Ultherapy vs Thermage: Differences in Effects & Why They Are Often Combined

Today, I’ll quickly introduce two very popular treatments: Ulthera and Thermage.

What is Ulthera?

Ultherapy is a High-Intensity Focused Ultrasound (HIFU) device developed by Merz Aesthetics in Germany.

Source: New Ultherapy method: Utilizing novel surgical and anatomical concepts yields outstanding results.

Results after 6 months.

It delivers energy to the SMAS (superficial musculoaponeurotic system) layer, stimulating collagen regeneration and tissue contraction to achieve lifting effects.

Think of it like grilling squid on a hot stone, just as the heat shrinks the squid, Ulthera contracts the fascia to lift the skin.

• Target layers: Can be adjusted for different areas to improve elasticity

• Clinical evidence: Studies on Korean patients show reduced pore number and size as well

The treatment tip can be adjusted according to the target layer

Reference: Treatment Protocol on Using Microfocused Ultrasound with Visualization for Skin Quality Improvement: The Korean Experience

What is Thermage?

Thermage uses monopolar radiofrequency (RF) to rapidly heat the dermis:

• Contracts existing dermal tissue

• Stimulates new collagen formation

• Provides both lifting and skin tightening effects

Reference: Monopolar radiofrequency for dermal temperature regulation and remodeling: A porcine model study

• After 30 days, microscopic observations show increased collagen density and dermal thickness.

Ulthera vs. Thermage: Key Differences

Why Combine Ulthera and Thermage?

Since the two devices target different skin layers, combining them creates a synergistic effect, improving both:

• Inner layer lifting (Ulthera)

• Outer layer tightening (Thermage)

Additionally, Ulthera’s effect develops gradually, while Thermage shows more immediate improvement. Using both can produce faster and more pronounced results, which is why many patients choose a combined treatment called “UlThermage.”

UlThermage Treatment Tips

• Combination isn’t always better: Selection should be based on skin type, concerns, and elasticity

• Facial volume and contouring: Ulthera is ideal

• Thin skin with elasticity concerns: Thermage can provide effective improvement

• More shots ≠ better results: Excess energy can cause burns or hollows

The key is personalized treatment planning, adjusting energy and design according to skin condition, age, and target improvements.

Personalized Evaluation at Repic Clinic

At Repic, we use 3D Meta-VU imaging to:

• Measure facial length and angles

• Simulate aging changes

• Evaluate individual results in detail

This allows our doctors to design customized treatment plans for each patient.

Summary

• Ulthera: Focuses on deep lifting via SMAS

• Thermage: Targets dermis for tightening and collagen regeneration

• Combination (UlThermage): Maximizes lifting, tightening, and overall skin improvement

If you’re unsure whether to combine treatments, Repic provides precision skin diagnostics and personalized consultations to determine the optimal plan.

FAQ: Thermage and Ultherapy