Between 2 to 6. The results are gradual & patients require several treatments to achieve desired results. Skin will look & feel tighter after every session. Once we achieve the rejuvenation you’ve been looking for, you’ll be able to maintain results with occasional touch-up sessions.

* 2 sessions following treatments such as laser resurfacing, collagen stimulating dermal fillers & PDO threads. 

**6 sessions as the company guideline for stand alone treatments.

Skin tightening should be performed on all levels of the skin. NuEra treats the deep dermis & SMAS layer which covers the facial muscles. Dermal fillers treat the level above radiofrequency, whilst lasers & deep peels address more superficial skin.

Immediate. Unlike lasers & peels with downtimes ranging from 1-10 days, the NuEra RF recovery is immediate. RF energy is focused to the deeper areas of the skin, by passing the upper layers, 

This is my theory on what I call momentum neocollagenesis, which means treating all areas of skin, the fibrous network of fat underlying skin, & the SMAS layer then envelops facial & neck muscles. Momentum is then built around these layers using specific techniques that are modified according to the patient’s skin type, quality, age, expectations, & budgets.

I did run Thermage for many years & here is my take on things. Thermage is like a microwave turned on high heat  for one minute, whilst NuEra is like the same microwave turned on low heat for 2 minutes. 

I got rid of my Thermage device several years ago as the response rate of this device is around 30%. Considering patients are out of pocket $3,000-4,000, it’s an expensive procedure to have, with little gain.

I prefer NuEra over HIFU (High Intensity Focused Ultrasound – Ultherapy- Ultraformer) in the majority of cases. This is why-

NuEra provides long-tail heating of collagen & the fibroseptal network (fat fibers). For patients with less facial fat, NuEra is safer & works better. In contrast, HIFU is useful for patients with a ‘higher content’ of facial & neck fat. In this scenario, HIFU can provide slimming through collateral inflammation of fat & contraction of the fat network. 

For patients with background solar damage, both HIFU & NuEra will more than likely not work. This is because collagen is broken. Lasers & deep peels can repair broken collagen – solar elastosis. 

RFM or radiofrequency microneedling is used on the lower ⅓ of the face & under the neck, usually at the same time as I perform liposuction. RFM is most useful to treat focal areas of skin laxity. For larger areas, I prefer NuEra. Think of RFM as high heat over a very short period of time.

I have been running Tempsure for many years. This is my take on things. NuEra gives more powerful immediate tightening of tissue. It takes half the time to perform as Tempure, hence if required more passes can be achieved with NuEra compared to Tempsure. 

If your skin quality is poor, your collagen & elastin is fragmented & will not contract. This is termed elastosis & is due to sun-exposure & smoking. For extensive sun damage, dermal heating devices such as RF & HIFU will not work. Lasers are indicated to stimulate & remodel collagen.

Fillers can either add volume (Hyaluronic acid fillers like Juvederm, Restylane, Boletero), or stimulate your own immune system to produce collagen. These include PLLA (Sculptra), calcium hydroxyapatite (Radiesse) or newer hybrid fillers like Profhilo. 

Collagen stimulating fillers require more treatments & more time to get the best results. Treatment intervals are 4-6 weeks apart. This is where NuEra comes in. By having RF at 4-8 week intervals, it provides momentum neocollagenesis– meaning collagen synthesis is more than the sum of the parts.

We want sustained collagen remodeling; much like how trains rely on momentum. A single push (whether it be laser, fillers, RF, HIFU) is helpful, but it is the continued small pushes after the main event that increases collagen & provides skin tightening.  Timing is everything. It looks something like this-

• First treatment; lasers, or deep peels or even collagen stimulating fillers.
• Second treatment; 4-6 weeks later; NuEra
• Third session; 4-6 week later; NuEra
• Fourth sessions; 4-6 weeks later; NuEra or option for Profhilo

I don’t perform threads, unless it is followed up by NuEra. PDO threads are placed in the hypodermis or subcutaneous layer. They represent one layer of skin tightening. Used as monotherapy (ie. by itself), the results from PDOs are marginal. 

NuEra provides the heating to both the hypodermis & the layer deeper. With sustained global heating, radiofrequency devices such as NuEra compounds the collagen stimulating ability of treads (momentum neocollagenesis).

No. Our group did a paper & published it in a leading journal showing the stability of dermal fillers. Here is the reasoning; dermal fillers (HA) are made with bacteria fermentation. They are sterilized at around 110 degrees for > 3 minutes. RF produces 67 to 69 degrees of heating for around 0.3 to 1 second. FIllers are hence stable.

Contraindications are divided into absolute & relative contraindications.

• Absolute: includes pregnancy, & metal implants.
• Relative: Moderate to severe skin laxity, unrealistic expectations, patients with severe photoaging.

Yes. Radiofrequency energy is skin color blind. In fact, skin tightening procedures work better on darker skin types. This is due to the heightened sensitivity of collagen producing cells located in the dermis.

Radiofrequency is a safe & effective treatment that can trigger natural responses in the skin to revitalize and renew the internal structure. If during the consultation your general health and medical history indicates that this treatment may not be suitable for you, then it will not be recommended. To date it remains as one of the safest and most effective anti-aging treatments on the market.

When performed with skill and precision, radiofrequency does not cause fat loss. In order of devices which have the potential to cause fat loss, it goes something like this-

• HIFU or Ultherapy, especially multi-stacking in patients with low facial fat.
• RFM using more than 2 pulses in one area (same depth, high energy, insulated)
• RF using high heat; example: Thermage

Yes. Unlike lasers or chemical peels, radiofrequency energy does not cause tissue swelling hence injectables such as Botox or dermal fillers can be performed after NuEra.

There are no serious side effects. NuEra uses low temperature heating, hence side effects such as thermal burns (eg. lasers, Thermage) are not seen. Additionally fat loss (Ultherapy – Ultraformer) is not seen with NuEra. As RF is color blind, skin color changes seen in deep peels & lasers are not seen with NuEra.

Cold sore virus activation with procedures such as dermal fillers, lasers, & peels are not encountered with radiofrequency treatment.

Nope. NuEra produces low heat to the dermal layers of skin, bypassing the epidermis where pigment cells live. Unlike peels or lasers you will not be more sun sensitive after NuEra.

Because NuEra causes changes deep within the structure of the skin, namely to stimulate & contract collagen, optimal results will take time. However, they also won’t diminish quickly either. Increased collagen production in the skin will mean smoother, tighter skin for months or even years to come. You can also schedule annual maintenance treatments to sustain your new collagen & keep you looking its best.

Yes. This treatment fully integrates with your skincare. As NuEra does not compromise your skin barrier, you can go back to your normal skincare routine immediately. A suggest skin care routine goes something like this-

• AM: Vitamin C, tocopherol, ferulic acid + sunscreen
• PM: Retinol or retinoid

Unlikely as it uses low heating sustained for 20-40 minutes. In this patient group transient redness can be seen, often lasting a few hours. If you have rosacea, you may also benefit from vascular lasers. 

Many people can safely have a skin-tightening procedure. You’re likely to get the best results if you:

• Are at a healthy weight and 
• Maintain your weight +/-5%
• Don’t smoke
• Eat a healthy diet
• Protect your skin from the sun 
• Have a small amount of sagging skin

A skin-tightening procedure isn’t right for anyone who is pregnant, has a skin infection, or takes certain medications. If you think devices can replace a deep plane facelift, non-surgical skin tightening is not for you.

NuEra is also useful for treating skin laxity on the chest, neck & limbs. Again patient selection is critical for the best results. 

RF can also be used to treat cellulite. It works best on wavy cellulite (buttocks, inner thighs) or as a combination with subcision & dermal stimulatory fillers.

This is uncharted territory as I have only started playing with microcurrent devices for home use in 2022. In theory a combination of RF in the clinic, followed by microcurrent should increase contractile properties of collagen. Watch this space.