Ultherapy ultrasound: how it reaches the SMAS, and who it suits
Dr. Hyo Seop Ryu explains what Ultherapy ultrasound does under the skin, why sun-tired skin often needs more than one layer treated, and how WELLS plans it.
What does Ultherapy ultrasound actually do under the skin?
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 taught dermatology at Seoul National University Bundang Hospital as a clinical instructor and then assistant professor. Patients often ask me what Ultherapy ultrasound does once it goes past the surface of the skin.
The short answer: Ultherapy focuses ultrasound energy into the SMAS, the deep supporting layer that a surgical facelift tightens. It heats small points in that layer, which stimulates collagen and lifts from deep down, while the skin surface is left largely alone. It also works on the fat layer above the SMAS.
In August 2025 I spoke to the Korean health outlet Medisobiza News about skin that comes out of summer looking tired. Long holidays in strong sun, heat and humidity take their toll, and the article looked at how to restore firmness without surgery. Ultherapy Prime was at the centre of that conversation, so this post explains the ultrasound side of it for readers outside Korea.
How does focused ultrasound reach the SMAS without treating the surface?
Ordinary ultrasound, the kind used for scans, spreads its energy out. Ultherapy ultrasound does the opposite: the transducer converges the energy at a set depth, a little like a lens focusing light to a point. Above and around that point, the energy is too spread out to heat tissue in the same way.
That is why depth selection is the heart of the treatment. Different tips reach different depths, and the dermatologist chooses which tip goes where. At WELLS your face is analysed with a 3D imaging system first, and an individualized treatment map sets the energy and the number of shots for each area.
| Ultherapy Prime FIT | Thermage MAX | Onda MAX | |
|---|---|---|---|
| Energy | Focused ultrasound + fitting laser | Radiofrequency (RF) | Microwave (Coolwaves) |
| Main layer | Subcutis to SMAS | Epidermis to dermis | Dermis to fat layer |
| Often chosen for | Sagging jawline and lower face | Loose skin on the cheeks, jawline and neck; fine lines | Soft jawline and double chin, keeping cheek volume |
| From | ₩1,925,000 | ₩3,465,000 | ₩700,000 |
Prices exclude 10% VAT. The table is the short version; your dermatologist checks your skin in person before recommending one.
What changed with Ultherapy Prime?
Ultherapy Prime is the upgraded version of the original Ultherapy system. As I explained in the 2025 article, it keeps what the earlier system did and adds practical improvements for the person treating you: faster screen switching, easier handling and quicker response.
Those sound like small engineering details, but they matter at the handpiece. They make it easier to work carefully around smaller, curved areas: the fine lines near the eyes and mouth, deeper smile lines, the double chin and the face line. For under-eye laxity, Eye Ultherapy uses a dedicated eye tip.
Every session at WELLS uses the Ultherapy Prime system with genuine tips. You can read the device details on our Ultherapy Prime page.
Why does sun-tired skin often need more than one layer treated?
After a summer of sun, the problem is rarely just one thing. Firmness drops in the deep layers, while the surface tends to look dry and dull. In the article I recommended pairing Ultherapy Prime with a second, moisture-focused treatment for that reason.
At WELLS, the combination we list is Ultherapy Prime FIT. Ultherapy Prime lifts from the SMAS, and a second Fitting laser works on the layer between Ultherapy and Thermage depth, so deep lifting and the surface contour are handled in the same visit.
If your main concern is loose skin and fine lines rather than a heavy jawline, a radiofrequency treatment may suit you better. My colleagues compare the two in Thermage vs Ultherapy.
Send a front and a side photo in daylight with your dates in Seoul. I'll tell you which layer your concern sits in and which plan I'd suggest.
Send a photo, get a planWhy does the person holding the handpiece matter so much?
Ultherapy ultrasound is strong and precise energy, and it is delivered into tissue you cannot see. In the article I stressed that the treating doctor needs real anatomical knowledge and enough experience to place it safely.
That is also why we do not use deep sedation. Ultherapy's own guidelines don't recommend it. Under sedation you cannot give feedback, so energy tends to be pushed higher and burn risk rises.
Instead we use Air NOX non-sedation with local anesthetic. You stay awake and can see the tip and the shot count. Most of our patients are satisfied with their results with 300–400 shots; only about 2% of WELLS patients need 600 or more.
Who is Ultherapy ultrasound for, and who should look at something else?
Ultherapy ultrasound earns its place when the problem sits deep. The people I most often recommend it to have sagging along the jawline and lower face, cheeks that have lost their definition, or simply want lifting without surgery or deep sedation.
- Sagging along the jawline and lower face
- Loss of definition in the cheeks
- Patients who want lifting without surgery or deep sedation
It is not the answer to every tired face. If your skin is thin and the concern is mostly crepey texture and fine lines, radiofrequency that heats the dermis is usually the more logical first step. If you are worried about losing cheek volume, a treatment such as Onda MAX is designed to tighten the jawline while keeping the cheeks full.
Air NOX, which we use instead of sedation, is not suitable in early pregnancy, with respiratory conditions, panic disorder or vitamin B12 deficiency. Tell the dermatologist about any of these before your visit, and we will plan the comfort side differently.
In other words, the device does not decide the plan. The layer your concern sits in decides the device, and that is the reason a consultation comes first, even when you have flown in with a treatment already in mind.
Planning Ultherapy ultrasound on a trip to Seoul
Our listed plans are FIT 400 (300 Ultherapy Prime shots plus Fitting 100 kJ) at ₩1,925,000 and FIT 500 (400 shots plus Fitting 100 kJ) at ₩2,409,000 (VAT excluded). Ultherapy Prime on its own is priced at consultation.
WELLS is a five-minute walk from Apgujeong Station (Line 3) Exit 3. There is no fasting, because there is no deep sedation, so the rest of your day in Seoul is easier to plan. Individual results vary and side effects are possible; the dermatologist explains both before you decide.
Tell us your dates and your main concern. We'll suggest a plan and confirm a time before you fly.
Plan my Ultherapy visitNot sure which layer your concern sits in?
Send a relaxed daylight photo and your dates in Seoul. A dermatologist will tell you whether Ultherapy ultrasound is the right tool, and which plan and listed price would apply.
Message the clinic on WhatsAppReplies on WhatsApp · prices in KRW, excluding 10% VATBefore you message us
Is Ultherapy ultrasound the same as an ultrasound scan?
It uses the same kind of energy, but focused to a set depth so it heats small points in the SMAS. A scan spreads low energy out to make an image.
Does Ultherapy ultrasound damage the skin surface?
The energy is focused below the surface, so the surface is largely spared. Side effects are still possible, which is why depth and energy are chosen by a dermatologist after a 3D analysis. Mild redness or swelling can occur and is discussed at consultation.
Can Ultherapy treat the area under the eyes?
Yes, with care. Eye Ultherapy uses a dedicated eye tip for under-eye laxity. Whether it suits you is decided at consultation.
Do I need to be sedated?
No. WELLS uses Air NOX non-sedation with local anesthetic, so you stay awake and can see the tip and shot count. There is no fasting, and you go home right after the treatment.
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
