Ultrasound · Radiofrequency · Pacific Plaza
Ultherapy vs Thermage is a comparison of two kinds of heat. Ultherapy places focused ultrasound in small points down to the SMAS, the support layer under the skin, while Thermage warms a broad layer of the dermis with monopolar radiofrequency. Both are offered at Atelier, and Dr Sin Yong chooses between them, or uses both, according to which layer has loosened and how much facial fat there is to protect.
Ultherapy, made by Merz, is micro-focused ultrasound with visualisation. The handpiece shows the skin, fat and SMAS on a screen, then converges ultrasound into small heated points at about 4.5 mm (the SMAS, the plane a surgical facelift repositions), 3.0 mm or 1.5 mm, with the surface left intact. Each point contracts and then remodels, so the change builds over weeks. Details are on the Ultherapy page.
Thermage FLX, made by Solta Medical, is monopolar radiofrequency at 6.78 MHz. Current passes from a treatment tip through the tissue to a return pad, warming the deep dermis and the fibrous strands beneath it as one volume, while bursts of cryogen spray cool the surface. There is no imaging: the tip and energy setting control depth. Atelier describes the treatment plane as reaching roughly 65–75 °C. See Thermage at Atelier.
So the real difference is not ultrasound against radiofrequency as brands, but focused points in a deeper support layer against an even field of warmth in the skin.
Side By Side
The table compares how each treatment works, not which is better; the studies below found no clear winner.
| Ultherapy | Thermage FLX | |
|---|---|---|
| Energy or mechanism | Micro-focused ultrasound with real-time imaging | Monopolar radiofrequency, 6.78 MHz, with cryogen cooling |
| Depth and target | Points at about 4.5 mm (SMAS), 3.0 mm and 1.5 mm | Broad heating of the deep dermis and fibrous septa |
| Typical sessions | One session, judged at about three months; any repeat set then | Planned as a single session; more is discussed at follow-up |
| Comfort and numbing | Brief, deep heat, stronger over bone; numbing cream | Heat pulses followed by cooling bursts |
| Downtime | Redness for hours; jaw tenderness for several days, sometimes longer | Redness, warmth and mild swelling that usually settle quickly |
| When results show | Collagen builds over 8–12 weeks; improvement develops over three to six months | Develops over two to six months |
| Who it suits | Early descent at the jowl, brow or under the chin, with enough soft tissue | Crepey texture and mild, widespread looseness, including around the eyes |
| At Atelier | Offered at Atelier | Offered at Atelier |
The Evidence
Direct comparisons are few and small. In a randomised split-face study of 20 patients followed for six months, monopolar radiofrequency and micro-focused ultrasound both improved laxity, with no significant difference between them (Alhaddad 2019). A study of 20 patients treated on the neck also found results that were not significantly different, and ultrasound was the more painful of the two (Jones 2017). An earlier lower-face study of micro-focused ultrasound, with 93 patients evaluated, found weaker outcomes in people with a body mass index above 30 (Oni 2014).
The fair reading is that neither has been shown to be better overall. What changes the outcome is matching the energy to the layer that has loosened.
Which Problem
For a broader look at focused ultrasound brands, see Ultherapy vs HIFU.
How Atelier Decides
Dr SY examines the face at rest and in movement and feels the thickness of skin and fat in each zone, so the plan starts from where laxity sits and how much fat the face can spare. From there the choice may be Ultherapy, Thermage, both, or neither. In a lean face, the VF Lift – Vertical Facelift, monopolar radiofrequency on the Volnewmer platform with continuous water cooling, may be preferred; in a fuller lower face, the Time Freeze Laser LCLR® may be. Dr Sin Yong holds a Key Opinion Leader appointment with CLASSYS, which makes Volnewmer.
Ask any clinic three things: which layer it thinks has loosened, how much fat it is protecting, and how the result will be judged.
Dr Sin Yong holds a Key Opinion Leader appointment with CLASSYS.
Atelier Aesthetics · Owned by AYA
9 Scotts Road, Pacific Plaza #12-01A, Singapore 228210 · +65 8023 7170
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