Ultherapy Pain: Is Sleep Anesthesia Necessary?

Don't Believe Anyone Who Says Sleep Anesthesia Is a Must for Ultherapy

💡 Before You Read — Quick Q&A


Q. Isn't sleep anesthesia necessary to reduce Ultherapy pain?

A. Not at all. With a proper pain-free anesthesia system combined with Cooling Care, pain can be significantly reduced without sleep anesthesia. In fact, sleep anesthesia may add unnecessary risks to your procedure.


Q. Why does Ultherapy hurt so much?

A. Ultherapy delivers concentrated thermal energy deep into the skin layers, so the level of discomfort varies greatly depending on the energy intensity and treatment depth.

"For patients who are anxious about Ultherapy pain, Beautystone Clinic offers a pain-free anesthesia system combined with Cooling Care to ensure a comfortable and reassuring experience."

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

What Is Ultherapy?

Ultherapy is a device that precisely delivers high-intensity focused ultrasound (HIFU) energy deep into the skin,

stimulating Lifting and Elasticity improvement from within.

Unlike lasers that work on the skin's surface,

Ultherapy bypasses the epidermis entirely and directly targets the SMAS Layer and fascia deep beneath the skin.

That's why the results are deep and long-lasting — but it also means the sensation can be quite intense.

The Real Reason Ultherapy Hurts So Much

This is something many patients misunderstand.

The intensity of Ultherapy discomfort has nothing to do with the quality of the device.

Ultherapy fires thermal energy in pinpoint precision

down to a depth of 4.5mm beneath the skin's surface.

Simply put, the surface feels untouched,

but deep inside, you suddenly feel an intense surge of heat.

Because this thermal stimulation directly activates nerve endings,

the Pain feels sharper and more intense in the moment compared to electrical therapy or standard laser procedures.

But here's the key point.

The intensity of that Pain ultimately depends on the energy level, treatment depth,

and how well pain is managed before and after the procedure —

and these factors can make a world of difference.

Sleep anesthesia can completely block that sensation.

But to be honest,

sleep anesthesia involves intravenous sedatives such as propofol,

which requires a board-certified anesthesiologist to be present at all times,

involves recovery time, and carries rare but real risks such as allergic reactions or respiratory depression.

That's why I believe the smarter approach isn't "sleep anesthesia is a must,"

but rather how effectively we can minimize the pain itself.

Here's what makes it nuanced:

even with the same Ultherapy device, depending on how the energy is calibrated

and which anesthesia method is used beforehand,

the perceived Pain can differ by more than three times.

Here's our typical approach at Beautystone Clinic.

We apply topical anesthesia before the procedure with sufficient time — at least 40 minutes —

and combine it with Cooling Care immediately before and after each energy shot.

This significantly reduces perceived Pain,

and in practice, almost no patients ask to stop midway through.

What Makes Beautystone's Pain-Free Anesthesia System Different?

Every case is different, but here's how I approach pain management step by step.

First, topical anesthesia is applied for a minimum of 40 minutes before the procedure.

Some clinics rush the process with only about 20 minutes,

but that significantly reduces how deeply the anesthetic penetrates.

Second, we never blindly maximize energy levels.

Lifting results don't require pushing the energy to its limit.

By calibrating settings to each patient's skin thickness and tissue density,

we can preserve the effectiveness while meaningfully reducing discomfort.

Third, Cooling Care is applied immediately before and after each energy shot.

Cooling the skin right after a heat surge shortens how long the Pain lasts

and allows the skin to settle far more comfortably.

That said, there's a balance to strike here.

Lowering energy too much for the sake of comfort

can compromise the results.

That's why I believe finding the optimal sweet spot —

where pain is minimized without sacrificing effectiveness — is the most critical part of the procedure.

Many patients who came to us after feeling unsatisfied elsewhere

were genuinely pleased after 2–3 sessions at our clinic,

and the difference came down to exactly this calibration.

Frequently Asked Questions

Q1. I'm particularly sensitive to pain — can I still go through the procedure without sleep anesthesia?

A. Pain sensitivity varies greatly from person to person,

so if you know you're sensitive, please let us know during your consultation.

We can extend the topical anesthesia application time

or divide the energy delivery into smaller segments to make the experience more manageable.

In our experience, even patients with high pain sensitivity

have been able to complete the procedure without interruption in most cases.

Q2. How many Ultherapy sessions are needed, and how long do the results last?

A. After a single session, Collagen production gradually builds over 2 to 6 months,

with results appearing progressively during this time.

How long results last depends on each patient's skin condition,

but on average, you can expect results to last approximately 1 to 2 years.

Patients with more advanced skin laxity may benefit from 2 or more sessions spaced apart over time.

Pricing varies based on the number of shots and treatment area,

so we recommend scheduling a consultation to determine the right plan for you.

Q3. Are there any side effects after Ultherapy?

A. There is one important thing I want to make sure patients are aware of.

Because Ultherapy delivers thermal stimulation deep into the skin,

Erythema, Swelling, and tingling immediately after the procedure are possible.

These typically resolve on their own within 24 to 72 hours,

and in rare cases, temporary Bruising or mild nerve sensitivity may occur.

However, these reactions are almost always temporary,

and using precise depth and energy settings significantly reduces their likelihood.

Applying Cooling Care immediately after the procedure also helps minimize these responses.

If you've been putting off Ultherapy because you're worried about Pain,


I encourage you to first ask whether sleep anesthesia is truly necessary for you.


I always recommend having a thorough consultation before making any decisions.


This has been Dr. Wi Young-jin.