Taking a closer look at ThermiVa

May 05, 2017

Based on RealSelf Worth It ratings, ThermiVa’s track record with patients is impressive. At last glance, with 164 ratings during 24 months, 95% say the radio frequency nonsurgical vaginal tightening treatment is worth it.

The RealSelf “vaginal rejuvenation” category, under which ThermiVa (Thermi Aesthetics) resides, has grown 37% year over year, with 3.8 million visits to the RealSelf website in 2016. And the number of consults has skyrocketed 52% in the vaginal rejuvenation, according to RealSelf statistics.

ThermiVa’s inventor Red Alinsod, M.D., a uro-gynecologist who practices in Laguna Beach, Calif., and is medical director for women’s health for Thermi Aesthetics, coauthored a paper in 2016 in the Journal of Obstetrics and Gyneacology of India, suggesting ThermiVa is revolutionizing vulvovaginal rejuvenation and noninvasive management of female stress urinary incontinence.

“It seems that the time has come, when women shall ever be grateful to their gynecologist for management of [stress urinary incontinence] with ThermiVa without an incision,” the authors write.

Beverly Hills, Calif., dermatologic surgeon Jason Emer, M.D., says ThermiVa has been a winning addition to his practice, which offers a range of providers experienced in noninvasive and surgical vaginal rejuvenation options.

“My patients love it,” Dr. Emer says. “The women notice a cosmetic improvement immediately because the soft tissue gets heated up, it gets swollen and immediately you get collagen production. We actually show them with a mirror before treatment; then, immediately after treatment.”

Dr. Emer says he has received calls from grateful husbands who say ThermiVa treatment restored their wives’ vaginal moisture and sensitivity.

“Now we have a subscription service, where we do monthly treatments for women… to maintain outcomes,” Dr. Emer says.

Clinical Aesthetician Carla Williams, with the plastic surgery practice Vinings Surgery Center, in Atlanta, Ga., tells much the same story about her experience offering ThermiVa.

Patients love it, she says. So much, in fact, that she no longer offers laser treatments and chemical peels at the practice because all she has time to do is ThermiVa procedures.

“Truly, we have spent nearly no advertising dollars on ThermiVa,” she says. “A couple of great RealSelf reviews and word of mouth from happy patients has driven most of this to our office. It has been a great investment.”

Ms. Williams says her patients range in age from 21 to 89.

Twenty year olds are looking for more of a cosmetic benefit, while older patients are there to address a range of concerns, from vaginal laxity and sexual dysfunction to stress urinary incontinence and overactive bladder, she says.

Ms. William’s oldest patient, an 89-year-old, was getting up two to three times a night because of overactive bladder.

“After three treatments, she said she was only having to get up once,” she says. “We’ve also had patients come in that survived different types of cancer. They were suffering from severe vaginal dryness, but for their safety, their doctors refrained from prescribing them estrogen creams and hormones. They hadn’t had sex with their husbands, sometimes in years, because they were so dry down there. After these treatments, their natural moisture production was turned back on and sex became more comfortable for them. One of them called me and said, ‘I think you saved my marriage!’”

ThermiVa Treatment Tips

Dr. Emer says he hasn’t seen a downside to offering patients the treatment. It’s important, however, to rule out medical problems before patients, undergo ThermiVa, according to Dr. Emer.

“The biggest concern to me is that if someone has a true medical condition that needs surgery — whether it be labiaplasty or internally there are issues with the cervix or the uterus — then, I feel the uro-gynecologist or somebody that specializes in the canal area really should be addressing it,” he says.

Ms. Williams says the practice’s plastic surgeon, Robert A. Colgrove, Jr., M.D., performs an exam on patients prior to their first ThermiVa treatment to make sure there isn’t evidence of infection or other issues. Ms. Williams gives each patient a pregnancy test, to make sure they’re not pregnant, and says it’s important to make sure patients are up to date on their gynecological exams and are cleared to have the radio frequency treatment.

ThermiVa treatment, which RealSelf has listed at an average price of $2,650, requires time and attention, according to Ms. Williams.

“In our office, I’m the person that handles everything from A to Z regarding this treatment. If people call the office and ask for more information, I ask the receptionist to let me talk with them directly. I answer all their questions on the phone…. They’re comfortable with me because I’m a woman, and because I’m able to give them personalized attention helping them to feel more at ease,” she says.

The first appointment, according to Ms. Williams, generally takes an hour. That includes the exam with the doctor, some time for her to get acquainted with the patients, to detail the procedure, as well as a discussion of what’s next. Subsequent appointments take about 45 minutes, she says.

“I like to schedule their first three treatments approximately four to six weeks apart. If it’s their third treatment, I’m explaining to them what they can expect over the next couple of months with collagen regeneration and when they would need to come back for a touchup. …with Thermi, the touchups are based on each individual. Some people come back in six months. Some of my patients come back in a year. Although it’s typically not necessary, some of them like to come in every three or four months because they love the results,” she says.

Ms. Williams says she has not experienced any patient complications from treatment. Office in-services for Thermi devices review the important aspects to avoiding complications, she says.

“It’s important to keep the temperature at a consistent, therapeutic level but, first and foremost, to be aware of the patient’s comfort at all times. While doing the treatment, I’m constantly checking in with the patient by asking how she’s feeling. It helps her relax knowing I’m dedicated to her comfort,” she says.

The GYN’s Perspective

Dr. GoodmanGynecologist and female genital plastic and cosmetic surgeon Michael Goodman, M.D., has done it all when it comes to vaginal rejuvenation. Dr. Goodman says he has done 700 labiaplasties; 150 vaginal tightening aesthetic operations and utilized fractional CO2 laser and radiofrequency.

“I have answered more than 1600 questions on RealSelf, and am the editor of the definitive genital plastic textbook, Female Genital Plastic and Cosmetic Surgery (Wiley Blackwell),” Dr. Goodman says.

According to Dr. Goodman, when it comes to turning to ThermiVa and other noninvasive devices for vaginal rejuvenation, buyer beware. Inspired by dubious statistics, anecdotal propaganda and scant true science, patients are spending thousands on procedures like ThermiVa, he says.

“While both fractional CO2 lasers (FemiLift [Alma Lasers], Mona Lisa Touch [Cynosure] and new-to-market ‘me-too’ copies) and radio frequency units, such as ThermiVa and Ellman Surgitron/Pelleve [now Cynosure], have excellent and elegant specific uses in gynecology, their use as a first line ‘vaginal tightening’ modality is substandard,” he says. “Yes, both fractional CO2 lasers…, as well as RF can ‘recondition’ both outside skin and inside vaginal mucosa by increasing elastin and collagen fibers. But the only verified usage of these costly therapies is for improving atrophic vaginal changes in postmenopausal women, and the only persons trained to use, and decide who to treat are gynecologists and uro-gynecologists.”

There is also an abundance of information that these modalities might be an excellent short-term treatment for mild urinary incontinence, he says. But ThermiVa takes three separate treatments a month apart and lasts only one year, and ThermiVa does not significantly tighten the vagina to help with friction after childbirths, “bulk up” a “saggy” opening, or in any way improve the appearance of the vaginal opening, according to Dr. Goodman.

“I am beginning to see many women who have been bilked out of thousands of dollars to have ‘vaginal rejuvenation,’ thinking wrongly that it would help change the appearance of their vaginal opening and produce more friction for lovemaking,” he says.

Women, he says, are spending thousands — usually in the neighborhood of $2,500 to $3,700 for initial therapy and about $2,000 annually for maintenance therapy — when they could have had definitive surgery, usually costing about $6,500 to $8,000, from a gynecologist or uro-gynecologist, who has been specially trained in female genital plastic and cosmetic surgery, according to Dr. Goodman.

Disclosures:

Dr. Emer has ties with Thermi, Eclipse, Aerolase and BTL Aesthetics.

Dr. Colgrove, for whom Carla Williams works, is a shareholder in Thermi Aesthetics.

Dr. Goodman conducts training courses for surgeons through the Labiaplasty and Vaginoplasty Training Institute of America in the skills of female genital plastic and cosmetic surgery.