Thermage vs Ultherapy

Thermage vs Ultherapy

“Should I get Thermage or Ultherapy, doctor?”

This post is dedicated to those of you who still are not sure about whether you should get Ultherapy or Thermage treatment. I get this question a lot from my patients, “Is Thermage or Ulthera better?”

How Thermage machine looks like (pictured above)

How Ultherapy machine looks like (pictured above)

Now, there is no one treatment that is perfect for everyone, so before deciding on doing which treatment, we always strongly advise each patient to come and get facial analysis.

In this post, we are going to discuss about each of the treatment to help you make a better decision.


Thermage has been around for longer than Ultherapy. And it has been known as the “godfather” machine of skin lifting and tightening. Thermage originated back in 2002.

Thermage is a non-invasive radiofrequency treatment that can smooth, tighten and contour skin for an overall younger-looking appearance.

It is non-invasive with no cutting and no needles.

How does it work?

As we age, the collagen that keeps our skin firm breaks down resulting in ageing skin that contains fine lines and wrinkles. Thermage uses radiofrequency technology to heat the deeper, collagen-rich layers of the skin. The applied heat causes collagen to contract and encourages new collagen to start growing. This helps create smoother skin after just one treatment.

How many treatments will I need?

Thermage delivers results after a single treatment. Best of all, results continue to improve over time.

How long will the results last?

Thermage is recommended as part of an annual skin rejuvenation maintenance program. For most patients, measurable results appear gradually in the two to six months following a single treatment session and can last for 1-2 years depending on your skin condition and aging process.

Does it hurt?

There is some discomfort during the treatment. Patients will feel a brief heating sensation when the treatment device’s tip touches your skin, followed by a cooling sensation to help protect your skin and minimize any discomfort.

Are there common side effects?

Some patients have temporary redness or minor swelling after treatment, but this usually goes away within 24 hours.

How long before I can get back to normal activities?

Most patients are able to return to their regular activities immediately following treatment. No special care is required afterward, aside from basic skin maintenance and sunscreens as part of a regular skincare regimen.


Ultherapy or Ulthera is the only non-invasive treatment approved by FDA for lifting the skin on the neck, chin and brow, and improving lines and wrinkles on the décolletage. Ulthera uses microfocused ultrasound to lift and tighten loose skin over time, without any visible downtime.

Ulthera was introduced more recently compared to Thermage.

How is ultherapy different from other cosmetic procedures?

By utilizing high intensity focused ultrasound energy, it stimulates the formation of new collagen deep below the skin’s surface. The production of new collagen takes time, so results can become more apparent over two to three months, even up to six months. The procedure takes about 30 to 90 minutes depending on the area treated. It also is the only procedure to use ultrasound imaging, which allows practitioners to actually see the layers of tissue targeted during the treatment and ensure the energy is deposited precisely to where it will be most beneficial.

How does ulthera stimulate the creation of collagen?

Collagen is a natural protein that gives skin its youthfulness by keeping it firm and tones. As we age, collagen breaks down, and the result is a loss of skin strength and elasticity. Ulthera uses microfocused ultrasound energy to generate a thermal effect under the skin. The thermal effect essentially jump-starts a process that produces fresh, new collagen.

What does the treatment feel like?

As the ultrasound energy is delivered, you may feel tiny amounts of energy being deposited to precise depths, stimulating the collagen-building process. Comfort levels vary from person to person, but the sensation only lasts while the ultrasound energy is being delivered.

(Face and neck grid for Ultherapy treatment)

Are there any side effects?

There may be slight redness that typically resolves within a few hours following the treatment. Some patients may have slight swelling, tingling or tenderness to the touch, but these are mild and temporary in nature.

Who is a good candidate for the therapy?

Typically, those in their 30’s and older who have mild to moderate skin laxity is a candidate. While ultherapy is not a replacement for a surgical facelift, there are many people who want some facial lifting but are not ready for surgery, whether mentally, physically or financially. There are also younger patients who want to “stay ahead of the game” as well as patients wanting an aesthetic maintenance option.

How long does the result last?

This tends to vary from one individual to other individual. Generally, results tend to improve within 6 months of the treatment. Hence we recommend as a maintenance treatment, to do every 6-12 months.

For more information on our ultherapy services, please click here


ManufacturerSolta MedicalMerz
Year of origin20022009
Energy utilizedMonopolar radiofrequencyFocused ultrasound
Depth of penetrationVariable <3mm4.5mm, 3mm, 1.5 mm
CostFrom $2000 onwardsFrom $1000(for small area) onwards, depending on the area treated
Duration of treatmentFrom 30 minutes to 90 minutesSmall areas may take 30 minutes, up to one hour for larger areas.
Ideal candidatePatients with wrinkled-skin and lines on the facePatients with saggy jowls and folds who do not wish to have facelift surgery
DiscomfortFairly uncomfortable, due to the amount of heat involved. Newer generation is more tolerableTingling or burning when the energy is delivered
ResultsSignificant results may start to be visible 6 weeks after the treatmentSignificant results are usually more visible after 2 months, can improve over time until about 6 months after treatment
ConsummableHigh consumable cost but lower price of machineLower consumable cost, but higher price of machine
Number of session neededOnce every 6-12 monthsOnce every 6-12 months
DowntimeUsually minimal, may have redness and swelling. Occasional blisters may occur although rare.Swelling and redness following treatment may occur, especially when higher energy is used.

How do you choose between Thermage and Ultherapy

Sinkers VS Saggers

First of all, there is no clear cut to show which one will be better. Usually, we can loosely categorize ageing individuals into 2 big groups, namely:

1. Sinkers

Sinkers usually have crepey skin riddled with fine lines and wrinkles. These patients are those who have sharp, angular features and remain slim throughout their lives

2. Saggerstightet

Saggers on the other hand are usually concerned about heavy, sagging skin that creates undesirable folds and jowls. They usually are ones with fairly full face to begin with and had put on quite a bit of weight over the years.

Generally, “sinkers” will benefit more from having thermage treatment done, whereas “saggers” will benefit more from having Ulthera. However, categorizing patients to both categories is not that straightforward. There are some individuals which will benefit from having both thermage and ulthera as they are “saggers” with some features of “sinkers” (crepey wrinkled skin).

DUAL-LAYERs skin lifting and tightening.

I will perform dual-layer skin lifting and tightening for suitable individuals with notable results. In one sitting, we have ulthera and thermage treatments done. We call this “dual-layers skin lifting and tightening”. That is why I strongly recommend you to get a detailed evaluation before deciding on any treatment.

Points to note:
1. When discussing options for treatment with your doctors, always be wary if they only have one or the other machine, as they will push for only that treatment that they have during the consultation, without considering which may be the most beneficial for you.

2. Although the machines are delivering similar energy, results vary from one patient to another patient and one practitioner to another practitioner, as there are specialized skills involved in delivering the treatment.

3. Be cautious when clinics are offering very low price on either of this treatment. There are fake machines originating from Korea or China. Always check with the distributor, which are the clinics that actually have either machine. Additionally, they may do less number of lines for the treatment in order to save costs – this especially applies to ultherapy.

So, check your treatment provider and do ask as many questions as needed to make sure that your doctor is experienced enough to provide the treatment and that you are comfortable enough with him or her. If you have any questions, do not hesitate to drop me an email at [email protected].


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