Thermage (Thermage FLX)
Korean: 써마지 FLX (Sseomaji FLX) · Medical name: Monopolar Capacitively Coupled Radiofrequency · Category: Energy-Based · Last reviewed: 2026-05-01
The longest-running commercial RF skin-tightening platform, in clinical use since 2002. Thermage FLX is the current fourth-generation device. Korean consumers describe 써마지 alongside 울쎄라 as the two dominant pillars of non-surgical lifting.
What it is
Thermage FLX is manufactured by Solta Medical, a division of Bausch Health Companies. The device first reached commercial use in 2002 and the FLX is its fourth-generation iteration. The system consists of a generator producing 6 MHz alternating current, a cryogen cooling unit, and a vibrating handpiece with a disposable Total Tip 4.0 cm².
It is the only non-invasive RF device FDA-cleared for treatment of wrinkles on both the upper and lower eyelids in addition to the face, body, and periorbital region. By 2025 Solta Medical announced surpassing 5 million Thermage treatment tips used globally.
How it works
The 6 MHz alternating current creates a monopolar circuit from the treatment tip through the patient's tissue to a grounding pad. The capacitive coupling design distributes energy across the entire tip surface area, creating volumetric heating through resistance of charged tissue particles to the oscillating electric field.
The AccuREP algorithm in the FLX generation automatically measures and adjusts energy delivery in real time based on tissue impedance readings. The Total Tip 4.0 incorporates pre-cooling, parallel cooling, and post-cooling via digitally pulsed cryogen spray on the skin-contacting surface. This maintains the epidermis at approximately 40 degrees Celsius while the deeper collagen-rich dermis (4.3 mm penetration depth) reaches the collagen contraction threshold of 60 to 65 degrees Celsius.
Thermal effects include immediate collagen fibril contraction and subsequent neocollagenesis, with measurable increases in type I and III collagen density at 3 to 6 months post-treatment.
Origin and development
Thermage, Inc. commercialized the world's first monopolar capacitively coupled RF aesthetic device (ThermaCool TC), which received FDA clearance for periorbital wrinkles in 2002. Solta Medical acquired the technology and developed subsequent generations. Thermage FLX received FDA 510(k) clearance on October 4, 2017. Key improvements at FLX included AccuREP automatic impedance tuning, a vibrating handpiece, and the Total Tip 4.0 cm² (25 percent faster treatment than the prior CPT generation).
Thermage has been available in Korea since the early-to-mid 2000s and is among the top global markets by treatment volume. The device holds MFDS 의료기기 registration through Solta Medical Korea. As with Ultherapy, Korean practitioners and consumers are attentive to "정품 인증" (authentic product certification) because counterfeit Thermage tips exist in the Korean market.
Regulatory status
| Jurisdiction | Status | Notes |
|---|---|---|
| Korea (MFDS) | Approved as 의료기기 | MFDS registration held by Solta Medical Korea. Thermage FLX registered for clinical use in dermatology |
| United States (FDA) | Multiple 510(k) clearances; FLX cleared October 4, 2017 | Non-invasive treatment of wrinkles (face, periorbital including upper and lower eyelids, body); temporary improvement in cellulite appearance. Class II, Product Code GEN. Thermage is the only FDA-cleared non-invasive device for upper and lower eyelid wrinkles |
| European Union (CE) | CE-marked | Total Tip 4.0 bears CE mark. Marketed throughout the EU |
Typical protocol
- Frequency: single session; maintenance typically every 12 months
- Korean shot count packaging (샷수): 300 shots (partial); 600 shots (full-face, most common); 900 shots (full face plus neck)
- Session duration: 30 to 40 minutes active treatment; approximately 90 to 120 minutes total including anesthesia and post-treatment care
- Anesthesia: topical lidocaine 4 to 5 percent applied 30 to 45 minutes prior. Some Korean clinics offer IV analgesic supplementation (통증수액) or sedation (수면 써마지) given the treatment's reputation for discomfort
- Downtime: transient erythema lasting 3 to 4 hours; mild soreness for 3 to 5 days
- Onset of effect: immediate partial contraction; progressive remodeling peaks at 3 to 6 months, lasting up to 12 months
Commonly reported effects
Intended effects are collagen contraction and remodeling, reduction in facial rhytids, and lifting and firming of jowls, neck, periorbital skin, and body skin. A Journal of Cosmetic Dermatology histometric analysis (Hwang et al., 2020) demonstrated measurable increases in collagen fiber density (type I and III) at six months post-treatment.
When excessive energy is applied to anatomical zones with thin subcutaneous fat (temples, jawline), heat can transfer to the fat layer, causing adipocyte apoptosis or liquefaction and resulting in permanent focal depressions. This is an overtreatment phenomenon correlated with operator technique and energy settings rather than an inherent device risk. Surface burns have been documented when excessive energy is applied. Following a published analysis of overtreatment effects, Thermage issued updated treatment guidelines that reduced subsequent adverse event incidence.
Korea vs US availability
Per 모두닥 (Modoodoc) 2026, 300-shot Thermage FLX at a Gangnam clinic is approximately ₩759,000 at event pricing. 900-shot ranges from approximately ₩983,000 to ₩2,750,000. A 2025 Mirae Asset Securities digital health report cited Thermage 600-shot pricing in Korea at approximately ₩2,700,000 versus approximately ₩4,000,000 equivalent in the United States.
US Thermage averages approximately $3,096 per session per RealSelf user data (186 reviews). Korean pricing for 600-shot full-face Thermage FLX is approximately 50 to 70 percent of US equivalent pricing.
What to research before
- Verify tip authenticity (정품 인증). Counterfeit Thermage tips are a documented problem in the Korean market. Ask to see the original packaging at the appointment.
- Confirm shot count up front. Pricing scales with shot count. A 300-shot session is materially different from a 600- or 900-shot session.
- Anesthesia decision. Thermage is more painful than Ultherapy. Korean clinics commonly offer IV analgesic supplementation (통증수액) or sedation (수면 써마지). Decide on pain-management approach before booking.
- Avoid over-treatment of thin-fat areas. Operator skill matters most around the temples and jawline, where thin subcutaneous fat creates risk of focal depressions. Our credential verification guide covers KSPRS and dermatology specialty registries.
- See also: our Korean Surgery Safety Guide.
Related procedures
- Ultherapy — HIFU alternative; different mechanism (focused ultrasound vs RF), commonly compared
- Shurink (Ultraformer MPT) — Korean HIFU alternative
- RF microneedling — needle-based RF energy delivery, complementary mechanism
- Thread lifts — mechanical lifting alternative
Sources
- Plastic Surgery Key. Radiofrequency: Thermage. https://plasticsurgerykey.com/radiofrequency-thermage-2/
- Bausch Health Companies. Solta Medical Receives FDA 510(k) Clearance for Thermage FLX System. October 4, 2017. https://ir.bauschhealth.com/news-releases/archive/2017/10-04-2017-130209501
- Bausch Health. Solta Medical Surpasses Milestone of 5 Million Treatments with Thermage. September 5, 2025. https://ir.bauschhealth.com/news-releases/2025/09-05-2025
- Hwang SH et al. Monopolar radiofrequency treatment for facial laxity: Histometric analysis. J Cosmet Dermatol. 2020;19(9):2349–2355. https://pubmed.ncbi.nlm.nih.gov/32319176/
- Moreira A et al. A Systematic Review of Subsurface Radiofrequency Treatments. Ann Plast Surg. 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9415206/
- 모두닥 (Modoodoc). 써마지 가격정보 2026. https://www.modoodoc.com/blog/price-detail
- 미래에셋증권 (Mirae Asset Securities) digital health industry report. 2025. https://files-scs.pstatic.net/2025/07/28/nH2ptsFDa7/
- 네이버 블로그 (Naver Blog), consumer account referencing 강남언니/바비톡 platform data. November 2024. https://blog.naver.com/ksherbet/223672579644