In 2013, Dr. Shelton was one of the very first physicians in New York City to start offering his patients, ThermiTight, to help produce facial, neck and body tightening and lifting without performing surgery. Patients are awake and the procedure may only take 45 minutes to slightly more than an hour to treat the face and neck, with local anesthetic injected, and without sedation.

Many years ago, there had been a great interest in non-invasive procedures that could help tighten and lift sagging faces and necks. Dr. Shelton had been performing liposuction and achieved very good results with improving lower faces and necks but it did a great job reducing fat and the skin would retract but sagging skin wouldn't lift that much. Thermage, utilizes external radiofrequency energy, and was developed initially to help tighten faces and body skin but for many patients there was not a significant improvement. Other devices including Ultherapy, Pelleve, ThermiSmooth, Titan, Exilis, VenusFreeze and others have been developed but all of these external, non-invasive procedures can only do so much. The homerun in improving sagging facial skin, no doubt, is a facelift. However, some patients may not be candidates to undergo a facelift. They may have medical conditions that preclude the risk, they may be fearful of anesthesia or being cut, or they may be taking medication that prevents them having elective surgery.

ThermiTight is an in-between procedure; it is in-between non-invasive and surgical procedures. It is micro-invasive, meaning that there is a small rod that penetrates the skin and enters the tissue planes underneath the skin, after local anesthetic is injected to numb the areas. Radiofrequency energy is then applied through this very thin rod called a cannula. There is a very sensitive temperature probe at the end of the cannula which allows the physician to know, real-time, the exact temperature to which they are heating up the underlayers. Dr. Shelton indicates that the company has engineered many fail-safes in the device to provide the highest level of safety to patients. The temperature is actually being read several times a second and the machine will cool down automatically if the temperature exceeds a safe upper limit. In addition, there is an extremely sensitive external infrared camera used to detect the surface skin's temperature.

Being minimally invasive refers to the fact that there is no cutting, nor stitches. The rod enters the skin through a needle-hole insertion and the cannula is passed back and forth to the desired areas of treatment. After the treatment, a compression garment is often worn. There will be some swelling and possible bruising. It is not a no-downtime procedure. Keeping in mind that the swelling may last more than a week, and that the amount of skin lifting can not be expected to be the same or come close to that of a face or neck lift, it is fascinating to see, Dr. Shelton says, that so many people have undergone ThermiTight since its evolution. Many just don't want to have surgery. They want to have a natural appearance and not as much downtime as surgery.

Dr. Shelton has performed ThermiTight on faces, necks, arms, thighs and knees. It can be used to help improve crepey skin and skin folds. There have been newer uses discovered on a continual basis.

The ThermiTight company continues to provide the doctors who perform the procedure an opportunity to learn from each other new and exciting uses of the technology as well as share with each other their techniques, on a monthly webinar basis. Dr. Shelton has attended most of these voluntary training sessions and states that it is the only device company that provides such a service. His patients are therefore able to benefit from the most up-to-date treatment protocols and feel secure that they are receiving the most effective and safest ThermiTight treatment.