Thermage: Body Procedure

Thermage: Body Procedure
Tip Selection
THERMAGE BODY TIP 16.0
Thermage CPT System: TT16.00E2
Most common treatment range: 483.0 to 485.0
Thermage NXT System: TT16.00E2
Most common treatment range: 482.0 to 484.0
AREA TREATED
Small torso
Under bra areas
Just above knees
Average torso
Thighs
Arms
Large torso
“Love-handles”
Buttocks, Larger thighs
GRID PAPER
1 Body 16.0
marking paper
1-2 Body 16.0
marking paper
2-3 Body 16.0
marking paper
FULL PASSES
2 passes
2 passes
2-3 passes
VECTOR PASSES
1-2 vectors
1-2 problem areas
2-3 vectors
2-3 problem areas
Multiple vectors
Multiple problem areas
REPs SUGGESTED
175-250 REPs
250-325 REPs
325 or more REPs
PROCEDURE TIME
30-40 minutes
40-50 minutes
50-60+ minutes
NUMBER
OF PASSES
REP
COUNTS
1
50
2
100
3
150
4
200
*Using 16.0 skin marking paper
Thermage CPT & NXT
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Tip Selection
THERMAGE BODY TIP 3.0
Thermage CPT System: TT3.00E4
Most common treatment range: 2.5 to 4.0
Thermage NXT & TC3 Systems: TT3.00E2
Most common treatment range: 381.5 to 383.0
AREA TREATED
Small torso
Under bra areas
Just above knees
Average torso
Thighs
Arms
Large torso
“Love-handles”
Buttocks, Larger thighs
GRID PAPER
1 large or 2 small
marking papers
1-2 large or 2-4 small
marking papers
2-3 large or 4-6 small
marking papers
FULL PASSES
2 passes
2 passes
VECTOR PASSES
1-2 vectors
1-2 problem areas
REPs SUGGESTED
PROCEDURE TIME
NUMBER
OF PASSES
REP
COUNTS
1
238
2
476
2-3 passes
3
714
2-3 vectors
2-3 problem areas
Multiple vectors
Multiple problem areas
4
952
600-900 REPs
900-1200 REPs
1200 or more REPs
45-60 minutes
60-75 minutes
75-120+ minutes
*Using large skin marking paper
Thermage CPT
Thermage NXT & TC3
TT3.00E2
Treatment Levels
Estimated J/cm2
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For body shape procedures
380.5 381.0 381.5 382.0 382.5 383.0 383.5 384.0 384.5 385.0 385.5 386.0 386.5 387.0 387.5
9
12
15
20
27
32
38
44
50
56
61
67
73
79
85
Procedure Preparation
Supply List
Lighting/Photo Set-up
U 70% Isopropyl Alcohol
U Gauze
U Gloves
Umbrella Light
Stand (2)
U Skin marking paper (large and small sizes)
Black
Background
U Skin marking pen
U Coupling fluid
U Return pad
U Thermage Body Tip
At belly-button and level
U Cryogen canister
Light stands slightly
in front of patient
Return Pad Placement
Abdomen and Buttocks
U Place return pad horizontally on either side of the upper back
U Return pad cable connection pointing away from the center of the
body and cable pointing away from the treatment area
Lights
U Use a black background
U Diffused with soft box or umbrella
U Equidistant from subject
U Equally bright
U Umbrellas nearly vertical so light rakes off surface and
reveals skin texture
U Tilted down
Legs and Arms
Camera
U Place return pad horizontally on either side of the lower back
U Mounted on tripod
U Return pad cable connection pointing away from the center of the
body and cable pointing away from the treatment area
U Vertical position
U Level with patient treatment area
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Photography Recommendations & Pointers
Patient
45 degrees - Left and Right sides
U Avoid wearing clothing that causes skin marks or indentations around
the abdomen the day of procedure
U Hips and shoulders aligned with feet
U Arms behind back and relaxed
Example of clothing that
will show indentations
U Remove pants or pull low enough to not distort treatment area
U Wear disposable underwear
Photo Positions
U Take pictures in five different positions
U Camera level with umbilicus
90 degrees - Left and Right sides
Full front
U Hips and shoulders aligned with feet
U Hips and shoulders aligned with feet
U Arms behind back and relaxed
U Arms hanging down about 1 foot away from side of body
U Focus camera on belly button for abdomen procedure
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Procedure Guidelines
Step 1 Pre-treatment assessment and planning
U Ask patient to identify areas of concern and treatment goals
U Mark problem areas by drawing circles
U Perform assessment while patient is standing
U Mark vectors (linear patterns) for multiple passes for incremental
tightening and lifting
U Record patient weight and circumferential measurements
- Measure at the level of the umbilicus
U Identify areas of treatment for optimal tightening and lifting
- Pinch and palpate skin/tissue for mobility, firmness, thickness
and proclivity
- Determine direction of desired contraction and tightening
Buttocks
Arms
Knees & Legs
Inner Thighs
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Procedure Guidelines
Step 2 Use moderate treatment levels
U Apply grid to area being treated
U Treat to a level 2.0-2.5 feedback “Hot, but tolerable”
- Adjust treatment levels according to patient feedback
- Thermage CPT: To determine patient’s heat tolerance, deliver
5-10 pulses without vibration
U Monitor tissue during treatment for erythema (excessive redness)
and/or edema (swelling)
U Common areas of patient sensitivity
- Rib cage area epigastrium
- Directly above the pubis area
- Adjacent to the umbilicus
- Sides of the abdomen
- Under arm
- Inner thigh
Sensitive
SensitiveAreas
Areas
U To help with discomfort pull tissue away from bony prominence or
palpate tissue as shown below:
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Procedure Guidelines
Step 3 Deliver passes to entire treatment area
Body Tip 16.0
Handpiece Technique
U Keep the treatment tip perpendicular to the skin ensuring full
tip-to-skin contact
U Use enough downward pressure to maintain full contact, but not so
much as to impede vibration (with Body Tip 3.0)
U Pre-position skin when placing pulses by pulling in the direction of
desired contraction
Tune Treatment Tip
U Use proper handpiece technique
U Use a generous amount of coupling fluid
U Tune in fleshy area, avoiding bony prominences
Coupling Fluid
U Regularly apply generous amounts of coupling fluid
1st row
2nd row
Other Considerations
U Tissue should be warm but not hot to the touch with each pass
U Treat inferior to superior
U Treat medial to lateral
U Abdomen procedures – treat 1-2 squares above the treatment area
(when using the Body Tip 3.0)
U Use approximately one 60 mL bottle for a 900 pulse treatment
Vibration with Thermage CPT (Body Tip 3.0)
Step 4 Treat vectors and problem areas
U Select the level of vibration that is most comfortable for the patient
U Usually a minimum of 4-6 passes over these areas
U Start with setting 1, then monitor patient feedback regarding vibration
intensity and adjust accordingly
U Treat 1-2 rows above the vector or problem area
U In thin skin areas, a lower vibration setting may be preferred by the patient
U For abdomen treatments: If no problem areas are evident after completing
the vector treatment, return to provide additional passes to the upper
half of the abdomen
Choose Treatment Technique (see Basics section)
U Two single passes over the entire grid of squares, and circles
U One Super pass: combined pass of circles and squares alternating rows
U One Staggered pass: combined pass of circles and squares, staggered
- Not suitable for treatment with Thermage CPT or the Body Tip 16.0
U Repeat chosen technique 2-3 times
U During the treatment, inspect the treatment tip for irregularities on
the tip surface, every 50 pulses
U Use medical judgement with the Body Tip 16.0
Step 5 Treat to visible and/or palpable clinical endpoint
U Visual tightening, firming, smoothing and contouring of treated areas
U Palpable change
U Utilize half-time assessment to identify clinical endpoint
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