The two procedures people compare side by side most often when looking into lifting are Ulthera and Thermage. They use different energy and reach different depths. Ulthera targets the fascia (SMAS) layer with ultrasound, while Thermage works across the dermis with radiofrequency. So the question that guides the choice is not "which one is better" but "at which layer did the sagging begin."
How Do the Working Principle and Reach Depth Differ?
Ulthera is a procedure that directly stimulates the SMAS layer with high-intensity focused ultrasound (HIFU). The target depths are divided into 4.5mm (SMAS), 3.0mm (dermis) and 1.5mm (superficial layer). It is a U.S. FDA-approved device, and the Ulthera used at Repic Clinic in Gangnam applies DeepSee™ real-time imaging so the depth can be checked during treatment. Its main targets are sagging of the jawline, cheeks and cheekbone area, and contour lifting.
Thermage uses monopolar radiofrequency (RF) energy to induce collagen contraction and regeneration in the dermis. The target depth is 2.0–3.0mm, which corresponds to the whole dermis. Its main targets are facial lifting, elasticity, fine lines and pore tightening, and it is a non-surgical method. This clinic offers Thermage FLX.
Selection Criteria by Age Group and Area of Concern
In the comparison guide, Ulthera is classified as suitable when the main concern is jawline and cheek sagging in the late 30s to 50s. Thermage is classified as suitable when the concern is an overall loss of elasticity in the late 20s to 40s. However, age is only a reference. Even at the same age, the suitable procedure differs depending on skin thickness, the composition of the facial fat layer and lifestyle.
If you are having it for the first time in your late 30s, take the change that appeared first as your guide. If the main concern is sagging below the cheekbones and along the jawline, Ulthera is considered first, and if the main concern is pores and an overall loss of elasticity, Thermage is considered first. The two procedures are sometimes combined as complements, but a combination is recommended only when there is a basis in the diagnosis.
Diagnosis-Based Design and Cost Consultation
Repic Clinic in Gangnam carries out Meta View (skin surface) and Mark-Vu (deep analysis) diagnostics before a procedure. Design Ulthera uses the same Ulthera device, but after measuring skin thickness, sagging position, facial proportions and skeletal structure, the doctor personally designs the treatment positions and energy levels. Design Thermage designs differently by area, for example by applying extra intensity to areas with many pores, adding shots to areas with reduced elasticity, and lowering the intensity on sensitive areas.
Because these are non-covered treatments, the cost differs by clinic and by the scope of the procedure. The number of Ulthera shots is generally set per patient within a range of 200 to 600 shots, and it also varies depending on which depth is applied first and the scope of application.
Whether a procedure is suitable, the recommended number of sessions, precautions and the possibility of side effects depend on the diagnosis. Checking the items below at your consultation makes comparison easier.
- Main area of concern: sagging below the jawline and cheekbones, or pores and overall elasticity
- Diagnostic method: whether skin thickness and sagging position are measured
- Need for a combination: whether there is a basis in the diagnosis
Repic Clinic in Gangnam is located on the B1 and 2nd floors at 318 Gangnam-daero, Gangnam-gu, Seoul. You can find detailed information on each procedure on the official page.
Frequently Asked Questions
What is the difference between Ulthera and Thermage in one sentence?
Ulthera uses ultrasound (HIFU) to target a depth of 4.5mm down to the SMAS layer to address sagging and contour, while Thermage uses radiofrequency (RF) to induce collagen regeneration across the 2.0–3.0mm dermis to address elasticity and fine lines. Which is better depends on where the sagging is and on your skin condition.
If I'm in my late 30s and having it for the first time, which should I consider first, Ulthera or Thermage?
If the main concern is sagging below the cheekbones and along the jawline, Ulthera is considered first, and if the main concern is pores and an overall loss of elasticity, Thermage is considered first. It also depends on the composition of your facial fat layer and the direction you want, so deciding after a diagnosis is recommended. Having both procedures is advised only when there is a basis in the diagnosis.
How is Design Ulthera different from regular Ulthera?
The device is the same Ulthera, and the difference lies in the design stage. After skin thickness and sagging position are measured through Meta View and Mark-Vu diagnostics, the doctor designs the treatment positions and energy levels. Even with the same number of shots, the position and intensity applied differ for each patient.
Results may vary from person to person, and before a procedure please confirm through diagnosis and consultation whether it is suitable, along with precautions and the possibility of adverse reactions. This article is intended for general information and does not replace individual medical care.
Official Information
You can find more details on the official website.
Repic Clinic official website →
※ This content is for general information only and does not replace a medical diagnosis or treatment. Please consult a medical professional before any procedure. Results, downtime and side effects vary from person to person.
