Given a Choice Between Thermage and Ultherapy, Which Treatment is More Effective and Lasts Longer?

Dear Patient, I have been performing Thermage treatments since the company released the first units in the US (about 10 years a go). For many year Thermage was the best non-surgical modality to tighten the skin of the face, neck and eyes. The first units were not fully reliable and some patients received only modest improvement. The second generation (NXT) was better and finally the CPT (newest generation of Thermage) did the Job. About 2-3 years ago Ulthera entered the market. It worked better than Thermage but was painful. The second generation Ulthera (Deepsea) is simply incredible and works better the newest Thermage. It is still painful and I do sedate my patients for the treatments. I would say that overall Ulthera is 2-3 times more effective than Thermage CPT 900 pulse. HOWEVER, the Thermage company Rep was here last week and told me about a NEW Thermage tip that goes twice as deep and achieves significantly better results. This is a 2 billion dollar industry and these devices will continue to improve. Find an experienced surgeon to do your treatment. All these devices are very very operator dependent. They all work to various degrees and can delay a "Cutting Lift" Good luck. Dr. David R.

I have found the Ulthera procedure to be well worth the cost in correcting facial laxity in the lower face.  Raffy Karamanoukian, Los Angeles

Technology continues to improve with both Thermage and Ultherapy. The Thermage CPT helped make treatment less painful, but it is not without pain. Newer off-label uses of other tips may help facial areas benefit, especially under the neck. Ultherapy has improved their transducers and software allowing more gentle treatment and increasing the number of lines of treatment. What seems to be true for both technologies ( I use both in my practice) is that the lower energy per pulse (thermage) or line (Ultherapy) makes it more comfortable, but then the number of pulses / lines must increase to obtain a good result.

Regardless of the choice of Thermage or Ultherapy, if a beneficial result is obtained, it might be a long term result as the collagen produced as a result of the treatment is not going to go away. Granted, we age with time, and there will be a constant sagging of the face but having one of these treatments will help allow us to stay ahead on the aging curve. Some patients get a second treatment at six to twelve months for continued improvement.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

I have used Ultherapy as it is FDA cleared for non surgical facial and neck tightening. I am not aware of any head to head studies comparing Ultherapy to Thermage. Read the Ultherapy ebook provided on the link below.

 I have been using the Ulthera technology  for 4 years and I personally have found the results to be superior to Thermage. The software on the unit was updated over a year ago and the treatment is even more effective and more comfortable.I personally do the treatments myself reather than delegating it to my staff.Perhaps this is why my results are consistently great.

I love Thermage.  It works on everyone and improves and builds collagen.  The new Thermage CPT technology allows you to maximize the results without any pain.  This is a completely painless procedure which lasts approximately 90 minutes in the office.  There is no preparation and no down time.  I have had tremendous results with both the face and the body in treating and tightening various areas.  I much prefer it to Ultherapy which is a painful procedure and requires pain control to heat the skin to treat the skin.  The treatment generally will show results in two to four months and the results will last around two years.  It has become one of the most popular procedures in my office.

In my practice, we switched from Thermage to Exilis for skin tightening about a year ago.  We are seeing nice results on the face and body with Exilis and patients seem to prefer it over Thermage.  Ulthera is an interesting technology.  We decided not to add that to our practice because it seemed more invasive and definitely more painful.

In the hands of an experienced technician who has learned the most resent new modifications of the technique, you can expect good results. While Ultherapy does give 30-50 % improvement it can not give the spectacular results that a brow lift and a face lift with fat grafting can give. Then again it only  takes a couple of hours with no pain or need for anesthesia and 45 minutes of recovery time. Make sure you are having this done in a Board Certified Plastic Surgeons office with technicians who have done a good number of treatments and are up on the latest techniques. Ask to see before and after photos.