writing this article.