Thermage vs Ultherapy: which one lifts what, and how we decide

Thermage vs Ultherapy: the short answer

Thermage vs Ultherapy is the question I hear most from people planning a lifting treatment in Seoul, usually after they've read ten opinions and trusted none of them. The honest answer is that they aren't rivals. They work at different depths, so the better question is which layer of your face is actually letting go.

I'm Dr. Won Sin Lee, a board-certified dermatologist trained at Asan Medical Center in Seoul, where I'm an adjunct professor in the Department of Dermatology. This is how I explain the difference in the consultation room.

• Thermage FLX uses radiofrequency (RF) to heat the dermis, the skin itself, for firmness, texture and fine lines.
• Ultherapy uses focused ultrasound to reach the SMAS, the deep supporting layer a surgical facelift tightens, for lift along the jawline and lower face.

In one line: Thermage tightens the surface, Ultherapy lifts from depth. Many faces need one more than the other, and some need both.

How do Thermage FLX and Ultherapy actually work?

Thermage FLX: heat in the dermis

Thermage FLX is a fourth-generation monopolar RF device. It heats the dermis so ageing collagen contracts and new collagen is stimulated over the following weeks.

Fine surface lines and loss of elasticity come mainly from collagen loss in the dermis. That's why Thermage is the tool for them.

Ultherapy: focused points at the SMAS

Ultherapy concentrates ultrasound energy into small points at the SMAS layer, a little like a magnifying glass focusing sunlight, without damaging the skin surface. The heat contracts the loosened layer, and collagen renewal continues during natural healing afterwards.

When the SMAS loosens, the cheeks drop and a double-chin line appears. That deep sagging is what Ultherapy is for, and RF at the dermis can't reach it in the same way.

Ultherapy vs Thermage: which one suits your face?

I decide by what I see and feel on your face, not by the brand you came in asking for. As a starting point:

Thermage tends to suit you if

• Your skin feels looser and thinner rather than dropped
• Fine lines and loss of firmness bother you more than jawline shape
• You want firmer skin across the cheeks, jawline and neck

Ultherapy tends to suit you if

• Your jawline has softened and the lower face has dropped
• Your cheeks have lost definition
• You want lifting without surgery or deep sedation

One caution applies to both. Where the fat layer is already thin, excessive energy can leave an area hollow, so thin areas are mapped before treatment with 3D analysis rather than discovered afterwards. For a very thin face, I may suggest a different plan altogether.

When does it make sense to do both?

Skin ageing rarely happens in only one layer. In many faces the surface loses firmness at the same time as the deeper layer sags, and that's when combining the two, pulling from within and tightening on the surface, makes sense.

Because the devices act on different layers, combinations are common. The dermatologist plans the order and timing at consultation, and shot counts are set for your face rather than taken from a package menu.

In a combined plan the two devices divide the face between them. Ultherapy is usually concentrated along the jawline and the double-chin line, where the deeper layer has dropped, while Thermage uses fine tips on thin areas such as around the eyes and mouth.

That split is also why a combination isn't automatic. If the deeper layer is holding well and only the skin has thinned, adding Ultherapy gives you cost without much benefit.

For the upper face, the same logic sits behind our 3X Upper Face Lifting: Eye Thermage (450 shots) for thin eyelid skin, EMFACE for the muscles that hold the brow, and Eye Ultherapy (50 shots) for the deeper layer around the brow. It is ₩2,500,000 (VAT excluded) per session, and it's where to start if you searched for eye Thermage.

Thermage FLX before and after: what changes, and when

People look up Thermage before and after results because they want to know what to expect, and when. Tightening can be felt straight after treatment, as the heat contracts existing collagen.

The bigger change comes from new collagen. Our Collagen Booster Thermage FLX page states that results may begin to appear after about two weeks and last six to fourteen months. Individual results vary.

Ultherapy follows a similar arc, because it also relies on collagen renewal after heat. For many people the lift keeps developing over the following months rather than appearing overnight, and the dermatologist explains what to expect for your face at consultation.

What you shouldn't expect is a different face. The aim of either treatment is firmer, better-supported skin that still looks like you, which is also why subtle changes are easy to miss in the mirror week to week.

Whichever you choose, daily sunscreen and good hydration are two simple habits that help the result last.

How Thermage and Ultherapy are done at WELLS

The devices differ, but the rules at WELLS are the same for both.

• A board-certified dermatologist handles consultation, diagnosis and treatment
• 3D skin analysis before lifting, and a skin-microbiome test before Thermage MAX
• Only genuine Thermage and Ultherapy tips; if one is ever found not to be genuine, we refund ten times the treatment price
• No deep sedation: Air NOX with local anesthetic keeps you awake

On the Thermage side, Thermage MAX adds two bottles of AQ MAX (alanyl-glutamine) before the RF and a collagen-peptide serum during it, to protect collagen-producing cells from the heat. On the Ultherapy side, Ultherapy Prime FIT adds a Fitting step aimed at the layer between Ultherapy and Thermage depth.

Staying awake under Air NOX matters for both. You can give feedback while energy is delivered, and see the tip and the shot count yourself.

Thermage FLX price vs Ultherapy price at WELLS

Because they're different treatments, they're priced differently. Thermage MAX is listed at ₩3,465,000 (VAT excluded) for 600 shots and ₩4,477,000 (VAT excluded) for 900 shots.

Ultherapy Prime FIT is ₩1,925,000 (VAT excluded) for FIT 400 (300 shots plus Fitting 100 kJ) and ₩2,409,000 (VAT excluded) for FIT 500 (400 shots plus Fitting 100 kJ). Collagen Booster Thermage FLX and Ultherapy Prime on its own are priced as confirmed at consultation.

For each treatment in more depth, read Thermage explained and Ultherapy explained.

Results and recovery vary by individual. Every treatment carries possible side effects, which are explained at the consultation. Prices are in Korean won, excluding 10% VAT, and confirmed at your consultation. This article is general information from the clinic, not a diagnosis.

Written by

Dr. Won Sin Lee

Medical Director · WELLS Clinic, Apgujeong

• Board-certified dermatologist in Korea; trained at Asan Medical Center in Seoul
• Dermatology residency, Asan Medical Center; board certification in dermatology in Korea
• Adjunct professor, Department of Dermatology, Asan Medical Center
• Former director, Bokji Dermatology Clinic, Korean Leprosy Welfare Association
• Commendation for Outstanding Service as a Public Health Physician

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