Ultherapy vs Thermage - which one is better?

First of all, what is the difference between them in regards to skin tightening? Secondly, which one do doctors usually recommend? Thank you in advance for your attention to this matter.


F, 51, California

Tags:woman age 45-54 skin skin tightening

Both Ultherapy and Thermage are popular skin tightening treatments which have been shown to stimulate collagen production and reduce skin laxity.

The difference between the two therapies lies in the type of energy used: Ultherapy uses ultrasound energy, while Thermage treatments use radiofrequency energy (RF). In both cases the general idea is the same. The energy emitted from either device penetrates through to the deeper layers of skin and stimulates the growth of new collagen via the body's natural collagen response.

Ultherapy treatment is capable of penetrating to deeper dermal layers, while Thermage works faster -- often resulting in some visible tightening of the skin surface immediately following the procedure. Individual results will vary depending on how deep wrinkles are and much loose skin exists prior to the Thermage treatment.

The answer to the question of which is better, Ultherapy or Thermage, depends on the area that needs to be treated. In my experience, Thermage is better for certain areas like the under eye area and loose skin around the body. However, Ultherapy's ultrasound technology is particularly well-suited to the forehead and neck.

My recommendation is to consult with a board-certified dermatologist or plastic surgeon to determine which treatment is preferable for your specific case.

Ultherapy and Thermage are both FDA approved non-surgical facelifting treatments. Thermage has been in use since 2002, while Ultherapy was introduced more recently in 2009. Both treatments work to stimulate collagen production in the deeper layers of the dermis to address the signs of aging in the skin. They are both suitable for treating fine lines, wrinkles, skin folds and facial creases.

The fundamental difference between the two treatments is the energy each uses, and the areas each is best suited to treating. Ultherapy delivers ultrasonic waves with precision technology into the underlying layers of skin, addressing issues from the inside out, while Thermage utilizes radiofrequency waves to induce heat in the skin, treating the skin from the outside inwards.

Ultherapy has proven success in treating the brow, corners of the eyes, area under the chin, neck and decolletage. Thermage can be used on the jawline, around the eyes and lips, but also on areas of the body such as the abdomen, arms, thighs and buttocks. Thermage therefore has more extensive applications than Ultherapy.

There is contention among surgeons regarding which treatment is most effective. Many practitioners, however, favor Ultherapy as it delivers more precise results. The dermatologist or expert performing Ultherapy has a display to monitor the depth of the skin that the sound waves permeate. At present, there are 3 distinct depths that the Ultherapy energy targets: 4.5 mm, 3 mm and 1.5 mm. The two deeper depths are used for lifting and tightening whereas the newly released 1.5 mm depth transducer can soften surface wrinkles. Ultherapy also uses a wand that enables the practitioner to target very specific areas with a precision that isn’t possible with Thermage.

Ultherapy also boasts no side effects, no downtime, and little to no discomfort. Informal clinical trials have also revealed that Ultherapy appears to deliver more dramatic results, as the ultrasonic waves are able to penetrate the skin at a deeper level than Thermage.

For patients with good skin tone seeking to maintain their skin, Thermage performed annually or every few years can be an excellent tool to keep the skin looking fresh and lifted. For patients with more facial laxity or sagging, Ultherapy is more appropriate. To determine the most effective treatment for you, it is advisable to arrange a consultation with a specialist who can advise you based on the condition of your skin and specific cosmetic goals.

Your question really depends on which issues the therapy needs to address. Ultherapy and Thermage are both good treatments for non-invasive face lifting and tightening loose, sagging skin.

The treatments work by intentionally causing damage to the subsurface dermal layers, which in turn stimulates the body's natural collagen production process.

The therapies rely on different underlying technologies, but work in more or less the same way: Ultherapy uses ultrasound energy, while Thermage uses RF energy. It should be noted that unlike Ultherapy, Thermage's RF energy devices have yet to be approved by the FDA for skin tightening.

To answer your question about which treatment is better would require a personal consultation. Each treatments has its strengths and weaknesses. Your doctor will be able to determine the treatment best suited to treat your specific fine lines, wrinkles and areas of skin laxity.

I suggest that you contact a board-certified plastic surgeon or dermatologist for a free consultation to determine which type of therapy makes the most sense for you.

Both Ultherapy and Thermage are good treatments, but we prefer to use ThermiTight for skin tightening.  

As with Thermage, ThermiTight also uses RF energy to initiate the body’s natural collagen production process.

Unlike Thermage however, ThermiTight does not require multiple treatments to achieve noticeable effects. ThermiTight’s skin tightening effects are visible after just one treatment.

ThermiTight is mildly invasive but gives us much better control and access to the subsurface skin. ThermiTight is excellent for skin tightening around the abdomen and breasts, and is also very effective on the neck and arms.

For skin tightening of the face -- including eyelids and under-eye areas -- we have been producing excellent results with ThermiSmooth. ThermiSmooth also uses RF energy, but is non invasive.

Depending on your specific presentation, we may also recommend SkinTyte therapy. Like ThermiSmooth, SkinTyte is also non-invasive but uses advanced infrared light technology to heat the skin and stimulate collagen production.

It’s impossible to say which therapy is actually best because the answer depends on your specific situation. I encourage you to schedule a consultation so we can discuss which options match your goals and will be the most suitable for you personally.

Thermage and Ultherapy both represent popular non-invasive treatments that can refresh your appearance by treating skin laxity and wrinkles. While both use heat energy to restore collagen production in the dermal layers of the skin to soften wrinkles and in some cases tighten the skin, the type of energy each uses is different. Thermage uses radiofrequency energy, while Ultherapy uses ultrasound energy. Both forms of energy can safely penetrate the skin to stimulate collagen production. However, ultrasound energy can access deeper levels of the skin, such as the layer of fat and SMAS layer, to stimulate more dramatic and noticeable tightening of the skin.

The practitioner delivering Ultherapy also has more control over the depth that the ultrasonic waves reach the skin, meaning more targeted treatment and precise results. Thermage treatments take between 45 minutes and an hour and a half, whereas Ultherapy treatments last between thirty minutes and an hour. In the case of each, it will take several months before you can see the final results as it takes time for collagen to be regenerated.

However, with Thermage you may see some difference right away, then a more gradual improvement in the weeks following your treatment. In the case of Ultherapy, it’s unlikely you will see any change immediately after treatment, but as the weeks and months progress you will notice your skin laxity begin to improve. In most cases the results of Ultherapy are long-lasting. Following an initial treatment, many patients schedule annual treatments to maintain beautiful results.

With respect to determining which treatment is more effective, it depends on multiple factors, such as the area you wish to treat and your general skin tone. Thermage is particularly effective at addressing facial wrinkles, correcting dark circles or bags under the eye area, and areas of sagging skin or bulges on the body.

Ultherapy, however, has three main treatment areas: the brow, the decolletage and the neck. It can tighten the skin above the eyebrows, and soften lines and wrinkles around the decolletage. While Thermage can be used to soften facial wrinkles, it does not have FDA approval for tightening the skin as Ultherapy does.

Schedule a consultation with a board-certified dermatologist or plastic surgeon. They will be able to advise on the most appropriate course of treatment based on your specific goals and the condition of your skin. Both Thermage and Ultherapy can provide a small amount of lift and tightening, but in some cases a surgical facelift or tummy tuck might be a better option if you are suffering from severe skin laxity.

I recommend over those options the Thermi Smooth 250 RF treatments. Gives better skin tightening with fat dissolving. Regards 

Neither works very well.  Look in to the Thermitight device.  For face and neck tightening this works much better than either Thermage or Ultherapy.  It is a bit more invasive, but well worth it.