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Dr. Romano’s “Exquisite Care”
Medical Spa

Injectables and Fillers

Thermage -
Radiofrequency energy
non-invasive skin tightening.

Medical Grade Skin Care
Prescription Strength Skincare Products
Wrinkles & Loose Skin
Skin Textural Irregularities
Stretch Marks
Sensitive Skin

Anti - Aging-
Reversing  external and internal
consequences of age.

Skin Maintenance
Postoperative Skin Care


Thermage or Thermacool MRF is simply the best option for non-surgical skin tightening as documented in my practice and in numerous peer reviewed published scientific and clinical research studies. Be aware that there are other RF devices on the market that claim efficacy, but, being bipolar, cannot produce a uniform heating of the tissues that is anywhere near comparable to the Thermage monopolar unit.

The RF energy creates electrons that are moved through the skin tissue. As these electrons move the natural resistance of the tissues creates heat. This resistance creates heat that is related to the amount of current applied (amps) and the length of time. Here, not only does the depth of penetration play a role, but also the kind of tissue since fat, ligaments and skin all have different resistances and will heat up differently. So, the RF energy source in the handpiece measures the skin and resistances then delivers a precise “pulse” of current that travels through the skin then the patient then out of the body by a grounding pad. The mechanism of action is two-fold. First there is an immediately seen collagen contraction and skin tightening due to the tissue resistance and heating the fibrous ligaments (septa). Secondly, there is a delayed effect seen by the process of some wound healing and tightening that occurs to repair the heated and denatured collagen. Multiple passes of the current at lower energy levels elicits a significantly more substantial tissue tightening effect than a single pass at a higher energy level.

The non-ablative Thermage technology bypasses the surface skin and requires no incisions or recovery time, making it the ideal "pick-me-up" procedure for restoring a youthful appearance. Treatment takes an hour or less to perform in my office and you can immediately resume normal activities. The results are lasting but the natural aging process continues.

You can often see an immediate result otherwise it usually occurs over 3-6 months.

Best Uses for Thermage

  • Tighten the slightly loose facial skin where a facelift is not indicated
  • Tighten up the slightly loose facial skin after a facelift
  • Raise the eyebrows and tighten forehead
  • Tighten loose and wrinkled eyelid skin
  • Firm up loose skin on top of the hands
  • Tighten up the loose crêpe skin of the arms or above knees
  • Tighten up loose skin of abdomen especially around the belly button
  • Contour the abdomen for a narrower waist by 1-2 inches at times


Before and After Photos

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Dr. Romano in the Media
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Botox , Cellulite / Fat Reduction, Injectable Fillers,
Skin Peels / Facials, Microdermabrasion, Laser Hair Removal, Laser Skin Resurfacing Laser Vein Treatment

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Dr. James Romano, M.D.
San Francisco Plastic & Reconstructive Surgery
1650 Jackson St., Suite 101, San Francisco CA 94109