Ultherapy Prime and Thermage FLX, explained from start to finish

Hello. This is Dr. Lee Yumin of MeSOnBom Clinic.

One of the questions patients ask most often is: "Doctor, should I have Ulthera or Thermage?"

Both devices have been proven in lifting over a long period, but people often do not know exactly how they differ or who each one suits.

So today I will explain the two devices that lead the lifting field in detail.

The non-surgical skin lifting field is led by two energy-based devices.

One is Ultherapy Prime, using high-intensity focused ultrasound (HIFU); the other is Thermage, using radiofrequency (RF) energy.

They were developed by Merz and Solta Medical in the United States respectively, and have become the standard for lifting worldwide.

The reasons they hold that position are clear.

First, safety and efficacy are recognised by the US FDA and the Korean Ministry of Food and Drug Safety.

Second, they are supported by clinical data and research accumulated over a long period.

Third, satisfaction rates as high as 95% speak to the result.

On that solid basis, the two have become bywords for lifting.

Because both are so well known, I am often asked: "Is it better to have both Ulthera and Thermage?"

The short answer is that they are not substitutes for each other — they are complements.

Ultherapy Prime targets the deep layer of the skin (the SMAS) to lift the facial contour; Thermage targets the shallower layer (the dermis) to improve surface firmness.

The depth reached, the way heat is applied and the area covered are all different, so combining them produces a synergy.

For example, where sagging of the upper and lower face needs correcting, lifting the deep layer first with Ultherapy Prime and then tightening the surface with Thermage produces a more complete result.

You get a double effect — lifting beneath the skin, tightening at the surface.

This combined approach can be an effective solution for people with several concerns at once.

But there is a point I want to emphasise.

However good a device is, it is hard to get the expected result if it does not suit the individual's skin.

Skin thickness, the distribution of fat, the position of the fascia and how far ageing has progressed all differ from person to person.

If treatment is applied uniformly regardless, the desired result naturally becomes hard to expect.

So the process of deciding, through precise skin analysis and assessment beforehand, which device is suitable and how much energy to apply at what depth and to which area, matters more than anything.

Side effects such as hollowing of the cheeks or burns mostly arise from uniform treatment that does not account for the individual.

Please remember that the practitioner's anatomical knowledge and experience, and a design made for the individual, decide how satisfying the result is.

Ulthera received US FDA approval in 2009 and has held a firm place in the lifting field since.

Recently the next-generation model, Ultherapy Prime, was released.

Ultherapy Prime is based on high-intensity focused ultrasound (HIFU).

Like a magnifying glass gathering light to a point, it concentrates ultrasound energy deep in the skin to form thermal coagulation points.

At those points collagen contracts, and new collagen is then produced, giving a natural lifting effect.

Its particular strength is that it can deliver energy as far as the SMAS — the deepest layer.

The SMAS is the very layer pulled during a surgical face lift, and the underlying cause of skin sagging.

Being able to act on that deep layer without surgery is what makes the device central to improving these concerns.

The biggest change in this upgrade is DeepSEE™, the improved real-time ultrasound imaging.

Where the previous model could see to a depth of 4.5mm, Prime shows skin structure in clear high-definition imaging to a depth of up to 8mm.

This allows the skin to be analysed more precisely before treatment and a plan to be made for each individual.

A display 35% larger and clearer, processing ten times faster and an improved ergonomic handpiece also allow more precise treatment.

Above all, delivering energy accurately to the target layer reduces unnecessary stimulation, so concern about pain and side effects is lower than with the previous Ulthera.

It works particularly well for those who need improvement in facial contour — sagging cheeks, a lost jawline, a double chin.

Thermage, by contrast, is the original radiofrequency lifting device, developed continuously for more than 20 years since FDA approval in 2003.

The current fourth-generation model, Thermage FLX, is a further step forward.

Thermage works on a reverse thermal gradient.

Put simply, a cooling system protects the skin surface while radiofrequency heat is delivered to the dermis beneath.

That heat contracts the collagen fibres in the dermis and then promotes new collagen production, improving firmness.

One core technology is the AccuREP™ algorithm.

An automatic tuning pulse is applied with every shot (REP), so consistent energy is delivered across each treated area.

Energy adjusts automatically to skin thickness and condition, allowing more even and stable treatment.

Thermage also has all-direction vibration.

Vibrating vertically and horizontally at once disperses the pain signal reaching the brain, so it is considerably less painful than the previous generation.

Because Thermage targets the shallower layers (the dermis and subcutaneous fat), it works on surface firmness, fine wrinkles, pore size and skin texture.

You may feel the skin tighten after treatment, and collagen remodelling then proceeds over several months for a gradual effect.

We have now looked at both treatments in depth.

Ultherapy Prime and Thermage FLX are proven lifting devices each with their own strengths: Prime aims at structural lifting of the deep layer, FLX at surface firmness and skin texture.

Both offer natural anti-ageing results without surgery, with a quick return to daily life.

Skin ageing arises from several factors together — declining collagen in the dermis, loosening of the fascia, descent of fat tissue — so it matters greatly to identify the cause and work on it at its foundation.

If you set a treatment plan that suits you through a full consultation with your doctor, these two devices can play a central part in resolving your concerns.

Keeping skin young and firm for as long as possible — we promise to do our best to help. Thank you.