Thermage Vs. Ultherapy

That’s why methods like Thermage and Ultherapy are gaining ground for people who want to minimize wrinkles, tighten skin, and appear younger.

Both procedures address similar issues, but there are also key differences to be aware of when deciding which method is best for you.

Read on to learn about:

  • how Thermage and Ultherapy work
  • what you can expect from the procedures and results
  • what the main differences are between the two procedures

What is Thermage?

Thermage is a nonsurgical procedure that uses radiofrequency (RF) to help tighten and smooth skin by promoting new collagen growth. RF waves induce heat into the skin that treats outer skin and then extends inward.

Thermage is generally recommended for:

  • eye area
  • abdominal area
  • thighs

One advantage to Thermage is its ability to treat larger areas. A single treatment takes about 30 to 90 minutes depending on the treatment area, and there is little to no downtime.

What is Ultherapy?

Ultherapy uses ultrasound imaging to bypass the skin’s surface and stimulate collagen production in the desired areas.

Ultrasound is best known for targeting smaller, deeper skin layers. In this way, Ultherapy is touted as treating the skin from the inside out.

Ultherapy is the only FDA-cleared, non-invasive procedure for lifting and tightening the areas around the:

  • brow line
  • chinneck
  • chest

The company that designed Ultherapy put protocols in place that allow it to be used on the face. It’s specifically approved for use on the lower face.

Procedures are done in a medical office and a local anesthetic can be used to help prevent discomfort. However, it’s not enough to manage the pain during treatment.

Currently, PRO-NOX, which is nitrous oxide, or laughing gas, is primarily used for pain management. It doesn’t replace the anesthetic, but in combination with other pain management protocols, such as taking ibuprofen (Motrin) prior to the procedure, it helps with pain relief.

Skin may appear red and irritated immediately following treatment, but this typically resolves in a few hours. You can resume regular activities following the procedure, as no downtime is required.

What are the differences between Thermage and Ultherapy?

Thermage and Ultherapy are similar in many ways, but there are some notable differences to be aware of before deciding on the right treatment for you.

Types of energy

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The main difference between Thermage and Ultherapy is the type of energy each uses to restore collagen production. Radiofrequency is used for Thermage, while Ultherapy uses ultrasound.

This energy difference is important because ultrasound can generally reach deeper into the dermal layer.

Treatment areas

Another key difference between the two methods is the areas treated.

If you’re looking to target the neck and décolleté area, then Ultherapy is the method of choice. These areas are not treatable with Thermage. Ultherapy is also best suited for mild to moderate skin laxity.

You may consider Thermage if you’re looking to target skin other than the face and neck.

In addition to the face, Thermage also works on sagging skin on the abdomen, thighs, arms, and buttocks — areas not approved for treatment with Ultherapy.

Timing of results

Both procedures take about the same time to perform. But in general, you can expect to see full results from Ultherapy in 2 to 3 months after treatment.

Results with Thermage can take 6 months.

FDA approval

Both Ultherapy and Thermage are FDA-approved nonsurgical procedures that addresses the signs of aging.

Who’s a good candidate for each treatment?

Nonsurgical procedures are an excellent option for people who cannot have surgery or wish to go with a noninvasive treatment.

According to the American Board of Cosmetic Surgery, these treatments are best suited for people who have mild to moderate skin laxity but do not require the dramatic lifting only possible with surgery.

Candidates for Ultherapy

In general, candidates for Ultherapy have some degree of skin laxity under the neck or chin or wrinkles on the chest, especially if you want to treat the skin around the neck and décolleté.

Candidates for Thermage

Thermage is recommended if you’re middle-aged and do not need a surgical facelift or want to go with a non-invasive approach. You should have mild to moderate skin sagging in these areas:

  • jowls
  • cheek
  • brows
  • eyelids

Thermage is also a good choice if you want to target larger areas like the thighs and abdomen.

A 2019 study also reports that RF-based systems are appropriate for any skin type.

How do I prepare for each procedure?

The preparation for each procedure is relatively the same. Since they’re nonsurgical procedures, there’s not much you need to do before arriving at the office.

For both treatments, come with a clean face, free of skin products and makeup. You may also want to avoid chemical treatments and facial peels prior to treatment.

What happens during each procedure?

Both Thermage and Ultherapy are done in-office with little to no downtime.

That said, there are differences in how each procedure is performed.


According to a 2020 review of studies, a cooling spray will protect the skin surface, helping reduce any pain you may experience during the procedure.


It’s not uncommon to experience intermittent feelings of heat and tingling during the treatment when the device is delivering ultrasound energy into your skin.

What result can I expect from Thermage and Ultherapy?

Thermage results vary and depend on the treatment area.

In general, most people see gradual results over 2 to 6 months following one Thermage session. Depending on your skin, results last 1 to 2 years.

Ultherapy results appear over 2 to 3 months as new collagen lifts skin on the neck and chin. Results may improve over 3 to 6 months and can last a year, though multiple treatments may be required.

According to a 2014 study, improvements in skin laxity were observed 3 months after an Ultherapy procedure in 58.1 percent of the 93 people who received the treatment.

Overall improvements were seen in 63.6 percent of the 93 people in the study after 90 days.

While most people see results with one treatment, some may require more than one visit. To maintain results, you may need an Ultherapy treatment once a year.

Should I check with a doctor first?

In general, Thermage and Ultherapy are safe.

But if you have preexisting medical or skin conditions, talk with a doctor or see a board certified dermatologist for a consultation and approval before either of these procedures.

You cannot receive either Thermage and Ultherapy if:

  • you’re pregnant or nursing
  • you have an implanted pacemaker
  • you have an implanted cardioverter/defibrillator (ICD)

Because Thermage uses RF radiation, some people may have concerns about exposure to low levels of radiation. If this is a concern, talk with a doctor about the risk and how it applies to your health.

How do I find a provider for these procedures?

When looking for a provider for Thermage or Ultherapy, use the Find a Cosmetic Surgeon tool on the American Board of Cosmetic Surgery website.

Additionally, you can ask your primary care physician or board certified dermatologist for recommendations. Many board certified dermatologists also perform these procedures.

Are there possible side effects from Thermage or Ultherapy?

As with any medical procedure, Thermage and Ultherapy come with potential side effects and complications.

Here are the most common temporary side effects from Thermage that typically decrease or go away within 24 hours:

  • temporary redness
  • minor swelling
  • tingling

You may experience small indentations in the skin, but these are usually temporary. Talk with your provider if they do not go away after 24 hours.

The most common temporary side effects from Ultherapy include:

  • heat sensations
  • skin tingling
  • redness
  • swelling
  • tenderness

Bruising can occur in rare cases, but bruises typically go away after several days.

The takeaway

Thermage and Ultherapy are both popular nonsurgical facelift procedures that are considered safe, require little recovery time, and have minimal side effects for targeting aging skin.

If you have any medical or skin conditions, make sure to get clearance from a doctor before trying one of these procedures.

It’s also a good idea to discuss all of your options with a board certified dermatologist or plastic cosmetic surgeon to determine which procedure is right for you.

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