What is the differene between ultherapy and thermage?

I know one uses ultra sound while the other uses RF. But looks like they both tigthening skin. I want to deal with face sagging signs in the early 30s. Can anyone tell me which procedure is better?

Doctor Answers 9

Ultherapy and thermage

While both technologies are aimed at lifting tissues, the 2 technologies
are very different. ULTHERA uses ultrasound, giving the ability to see
precisely the layers being treated adding precision. It is able to
target 3 depths: surgical death(muscle), bottom of dermis and mid
dermis. This allows deconstruction and NEW rebuilding for lasting
results. Thermage is older technology that uses Radio Frequency to
tighten old tissue. The comparison by patients is that they are
disappointed after feeling no visual results and Thermage is more

Ultherapy vs. Thermage

Ultherapy uses ultrasound to target the different layers of the facial tissue that can be visualized by the technician performing the treatment.  This makes the treatment more precise and creates better results than RF (radiofrequency) devices such as Thermage.  Ultherapy can target three different depths: the Dermis (deeper skin), Fat + Connective tissue (Superficial Musculoaponeurotic System-SMAS) and Muscle. The Superficial Musculoaponeurotic System (SMAS) is located below the fat and is a strong tissue that envelops the face. It is made up of collagen, elastic fibers, muscle fibers and fat cells. The ultrasound energy produced during an Ulthera treatment, precisely and consistently heats the targeted tissue to 60-70 degrees centigrade, which is the optimal temperature for contraction and denaturation of collagen. Other non-invasive devices like Thermage only heat the tissues to 40-50 degrees, which is suboptimal for neocollagenesis.

The results from an Ultherapy treatment work in a two-step process. The first stage is the contraction and denaturing of collagen, which causes an immediate tissue tightening, and resultant lift. The second stage occurs over time while the body’s healing response builds new collagen (neocollagenesis).  New collagen production is generated over 2-3 months and often continues for 6 months after the treatment. Full results are visible after 3 to 6 months.

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Ultherapy vs Thermage

Thank you for your question.The main difference between the two treatments is the technology they use to penetrate the deeper layers of the skin.As you mentioned, Ultherapy uses ultrasound and Thermage uses RF.However when it comes to using RF, Thermage is the most dated of the treatments out there.If you are leaning in this direction, I would recommend looking into Infini or Venus.I would also suggest a consultation with a Board Certified Plastic Surgeon who can suggest which treatment would work best for your situation.

Reps B. Sundin, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 25 reviews

Ultherapy vs Thermage

Thanks for your question.Ultherapy uses ultrasonic energy delivered in two layers, whereas Thermage uses radiofrequency (RF) as you mentioned.That being said, of all the radiofrequency devices out there, Thermage is the oldest technology and typically yields the least amount of results.If you are considering using an RF, you would be better off using Venus or Infini for the face/neck.I hope this helps.

Burton M. Sundin, MD
Richmond Plastic Surgeon
4.6 out of 5 stars 54 reviews

Themage and Ultherapy

OK, both can give good results, but the results with Ultherapy on facial areas are generally better. Ultherapy uses HIFU or high energy focused ultrasound to heat different levels under your skin. Themage is older tech. and uses RF. It is not as focused or as accurate in placement as Ultherapy. 

Both of these devices are user dependent, for Themage, using the entire tip in appropriate settings will give better results, and for Ultherapy, the direction of 'lines' and the number of lines used will also be important. Patient selection is critical as well. 

As you suggested, being in the early to late 30s, 40s is a good age group. I often combine non surgical skin tightening with lasers to improve skin texture, or fillers to address volume loss. Remember its the combination of improving skin texture, volume and tone (Ulterapy- Themage) that will give the best outcomes, 

All the best

Dr Davin Lim 
Laser and aesthetic dermatologist
Brisbane, Australia. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 56 reviews

Ultherapy and thermage for facial tightening

Yes, Ultherapy uses focused ultrasound and Thermage uses radiofrequency as does ThermiSmooth and ThermiTight.
Ultherapy, Thermage and ThermiTight are done as a solitary procedure whereas ThermiSmooth is done as a series of treatments.
I have found over the years that Ultherapy has a higher patient satisfaction rating than Thermage when I have performed the treatment but there are some colleagues of mine that are happy with they can do with Thermage. Both procedures hurt to some extent, but Ultherapy produces more discomfort and I tend to give my patients pills to relax them and ease the pain when I do Ultherapy.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 36 reviews

Ultherapy and Thermage

Hi and thank you for your question!

Ultherapy uses high-intensity focused ultrasound (HIFU), it allows us to image the tissue, decide which layers (transducers) are best suited for the individual and their desired results and then delivery energy at therapeutic temperatures to precise areas. This is a more efficient delivery than RF devices, which use bulk heating. Because of this, we find  the results to be more dramatic and consistent when we want to lift and tighten the deeper layers of tissues. It sounds like Ultherapy would be a great treatment for your concerns. If a patient is concerned about superficial issues, such as fine lines/wrinkles/texture, that's when we may consider a skin resurfacing treatment.


Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 121 reviews

Ultherapy Versus Thermage

One is ultrasound and the other RF.  For RF its very operator dependent, although i have been doing this procedure for almost 8 years and get amazing results.  Ultherapy is based on the number of lines and will get more improvement the more lines used.  I find this works best on the jowls and brows while thermage is great for lateral facial lifting and eyes, neck and chest.  Combined with sculptra you get better outcomes. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Ultherapy vs Thermage

There have been no "head to head" comparison studies on Thermage vs Ultherapy, so it is really a matter of opinion. I switched from Thermage to Ultherapy in my practice because the precise focusing of the ultrasound allows me to customize the treatment. Ultherapy remains the only FDA-cleared noninvasive treatment for facial skin lifting. Both rely on the body's healing response to tissue heating.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.