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

Written by Kelly Wala, RN BSN, Advanced Nurse Injector on February 28, 2019 29 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 deeper into the skin compared to the radiofrequency used in Thermage.


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. Kelly is a Faculty trainer for Allergan Facial Aesthetics and Coolsculpting as well as a Faculty trainer for Galderma Facial Aesthetics and Sculptra. Aesthetics

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

  1. Avatar Jayne says:

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

  2. Avatar 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. Avatar 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

      • Avatar Margaret says:

        What is the price range for ulthetapy ?

        • WD Staff WD Staff says:

          Hi Margaret,

          Pricing depends on the specific area they are getting treated, but the most common treatments are full face/upper neck ($3,500) and lower face ($2,500). We offer complimentary consultations if you would like to book an appointment. We also offer no interest financing as well!

          We hope that helps!

          WD Staff

  4. Avatar 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

  6. Avatar Penelope says:

    Thermage is amazing!!!

  7. Avatar Terry says:


    I did Thermage about 8 years ago and got ZERO results. The before and after photo’s look exactly the same. Is it possible some people have skin that just doesn’t bounce back? On that note It was suggested recently I try Ultherapy. If thermage yealded no results I am not sure why Ultherapy would be any different. They are both expensive around $3k and to not see an noticeable difference I am leary of trying Ultherapy. Curious what your opinion is.

    • WD Staff WD Staff says:

      Hi Terry,

      Thanks for sharing your experience with our readers and for reading our post!

      It sounds like a more invasive (potentially surgical) option may be needed to yield your desired end result. The best way forward may be for you to get an in-person consultation with a skilled (board certified) plastic surgeon who has experience with both surgical and non-surgical methods. After being assessed and seeing the Thermage before/after photos, the surgeon may recommend a lift procedure.

      Would you be open to a more invasive procedure?

      WD Staff

  8. Avatar Paul says:

    It apoears that the sections, “How They Work” and “Effectiveness”, contradict each other.

    ” Thermage is capable of not only tightening closer to the surface of the skin, but also deeper under thicker skin”

    “Thermage is unable to go beyond the outermost layer of skin.”

  9. Avatar Ruby says:


    How about pain level during treatment? I heard that ulthreapy is really painful. Many thx

    • WD Staff WD Staff says:

      Hi Ruby,

      Thanks for the great question. In our experience patients have said that Ultherapy is minimally painful. Most cite feeling some quick bursts of heat, but nothing more. We’ve heard of people needing feeling some discomfort post treatment, but simple Tylenol or Advil is all that is needed to minimize that.

      The treatment is also customizable, so its power can be turned down if patients express discomfort during the procedure. Also topical numbing cream can be applied in the area to minimize any pain or discomfort.

      We hope that helps!

      WD staff

  10. Avatar Kelly says:


    Which is more effective for a small section of loose skin on the abdomen a year after pregnancy?

    • WD Staff WD Staff says:

      Hi Kelly,

      Thanks for this great question. We would have to assess the elasticity of your skin to determine the exact best course of treatment. However, in previous cases with patients looking to correct similar issues on the abdomen we have achieved great results using Ultherapy.

      Please give us a call to setup a consultation!

      WD Staff

  11. Avatar J Hubble says:

    Which is less painful?

    • WD Staff WD Staff says:

      Hi J Hubble,

      While both treatments are non-surgical and generally considered not very painful patients who try both often say Ultherapy is the less painful of the two.

      WD Staff

  12. Avatar Tiffiny :o says:

    I have have had Ultherapy and was very happy with results. My provider no longer offers and only does thermage. They “ suggest “ 3 treatments, I only had one treatment with Ultherapy, was 12 months ago, why so many

    • WD Staff WD Staff says:

      Hi Tiffiny,

      There can be some variance between the two treatments, I would definitely follow up with your provider to ask why the recommend so many Thermage treatments.

      Honestly, you may want to find a new provider who currently offers Ultherapy. It’s always good to stay on the same program if its working for you and your happy with the results.

      We hope that helps!

      –WD Staff

  13. Avatar Layne says:

    How many areas can be done in 1 session. I would like to have my face, arms, and legs done …. abdomen and butt would be nice too.

    • WD Staff WD Staff says:

      Hi Layne,

      Thanks for reading our post and submitting your great question! Multiple areas can be done within a single treatment session! However, it would all depend on how extensive the required treatment is for each area.

      Please give us a call to setup a consultation. An in-person assessment would allow us to create a treatment plan which would include number of treatments and how many areas will be treated per session.

      WD Staff

  14. Avatar sarah says:

    How long after cosmelan can I do Ultherapy etc on my face?

    • WD Staff WD Staff says:

      Hi Sarah,

      Great question! Typically you will want the skin to fully heal after Cosmelan treatment before doing anything else. Healing time can vary, it usually ranges from 2-4 weeks.

      You’ll definitely want to tell your provider about the Cosmelan treatment and have them assess your skin prior to undergoing Ultherapy (or other professional treatments).

      We hope that helps!

      WD Staff

  15. Avatar Dee says:

    Several years ago, I tried Thermage and got no results. Here are compare and contrast photos. Does it seem that some people just don’t bounce back after using the products? Recently, Ultherapy was recommended to me. I don’t know why Ultherapy would work differently if the rage did not produce results. Considering that both are around $3k and that they don’t produce any noticeable results, I am hesitant to try Ultherapy. I would appreciate your opinion.

  16. Avatar Mae says:


    Which is more effective for upper eyelid sagging? I’m only 40, but have noticed the corners of my eyelids starting to sag.

    • WD Staff WD Staff says:

      Hi Mae,

      Thanks for submitting your great question. Unfortunately it is hard to provide an exact answer as we cannot assess you in person. You may qualify for an Ultherpay, however you may require surgical intervention (eyelid surgery) depending on the exact characteristics of the skin.

      Your best bet would be to come in for a free consultation or find a Board Certified Plastic Surgeon near you.

      WD Staff

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