Achieving optimal results with thermage using mesoanesthesia and revised treatment parameters.

The author describes how he improves comfort in patients receiving Thermage with a combination of topical lidocaine 5% cream and mesoanesthesia, a technique involving multiple tiny intradermal injections of anesthetic solution. Although it relieves pain, mesoanesthesia allows adequate subcutaneous and deep sensation for patients to recognize overly-high treatment levels, thus diminishing the chance of skin burns or fat necrosis. Optimal parameters, based on the author's experience, for treating the face, neck, eyelids and abdomen are reviewed.