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Skin Tightening Devices Review: Thermage vs Ulthera

Ulthera is a new option in skin tightening that is challenging the more established Thermage.

When it comes to skin tightening devices, the choices are widely varied and there are always new options available. For years, Thermage has held the top spot as the gold standard of devices amongst many physicians. Now another choice is gaining popularity. Ulthera uses a different energy modality and many are impressed by the results.

Seattle cosmetic surgeon Dr. Craig Jonov has experience with both systems and says they each have their use. He likes to use Ulthera with patients who have more skin issues. "I like it with individuals that are maybe a little older, who have more damaged skin. Ulthera is a little more predictable for certain individuals." He has found that in patients who may traditionally have been surgical candidates, Ulthera provides a somewhat greater result. "With this new technology, we have a little more ability to improve the outcome."

ulthera before and after photos
Actual results of Ulthera of Dr. Craig Jonov with 50 year old patient


He says that originally, he was using Ulthera on the face and neck area, but now is finding it useful in other areas like the stomach, thighs and arms. Dr. Jonov says that he has found it to be safe and efficient and less painful than Thermage in some areas, but that as everyone's pain threshold is different, opinions vary. "Some patients will tell you that Ulthera is less painful than Thermage and some tell you that it's more. Ulthera is a little quicker, and I would imagine the areas of tenderness and sensitivity are less. There are certain specific areas that are going to be more uncomfortable than others," says Dr. Jonov.

Thermage uses radio frequency (RF) to heat deep within the skin and stimulate the growth of collagen. Ulthera on the other hand, uses ultrasound and enables the physician to see just how deep into the dermis the energy is reaching. As Dr. Jonov explains, "We're able to actually visualize and see where the dermal layers are and effectively treat them at different levels. You might get more of a contraction because the level of energy is going to be deeper in the subcutaneous tissues than the level that Thermage may go."
ulthera before and after photos
Actual results of Ulthera of Dr. Craig Jonov with 50 year old patient


Dr. Jonov says there is minimal risk with Ulthera, and that pain is generally minimized. Patients may feel a bit of a burning sensation, but this can usually be cooled on the outer surface of the skin. Prices vary greatly depending on factors such as geographic area and part of the body treated, but Thermage and Ulthera should be in the same ballpark for cost.

With Ulthera, patients generally see improvement right away, but should be aware of the limitations of the results possible with a non-surgical treatment. Those whose expectations are accurate are typically pleased with their outcome. "We've found that the patients who've been able to see a response really have expressed satisfaction immediately. It's been very exciting for the patients," says Dr. Jonov.
ulthera before and after photos
Actual results of Ulthera of Dr. Craig Jonov with 60 year old patient


Both Thermage and Ulthera treatment times vary depending on the area treated. It could be anywhere from just a few minutes to an hour. As with Thermage, Ulthera patients will see their results improve for several months as new collagen continues to grow. How long the results last will vary for each patient, but you can reasonably expect to see improvement for around a year or more.