"They say Ultherapy and Thermage are both lifting, so what's the difference?"
"Which of the two should I get?"
As we prepare for consultations, we get this question really often.
This is Director Kwon Si-jin of DA Clinic Myeongdong.
We're set to open in Myeongdong soon, and since so many people find the two treatments confusing, we wanted to lay out the differences for your information.
Ultherapy and Thermage act on different 'layers' to begin with, and which one suits you depends on the layer your concern sits in.This is a part I'd rather state clearly.
Ultherapy Reaches the 'Deep Layer' with Ultrasound
Ultherapy is a lifting treatment that focuses micro-focused ultrasound (HIFU) energy into the deep layers of the skin to create coagulation points, and draws out collagen regeneration during that recovery process.
The Ultherapy PRIME that DA Clinic Myeongdong is preparing uses the MFU-V method, delivering energy while viewing the treatment layer in real-time imaging.For reference, it's also a device whose effectiveness for non-invasive lifting of areas like the brow, under the chin, and the neckline has been recognized by the U.S. FDA.
How Deep Does It Reach?
Ultherapy delivers energy split across three depths: 1.5mm, 3.0mm, and 4.5mm.
The deepest, 4.5mm, is the depth that reaches the SMAS layer that supports your expressions and contours.It creates coagulation points in the deep layer without touching the epidermis.
It's easier to understand if you picture not heating the surface, but tightening the supporting pillars from the inside.
So How Is It Different from Thermage?
Thermage is a 'tightening' that applies bulk heating to the dermis with radiofrequency (RF).
Ultherapy, by contrast, is a 'lifting' that focuses ultrasound into the deeper SMAS layer.One puts its weight on skin firmness, the other on deeper sagging and contour.
So to the question "which of the two is better," there's no fixed answer. The right one diverges depending on whether your concern is skin firmness or deeper-layer laxity. In fact, there are many cases where the two are used together, spaced out over time.
It doesn't use a single depth
Ultherapy doesn't fire at one depth only. It's generally divided across three layers.
- 4.5mmthe deep layer called the SMAS, described as the same depth surgeons work at when they lift
- 3.0mmthe layer above that, below the dermis
- 1.5mmthe shallow layer. Texture and fine lines
So the same "however many shots of Ultherapy" produces different results depending on how those shots were divided across the depths.Ask about this in consultation and the explanation comes back far more specific.
And this family runs on genuine tips (cartridges) with a set shot count tied to them.That's why "how many sessions I've had" matters less than "whether I received the set shot count from a genuine tip." Asking to see the tip opened is a perfectly legitimate request.
The mapping is done sitting up
People find this surprising, but what most changes the result is the preparation before anything is fired.
Lying down pushes sagging tissue up and back, so where it has actually descended looks different.Lines drawn while you're lying down miss the places that need work and put energy into places that don't.
The other point is whether the layers are visualised while firing.The Ultherapy family is described as being able to run with ultrasound imaging that confirms the skin layers.Confirming the layer reduces wasted shots, and fewer wasted shots means the same effect for less stimulation.
The whole treatment is generally described as around an hour.If it's markedly shorter, it's worth asking whether mapping and distribution were skipped.
This Suits Some People; Others Should Be Cautious
It tends to suit people whose contour lines are starting to blur and whose deep-layer firmness is beginning to decline.
On the other hand, if the skin has sagged a lot or the sheer amount of laxity is large, ultrasound lifting alone may not bring as much change as you'd hope.
If you're pregnant, if there's a wound or infection in the treatment area, or if you've recently had filler or an implant placed in that area, it's safer to postpone the treatment and consult first.
Side Effects and Limits Worth Knowing
Right after the treatment, you may experience redness, swelling, a pressing kind of pain, and temporary reduced sensation.These generally settle over time.
Rarely, nerve stimulation can cause temporary muscle weakness, so it's important to proceed while precisely confirming the treatment layer and location.
Ultherapy works on the deep layer, but it isn't a treatment that delivers the same degree of change as a surgical lift. It's good to know this point before you start.(how much you feel it differs from person to person)
Pain divides by area and depth
With Ultherapy, the closer to bone and the deeper the layer, the more it registers.
Because the energy gathers at a point and lands in an instant, it passes as a sharp or stinging sensation rather than a warm one.And the vibration carries more strongly near bone, so at the same intensity the forehead, jawline and around the mouth register more.
Say so immediately if it's hard to bear. The energy can be adjusted area by area. Pain relief and anaesthetic options are worth discussing in advance with wherever you're having it done.
One thing I want to flag: how much it hurts and how well it works are not proportional. Going in harder than necessary to match the idea that "it has to hurt to work" grows the strain faster than the repair.
- Ultherapy works on the deep SMAS layer, Thermage on the dermis
- How many shots at which depth decides the result
- Check the genuine cartridge and whether they watch the layer while shooting
FAQ
Q. When will I start to see results?
A. Ultherapy results tend to appear gradually over the 2~3 months while collagen builds up, not right after the treatment.Some people feel a slight tightening on the day of or right after the treatment, but that's closer to a temporary reaction. The real change comes during the process where the coagulation points created in the SMAS layer recover and new collagen settles in. So even if you feel like "not much has changed" around a month in, it's right to give it two or three months.Keep in mind, too, that the timing and degree of change differ from person to person depending on age, skin thickness, and the extent of sagging.
Q. Does it hurt a lot?
A. The pain from Ultherapy appears as an aching or briefly hot sensation as the ultrasound energy is delivered to the deep layer.Since it reaches the deeper SMAS layer than Thermage does, you may feel some stimulation at the moment the energy goes in.That said, rather than unbearable, many people describe it as "a sharp twinge that passes." We apply numbing cream before the treatment and manage the pain while adjusting the energy intensity step by step, so the burden can be reduced.Areas close to the bone can feel a bit more sensitive, and if it's uncomfortable, just let us know right away.
Q. How do I care for it after the treatment?
A. After Ultherapy there's almost no downtime where you have to rest separately, but a few days of care will shape your result. Above all, it's important to avoid UV exposure and pay attention to moisturizing and hydration.Since it's a period when the deep layer is recovering, it's safer to put off activities that apply a lot of heat, like saunas or jjimjilbang, for about a week.Right after the treatment there may be temporary swelling, a pressing feeling, or slight redness, but these generally settle within a few days.Refraining from alcohol and intense exercise for a few days will also help recovery.As usual, washing your face and basic makeup are fine from the same day.
Q. How do I confirm it's genuine?
A. You're welcome to ask to see the tip opened. The set shot count is tied to the tip, so checking tip and shot count together is the surest way.
Q. Can I have it with Thermage?
A. They target different layers, so they're sometimes planned together. Doing everything on one day isn't always better, so order and interval are safer settled in consultation.
Q. When does the effect show?
A. Right afterwards it's a light tightness, and it's described as emerging over two to three months as collagen builds.There's no need to judge it in the mirror the next day.
Depth decides the choice
It's been a long read, and this is the only line worth keeping.
Ultherapy is deep SMAS-layer lifting, Thermage is dermal tightening. The 'depth' of your concern decides the choice.
What I asked at the very top — has it come together for you now?
DA Clinic Myeongdong is set to open soon.We'll share news of our opening and treatment information first on our blog and Instagram ^^
Thank you for reading.This was Director Kwon Si-jin of DA Clinic Myeongdong.
This column is an informational article meant to provide general medical information, and the effects and side effects of treatments may vary by individual. DA Clinic Myeongdong is set to open soon. (Medical Service Act Art. 56)