Ultherapy machine vs Thermage: two devices, two layers, one plan
Dr. Hyo Seop Ryu on what the Ultherapy machine does that Thermage doesn't, why the two are sometimes combined, and how WELLS decides.
What is the Ultherapy machine, and how is it different from Thermage?
Hello, I'm Dr. Hyo Seop Ryu, a board-certified dermatologist and Chief Director at WELLS Clinic in Apgujeong, Seoul. I hold an M.D. and Ph.D., and I was an assistant professor of dermatology at Seoul National University Bundang Hospital. Patients often ask me what the Ultherapy machine does that Thermage doesn't, and whether they need both.
Here is the short answer. The Ultherapy machine uses focused ultrasound to reach the SMAS, the deep layer a surgical facelift tightens, and lifts from there. Thermage uses radiofrequency to heat the dermis, which tightens skin and builds collagen closer to the surface. One lifts from below; the other firms the skin on top.
In November 2022 I wrote a column for the Korean health outlet Medisobiza News about this exact pairing. Koreans call the combination "Ulthermage", and the column explained why two devices that are both called lifting treatments actually do different jobs. This post is the same reasoning, written for someone planning a visit from abroad.
Two machines, two layers: what each one does
In the column I described Ultherapy as directly stimulating the SMAS with ultrasound, which gives a strong lifting effect and also works on sagging fat tissue. That makes it useful along the jowls and under the chin. Thermage, by contrast, uses radiofrequency heat to drive collagen production and improve the skin's elasticity.
| Ultherapy Prime FIT | Thermage MAX | |
|---|---|---|
| Energy | Focused ultrasound + fitting laser | Radiofrequency (RF) |
| Main layer | Subcutis to SMAS | Epidermis to dermis |
| Often chosen for | Sagging jawline and lower face | Loose skin on the cheeks, jawline and neck; fine lines |
| From | ₩1,925,000 | ₩3,465,000 |
Prices exclude 10% VAT. If you want the longer comparison, my colleagues cover it in Thermage vs Ultherapy. Neither device is better in general; each is better at its own layer, and the right choice depends on where your face has changed most.
Why combine the Ultherapy machine with Thermage?
Ageing rarely happens in one layer. A face can have a heavy jawline and crepey surface skin at the same time. In the column I put it this way: Ultherapy reduces and pulls up the deep tissue along a sagging jaw, while Thermage tightens the skin surface across the whole face.
At WELLS we have built that layered logic into our own protocols. Ultherapy Prime FIT pairs Ultherapy Prime with a second Fitting laser that works on the layer between Ultherapy and Thermage depth. 3X Upper Face Lifting combines Eye Thermage, EMFACE and Eye Ultherapy for the forehead, brow and eyelids.
Whether you need one device, both, or a different tool entirely is decided after the dermatologist has looked at your face. A combination is a plan for a specific face, not an upgrade everyone should buy.
Send a front and side photo with your dates in Seoul. I'll tell you which layer your concern sits in and whether one device is enough.
Ask if I need one or bothOriginal machine, genuine tip: why it matters
In the 2022 column I also made a point about the machines themselves. Original devices like Ultherapy and Thermage have been validated over many years of clinical cases, and that track record is part of why I choose them.
The machine is only half of it. The tip that touches your skin must be genuine too. WELLS is a Merz Ultherapy Golden Record Award clinic, every session uses the Ultherapy Prime system with genuine tips, and we offer a 10× refund if a tip is ever found not to be genuine. For Thermage, you see the tip's ID card before we start, and we confirm the shot count with you before and after treatment.
What can go wrong, and how are the settings chosen?
Even non-surgical lifting has risks. The column listed the ones I try to prevent: a burning or hot sensation, pain, swelling, blisters and redness. Avoiding them depends on setting the right energy and the right handpiece pressure for each face.
That is a judgement call, and it depends on the current state of your skin, how far ageing has progressed and the direction of your wrinkles. Before treatment your face is analysed with a 3D imaging system, and an individualized treatment map sets the energy and shot distribution for each area.
We also avoid deep sedation. Ultherapy's own guidelines don't recommend it, because under sedation you cannot give feedback and energy tends to be pushed higher, which raises burn risk. With Air NOX non-sedation and local anesthetic you stay awake, need no fasting, and can drive afterwards.
What does each machine feel like on the day?
Patients who have read about both devices usually want to know how the treatment itself feels. The honest answer is that both create heat, and you will notice it, but in different ways.
Ultherapy Prime
The Ultherapy machine delivers its energy in short pulses at depth, so the sensation follows the line the handpiece moves along. We use local anesthetic with Air NOX, and because you stay awake you can tell us when an area feels too strong. That feedback is part of how the energy is set safely.
Thermage MAX
Thermage creates a hot, stinging feeling. At WELLS we ease it with numbing cream, local anesthesia and a collagen-peptide booster serum applied during treatment. A Thermage MAX visit takes about two hours in six steps: skin microbiome sample, numbing, booster serum, AQ MAX infusion, Thermage FLX, then a review of your microbiome results.
- No fasting is needed for either treatment
- You stay awake throughout, with no deep sedation
- You can drive and go back to your plans afterwards
If you are combining the two on one trip, the dermatologist will tell you whether they fit on the same day or are better spread across your stay. That depends on the areas being treated and how long you are in Seoul, so send your dates with your first message.
Planning Ultherapy and Thermage on a trip to Seoul
Our listed prices: Ultherapy Prime FIT 400 at ₩1,925,000 and FIT 500 at ₩2,409,000; Thermage MAX 600 shots at ₩3,465,000 and 900 shots at ₩4,477,000. All are VAT excluded.
With Thermage, changes typically begin about two weeks after treatment, so on a short trip you will notice them at home. Most of our Ultherapy patients are satisfied with their results with 300–400 shots, and only about 2% of WELLS patients need 600 or more. Individual results vary, and side effects are possible.
WELLS is a five-minute walk from Apgujeong Station (Line 3) Exit 3, and consultation, analysis and treatment happen on the same floor.
Tell us your dates and your main concern, and attach a quote if you already have one. We'll reply with a plan and the listed price.
Plan my lifting visitOne device or two?
Send a relaxed daylight photo and your dates in Seoul. A dermatologist will tell you whether the Ultherapy machine, Thermage or a combination fits your face, with the listed price.
Message the clinic on WhatsAppReplies on WhatsApp · prices in KRW, excluding 10% VATBefore you message us
Is the Ultherapy machine the same as Thermage?
No. Ultherapy focuses ultrasound into the SMAS; Thermage heats the dermis with radiofrequency. They work on different layers.
Can I have both on the same trip?
Sometimes. Whether combining them makes sense, and in which order, is planned by the dermatologist after seeing your face.
Which machine is better for a double chin?
Ultherapy works on sagging tissue along the jaw and under the chin. Depending on your face, InMode Mini FX or Onda MAX may also be options; the dermatologist decides at consultation.
How do I know the tips are genuine?
You stay awake under Air NOX and can see the tip and shot count. WELLS uses genuine tips only, with a 10× refund if one is ever found not to be genuine.
How long do Thermage results take to show?
With Thermage, changes typically begin about two weeks after treatment, as new collagen builds over the following weeks. Results vary from person to person, and the dermatologist explains what to expect for your skin at consultation.
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.
Dr. Hyo Seop Ryu
- Board-certified dermatologist, M.D., Ph.D.
- Clinical instructor, Department of Dermatology, Seoul National University Bundang Hospital
- Assistant professor, Seoul National University Bundang Hospital
- Visiting professor, Dubai Maris Clinic, through International St. Mary's Hospital
- Former chief director, Bundang Bon Dermatology Clinic
