Ultherapy vs. Thermage: Which Non-Surgical Skin Tightening Laser Is Better?

By Kelly Wala, RN BSN February 28, 2019 7 Comments

ultherapy vs thermage

In their quest for a non-surgical treatment that tightens and lifts loose or lax skin, many patients will come across two popular treatments: Ultherapy and Thermage. On the surface both treatments appear similar, they are both minimally invasive procedures that can yield skin tightening benefits without the downtime and risks of surgery.

There are, however, significant differences between Thermage and Ultherapy. Here’s a brief comparison of both treatment options.

How They Work

Ultherapy uses ultrasound technology to strengthen the skin from the inside out. It works by using ultrasound energy to gently heat the tissue under the treatment area. The skin responds to this energy by stimulating the production of new collagen, resulting in a gradual tightening and firming which naturally lifts surface layer skin over time.

Thermage uses radiofrequency energy to tighten and contour the skin. A special handpiece is used to deliver the energy which heats the tissue under the skin, stimulating the body’s natural renewal of collagen. Thermage is capable of not only tightening closer to the surface of the skin (for better smoothing and tightening), but also deeper under thicker skin (for contouring on the body).

Treatment Areas

Ultherapy is FDA approved to tighten and lift the brow line, chin, neck and chest. For facial treatments, Ultherapy is great at improving the muscle fascia which is the primary muscle addressed in traditional facelift procedures. It’s also a good non-surgical way to address mild to moderate submental fullness (double chin). Ultherapy can be used off-label with successful tightening of the skin on the abdomen, arms and knees.

Thermage can be used to address the same facial areas as Ultherapy. However, it can also be used off-label to address many areas of the body including the hands, arms, abdomen, buttocks, and thighs. Thermage is also a viable treatment option for light to moderate cellulite.

Number of Treatments Needed

Ultherapy and Thermage are similar in that most patients will only require a single treatment every 6 months to a year a part to realize their desired end result. However, additional treatments may be necessary for some patients who have higher skin laxity or exhibit more severe aging symptoms.  Most patients benefit from additional treatments after a year or two as well as a follow-up to maintain results.

Treatment Time

Ultherapy treatment sessions are typically shorter than Thermage treatments. An Ultherapy treatment for the full face and neck typically lasts around 60 minutes whereas as similar Thermage session may take closer to 90 minutes because of the cooling that has to occur on the top layer of the skin, which is called the epidermis.

Recovery & Side Effects

Both procedures are minimally invasive and require no downtime. Patients can undergo either treatment on their lunch break. Common side effects of Ultherapy and Thermage include redness, swelling, and tenderness of the skin, which will resolve on its own in a few days without intervention.


While both treatments have been shown to fight the signs of aging, Ultherapy does have a slight edge in terms of effectiveness as its ultrasound energy is able penetrate to deeper layers of the skin. In contrast, the radiofrequency used in Thermage is unable to go beyond the outermost layer of skin.


The procedures differ greatly in how quickly results become apparent. The final results of Ultherapy typically become apparent within 2-3 months of treatment while it can take up to 6 months for optimal Thermage results.

It’s important for patients to understand that neither Ultherapy or Thermage offers permanent results. However, patients can choose to undergo maintenance (“touch up”) treatment sessions in order to keep their results long-term.


Kelly Wala, RN BSN

Kelly Wala is a Registered Nurse with a Baccalaureate Degree of Science in Nursing from Eastern Kentucky University. As an Aesthetic Nurse Specialist for the past 10 years Kelly specialized in a full complement of non-surgical aesthetic services such as facial injectables, laser and light therapy, body contouring, and skin care. Kelly was the first in Texas to perform the Injectable Threadlift.

7 Responses to “Ultherapy vs. Thermage: Which Non-Surgical Skin Tightening Laser Is Better?”

  1. Jayne says:

    Question: Is this a typo – should it have read “neither”, instead of “either”?

  2. Jayne says:

    Oops – left this off my last question:

    It’s important for patients to understand that either Ultherapy or Thermage offers permanent results.

    • WD Staff WD Staff says:

      Hi Jayne,

      Thanks for finding that typo, it should be neither (and has been changed). We appreciate you taking the time to point that out!

      WD Staff

  3. Joanna says:

    Which is better for under eye/top of cheek indentation?

    • WD Staff WD Staff says:

      Hi Joanna,

      Thanks for submitting that great question. As always, we recommend seeing an experienced and licensed professional for an in-person assessment. If you are in the Austin area please give us a call!

      It’s a bit tough to give a good answer without assessing you in person. However, we’ve seen better results with Ultherapy.

      WD Staff

  4. Rosy says:

    The skin on my face is thick I had a lower facelift approximately 8 years ago. With thicker skin which is more effective Ultherapy or thermage?

  5. WD Staff WD Staff says:

    Great question Rosy! We’ve had better experience using Thermage on patients with thicker skin. We’d have to assess the characteristics of your skin to be sure, but that would most likely be the direction we recommend. You’ll definitely want to get an in-person assessment by a skilled provider of both treatments though.

    Thanks again,
    WD Staff

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