Thermage works by delivering heat energy through a handpiece to the deeper parts of the skin (dermis). This handpiece also has a cooling spray that protects the superficial part of the skin (epidermis) from injury. The heat energy causes the deeper tissues to contract to decrease the appearance of lines. Eventually new collagen develops and remodels to give an even firmer appearance to the skin. This technique is non-ablative in that it does not cause damage to the surface of the skin.

Therefore, there is very little down time. Treatments can take up to a couple of hours, depending upon the size of the treatment area. Patients can return to work the same day, unlike a facelift in which patients usually take at least 2 weeks to recover. Similarly, there is no scar unlike the surgical facelift procedure. Effects of this procedure can last from 6 months up to 2 years.