Thermage vs Ultherapy: You Can't Treat Them as the Same Just Because They're Both Lifting Procedures

Thermage vs Ultherapy: You Can't Treat Them as the Same Just Because They're Both Lifting Procedures

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Q. Thermage and Ultherapy are both lifting devices, so don't they have similar effects?

A. No, they don't. They use different types of energy and target completely different skin layers. Even when used on the same face, the structures they stimulate are completely different.


Q. Then which one works better?

A. There's no universal answer of "which is better." The optimal choice depends on your skin condition and which layer is experiencing sagging.

"Thermage uses radiofrequency (targeting dermis), while Ultherapy uses ultrasound (targeting SMAS layer), so the optimal choice varies based on your skin condition."

— Dr. Wi Young-jin (Beautystone Clinic, Hongdae)

Thermage and Ultherapy: Let's Start by Understanding Their Names

Many patients misunderstand this,

using "lifting = Thermage or Ultherapy"

almost as synonyms.

But these two devices differ from their very energy types.

Thermage FLX uses radiofrequency (RF)

technology.

It delivers thermal energy uniformly

from the skin surface to the dermis

to stimulate collagen production.

Ultherapy uses focused ultrasound (HIFU).

It concentrates ultrasound energy

to a single point and delivers energy

to deeper skin layers, specifically the SMAS layer.

Unlike Thermage, Ultherapy

barely touches the skin surface

and precisely stimulates deep layers.

Why Is This Depth Difference So Important?

Honestly speaking,

this is the absolute core difference

between these two devices.

Our skin consists of multiple layers.

From outside to inside: epidermis → dermis → subcutaneous fat → SMAS layer

in that order.

The SMAS layer is essentially

the 'fascia' that connects

muscles and skin.

When this layer becomes loose,

cheek fat sags, nasolabial folds deepen,

and jawlines blur.

Thermage primarily targets the dermis.

It contracts collagen fibers in the dermis with heat

and induces new collagen formation.

It's particularly effective for

skin elasticity, texture, and fine lines.

Ultherapy concentrates ultrasound energy to the SMAS layer.

Since it directly stimulates deep skin structures,

it's more effective for

'structural sagging' like saggy cheeks and blurred jawlines.

What's somewhat confusing is that

both do provide lifting effects.

But since they stimulate different layers,

you shouldn't expect identical results.

"It's not simply about expensive being better,

but which layer of your skin is problematic

should be the selection criteria"

- this is where this principle comes from.

But there's one important point here.

Just because Ultherapy penetrates deeper

doesn't mean it's always the answer.

For patients with thin, dry skin lacking elasticity,

treating only the SMAS layer won't solve the problem.

The dermis itself lacks collagen.

For such patients, Thermage should come first

to build up the dermis.

Conversely, for patients whose skin maintains elasticity

but experience sagging cheeks or deepened nasolabial folds,

SMAS layer stimulation is needed,

making Ultherapy more suitable.

Thermage vs Ultherapy — Which Is Right for My Skin?

Let me organize this in a table below.

Compare it with your condition for guidance.

While it varies by case,

here's typically how I approach it.

For early to mid-30s patients with

remaining skin elasticity, Ultherapy alone.

For late 30s to 40+ patients with

both elasticity and sagging concerns,

I often recommend combining Thermage and Ultherapy.

Among patients who come saying they've had multiple treatments elsewhere without results,

quite a few had repeatedly used devices unsuitable for their skin condition.

When we switched to energy appropriate for their layer,

many noticed changes within 2-3 sessions.

Frequently Asked Questions

Q1. Can I receive Thermage and Ultherapy on the same day?

A. Combining them is possible.

Since they target different layers,

there's minimal interference when performed on the same day.

However, depending on skin condition and recovery capacity,

I sometimes recommend spacing them out.

It's best to decide after

examining your skin condition during consultation.

Q2. There's quite a cost difference - should I consider maintenance duration too?

A. In terms of effect duration,

Thermage lasts about 6 months to 1 year,

while Ultherapy lasts about 1 to 1.5 years,

so Ultherapy tends to last slightly longer.

It's realistic to calculate

the cost difference divided by maintenance period.

However, this varies by individual skin condition,

so consider these as reference numbers only.

Q3. I've read reviews saying Ultherapy made cheeks look more hollow - is this a side effect?

A. There's something important I must mention:

Ultherapy's energy structure passes through

the boundary between SMAS layer and subcutaneous fat,

so patients with thin fat layer

may experience a more

hollowed cheek appearance.

For patients with already lean faces

or minimal subcutaneous fat,

Thermage might be

a safer choice than Ultherapy.

Please get this checked before your procedure.

Feel free to contact us via KakaoTalk or phone with any questions. This was Dr. Wi Young-jin.