Ultherapy vs. Thermage [Pros and Cons]

by | Jul 15, 2020


Did you know that after we hit 20, our skin loses one per cent less collagen each year? This means that we can expect to see the skin becoming thinner and fragile with age as it gradually loses its elasticity and bounce. Menopause won’t do anything to help either because declining estrogen levels can also leave the skin drier and easily prone to sag.



Thermage Machine


Usually, when people mention Thermage, the first thing that comes to mind are the painful sessions. It’s unfortunate that good treatment is overlooked because the discomfort overshadowed its potential. However, today’s version highlights patient comfort without neglecting efficiency and quality.

The Thermage Process


Thermage Process


The physics behind Thermage starts with the electrical current directed to the skin which is met by the cells in these areas. Resistance converts the radiofrequency (RF) energy into heat energy. The heat generated alters the protein composition of collagen resulting in two reactions:

  • First, heated collagen breaks down the hydrogen bonds in its chains causing the structure to shorten and thicken. This process is similar to how eggs turn out when you scramble them. Like eggs, collagen can also be drastically affected by heat. This explains the visible tightening soon after treatment up to a few weeks after that. However, that initial effect does not last as the body clears out damaged collagen.
  • Second, denatured collagen signals cells within the dermal skin layer (responsible for tissue regeneration and recovery) to produce new, healthy collagen. This results in the tightening experienced after a few months of the procedure. Furthermore, the heat increases blood flow which can increase the metabolism of the fatty layer. This process is the long term effect that Thermage provides for the skin. 

Deep tissue effect occurs between 65-75 degrees Celsius (149 to 167 degrees Fahrenheit). However, the skin surface temperature is maintained at 40 degrees Celsius (104 degrees Fahrenheit). As a non-ablative treatment, it means the change unfolds within the skin layers, leaving the skin surface intact. This means shorter downtime. 

Thermage utilises proprietary monopolar frequency, which penetrates deeper than bipolar radiofrequency. The treatment also provides uniformed volumetric heating to these underlying tissues. It comes with the kind of efficiency delivered by its array of specialised tips designed for various areas. Adding to that it’s also fitted with comfort measures, such as a vibrating handpiece and cooling before, during, and after pulses.

Thermage Coverage

Thermage can comfortably treat areas such as the eyes, lips, face, abdomen, arms, buttocks, hands, thighs, and knees. It is  beneficial for lax and loose skin, thin skin, saggy jawlines, and those crepey skin above the knees. 

To address these areas, the average length of treatment can run for forty-five minutes to an hour and a half. This will vary based on the number of areas you want it to be treated and the condition of your skin.

Unlike other procedures requiring four or more sessions, Thermage patients can benefit from a single treatment. However, with customised care, your doctor will determine the course of treatment that is suitable for your needs and aesthetic goals. Therefore, some may need more than one treatment based on the condition of your skin and the natural ageing process.

The Thermage Rejuvenating Effect

Since collagen renewal requires time, it can take months before significant changes can be observed. Measurable tightening and contouring gradually take shape over a 6-month period, leaving the skin looking youthful and rejuvenated, especially with the right patient.

However, you shouldn’t expect it to be comparable to the dramatic outcome provided by surgery where even the muscles are lifted. However, Thermage produces the following results:

  • Tighter and contoured skin
  • Rejuvenates the eye area
  • Helps minimise the appearance of wrinkles around the eyes
  • Corrects eyelid hooding
  • It softens nasolabial folds
  • Improves laxity of the jawline and neck
  • Enhanced complexion
  • Lightens the appearance of acne scars
  • Tightens the skin of the arms, abdomen, buttocks, and thighs
  • Minimises the appearance of cellulite

These results can last about a year and a half to two years depending on how your skin ages, although you can always get touch-up treatments to maintain it. 

Suitable Candidates

Thermage is suitable for the following patients:

  • Ages 30 to 60, with mild to moderate skin laxity
  • Individuals with realistic expectations
  • Patients who have had surgical facelift years back, and are starting to experience some sagging
  • All skin types

This treatment is not advised for those who fall under this criteria:

  • Severely obese patients 
  • Severely photodamaged or aged skin
  • Patients with pacemaker or defibrillator implant
  • Individuals with metal implants of any kind, especially on target areas
  • Patients who have had corneal surgery or LASIK are advised to wait for a few months to heal before undergoing treatment
  • Patients with habits or conditions that impair wound healing as Thermage works by creating controlled wounding to stimulate the healing process and produce healthy collagen.

Thermage vs Ultherapy


 Ultherapy Device


Ultherapy has always been constantly compared to Thermage as it is also a non-surgical skin tightening treatment. To trigger the body to produce more collagen is to subject the skin to controlled damage. While Thermage uses heat to initiate this response.  Ultherapy uses ultrasound to deliver the intended results.

The Ultherapy Process

Ultrasound technology also bypasses the skin to safely deliver focused energy to the dermis and foundational layers where laxity begins. The pulses penetrate up to 4 millimetres below the skin surface to stimulate the natural process of collagen regeneration or neocollagenesis. It’s similar to burning paper with a magnifying glass. However, the “burn” occurs below the skin surface and it stimulates the body to initiate repair in those targeted areas by generating healthier collagen than was damaged.

Similar to Thermage, renewal continues weeks after treatment through an extended regeneration process that lasts anywhere between 3-6 months. Eventually, this gives the tissue a lift particularly for those who experienced mild to moderate skin laxity


Ultherapy Process


Ultherapy Coverage

Ultherapy may seem like a non-surgical facelift, but it’s more like an uplift. This treatment targets the following areas:

  • Full face
  • Full neck
  • Lower face
  • Upper face
  • Brow area
  • Around the mouth
  • Decolletage

 This treatment is a viable option for those who are not yet ready to undergo a facelift but still want to stay ahead of the game. Sessions can take sixty to ninety minutes, and some patients claim that they experience some discomfort during the treatment, while others say that they can tolerate it well. Generally, there’s no need for any downtime after treatment. 


The Ultherapy Transformation

This treatment won’t leave you looking radically different overnight. Unlike Thermage, patients won’t see any change after each session. However, since biochemistry is unique to the individual, we produce collagen at slightly different rates. This means that even though results generally become evident between three to six months, it’s possible for you to experience improvements earlier. 

Patients usually require one treatment every year or so, but there are individuals who require multiple treatments done frequently to achieve their desired results. 

Suitable Candidates

Ultherapy is suitable for patients who are relatively young, or those in their early forties to mid-sixties as a way to stave off the ageing process to the skin. It is ideal for someone who doesn’t need a facelift but wants some minor improvements done. The treatment is also done on patients who wish to improve a few years after their facial enhancement surgery.

The Bottomline


Skin Structure


Thermage and Ultherapy are treatments that are suited for mild to moderate sagging. Obviously, they differ in the way that they trigger collagen regeneration. The point is not about which is better, but how you wish to achieve skin rejuvenation. 

Thermage offers appreciable results after treatment, and it will continue to improve over time. Meanwhile, Ultherapy also promises the same improvement, with some amount of time before changes can be observed. 

If you wish to learn more or opt for this treatment, we would be happy to help you through this process. We’re just a call away if you wish to book a consultation with Dr Tyng Tan



About Dr Tyng Tan

Dr. Tan Tyng Yuan, MBBS completed her graduate and medical education in the United Kingdom over a span of 10 years.

She is also certified by the Aesthetic Practice Oversight Committee (APOC) to operate various laser devices for skin conditions, administer dermal fillers, Botox and chemical peel.

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