My clinic added Thermage to Ultherapy. Do I need both?

1. What changes when Thermage is added to Ultherapy?

A treatment that delivers heat using a different form of energy is added. Ultherapy uses imaging to view tissue while delivering focused ultrasound; Thermage uses monopolar radiofrequency. The Korean term “Ulthermage” describes the combination, not a separate device.

A consultation may describe Ultherapy in relation to sagging contours and Thermage in relation to skin firmness and fine lines. This is a starting point for discussion. It does not mean Ultherapy has no effect on firmness or that Thermage never addresses laxity.

Calling both treatments lasers, or saying one “lifts the framework” while the other “fills the surface,” does not explain the plan clearly. Ask about ultrasound versus radiofrequency, the treatment areas and each goal. Neither should be understood as filling a hollow cheek like an injectable filler.

Sources: Ulthera System PRIME: US Instructions for Use / Thermage: safety information / Alhaddad et al. (2019): monopolar radiofrequency versus MFU-V (PMID 30531187)

2. Should I start with my jawline, jowls or fine lines?

Start with the one area you most want to change, and ask why it looks that way. It is fine to begin with “My whole face looks older.” Then identify whether your jawline looks less defined, tissue beside your mouth seems to descend, or your skin feels less firm.

Submental fat, loose skin and your underlying jaw structure are different issues. Jowls and nasolabial folds are not interchangeable targets with the same promised response to one device. Ask the clinician to distinguish laxity from volume deficiency and explain what the proposed treatment would leave unresolved.

If fine lines are your priority, specify whether they are around your eyes or mouth. Even if pores and skin texture concern you too, do not assume they are included in a jawline plan. Ask which device and tip will be used for each area so your expectations match the plan.

Sources: American Academy of Dermatology: skin tightening / Secret Plastic Surgery Clinic: thin faces and Ultherapy / Resum Plastic Surgery Clinic: Ultherapy and Thermage combination

3. If sagging and firmness both concern me, is combining treatments more effective?

There may be a reason to consider a combination, but that does not mean double the effect or greater satisfaction for everyone. Ask which concern Thermage would address that Ultherapy alone is expected to leave. The word “synergy” does not quantify the additional benefit.

When reading research, check what was compared. In PMID 30531187, 20 people with mild to moderate laxity received radiofrequency on one side of the face and microfocused ultrasound with visualization on the other. This is different from testing both treatments together on the same side.

Laxity scores improved on both treated sides at 30 days, with improvement also observed at 90 and 180 days. The assessed laxity measures, satisfaction and adverse events did not show a statistically clear difference between modalities. This does not establish identical effects and risks in all circumstances.

With only 20 participants, the trial has limited ability to assess rare adverse events or differences across many facial types. The abstract also cannot decide which device suits you personally. In particular, the results do not prove that combining the treatments is better than one alone. Six months of study follow-up is not a universal duration of benefit.

If a clinic presents a study or before-and-after case, ask whether the starting condition resembles yours and what it shows beyond treatment alone. Then weigh the added cost and recovery burden.

Sources: Alhaddad et al. (2019): monopolar radiofrequency versus MFU-V (PMID 30531187) / Resum Plastic Surgery Clinic: Ultherapy and Thermage combination

4. Do I need both if my face is thin and I worry about hollow cheeks?

Show the clinician the hollow areas and the volume you want to preserve first. Be clear if you want a more defined jawline rather than a smaller face. In that situation, discussing where to treat and where to avoid comes before choosing the number of devices.

The US Ulthera System PRIME instructions include postmarketing reports of fat or volume loss and asymmetry. Spontaneous reports alone cannot establish frequency or the cause of a particular person’s change. The name Thermage does not guarantee freedom from cheek-hollowing risk either.

Instead of accepting “fewer shots means safe,” ask which tissue will be treated at what depth and intensity. Ultrasound imaging and checking genuine consumables are separate matters, and neither guarantees your outcome. Mention the dates and areas of previous fillers, fat grafting, threads and other lifting treatments.

The Gangnam Unni writer names AB Clinic in the post; this is not a review of Resum Plastic Surgery Clinic. The writer reports 300 shots of Ultherapy PRIME and 300 of Thermage, but that configuration and its safety cannot be transferred to someone else.

Sources: Ulthera System PRIME: US Instructions for Use / Thermage: safety information

5. If I can afford one treatment, which should I start with?

Ask first for a single-treatment plan addressing your main concern. If jawline sagging is the priority, discuss what Ultherapy alone is expected to achieve; if firmness and fine lines are the priority, discuss a Thermage-only goal. Your facial assessment may also lead to a different option or postponing treatment.

Look at the actual extra payment and its purpose rather than the package discount percentage. Instead of accepting a combined figure such as 900 shots, ask for each device’s shots, areas, anesthesia charge, VAT and aftercare inclusions. Adding shot counts from different devices does not create a common measure of effect or intensity.

The decision process is the same even if you can afford the extra cost. Go beyond “it will be better” and ask which area should change further, by what measure and when. If the clinician cannot give a reliable numerical estimate, include that uncertainty in your decision.

This is a Babitalk user’s consultation experience. The post refers to AB Dermatology, but its formal clinic name and branch were not independently matched, so it is not presented as a verified case from a particular clinic. It does not establish treatment effectiveness or an appropriate shot count.

Sources: Resum Plastic Surgery Clinic: Ultherapy and Thermage combination / Beautystone Clinic: treatment order and timing for Thermage and Ultherapy

6. Must both be done on the same day, or can I start with one?

Whether you need both and whether to have them on the same day are separate decisions. Some clinics perform sequential treatments on one day; another approach is to begin with one and discuss the next after assessing recovery or change. Saying they need not be simultaneous does not settle whether the second treatment is needed at all.

If you start with one, agree on what will be assessed at the next consultation. The time to check recovery may differ from the time to compare results. If you recently had Thermage or Ultherapy, provide its name, date, area and any persisting discomfort, and ask how the new plan accounts for it.

The Gangnam Unni writer names Dress Plastic Surgery Clinic in the post; this is not a Beautystone Clinic review. The exact interval described as “recent” is absent, and the photos are labeled day one. This excerpt does not establish a recommended interval or long-term effect.

Sources: Beautystone Clinic: treatment order and timing for Thermage and Ultherapy

7. If I see little change after Ultherapy, should I add Thermage?

First reassess the course of the treatment you already had and the concern that remains. Judging failure or paying for more treatment from an immediate impression makes it harder to identify what is missing. Bring before-and-after photos with matching lighting and angles to discuss the target area.

Distinguish whether the reason for adding Thermage is fine lines that were already present or a jawline that differs from your Ultherapy expectations. Rather than accepting a promise that another device will fix the disappointment, check how the remaining problem connects to the proposed addition.

Sources: Ultherapy UK: timing and duration of patient results / Beautystone Clinic: realistic Ultherapy experience and consultation case

8. Should I also consider pain and recovery when combining treatments?

Yes. Discuss recovery as well as the goals of both treatments. Ultherapy instructions describe pain and temporary sensory or muscle changes; Thermage manufacturer safety information includes burns and surface irregularities. One review reporting little pain does not establish safety.

Alongside facial volume, mention implanted electronic devices, previous procedures in the area and current skin problems. Thermage’s manufacturer lists implanted electrical devices such as pacemakers as a contraindication. Ask about anesthesia and your plan for getting home as well.

Give the date of an important shoot or event before treatment. If you have already been treated and develop blisters or a suspected burn, worsening pain, or changes in sensation or facial movement, contact the treating clinic for medical assessment rather than waiting for the scheduled result review.

Sources: Ulthera System PRIME: US Instructions for Use / Thermage: safety information

9. Can reviews of both treatments tell me Thermage’s added benefit?

The reasons for satisfaction may be useful, but the second treatment’s added effect is difficult to isolate. A review of combined treatment does not include that person’s result with one treatment alone. If Botox, a skin booster or threads were also performed, attributing changes becomes still harder.

Check the area, starting condition, other procedures and observation time as well as treatment names. An immediate impression and several months of follow-up provide different information. That is why photos without an account of the treatment, or a price alone, are not enough for a decision.

The Babitalk review has Ultherapy and Thermage tags and a treatment date of 2026-10-13; it describes an early impression. The Gangnam Unni excerpt recalls prior treatment before seeking other care for sagging after weight loss, without the earlier treatment details. These are not like-for-like comparisons or grounds to recommend surgery.

10. What should I understand before paying for a same-day package?

Get separate explanations of the single-treatment plan and the proposed addition before deciding. Recommending both does not by itself establish overtreatment, but a discount deadline does not explain your medical need.

Ask who will assess and treat you. If a specialist qualification is advertised, ask which specialty and who actually performs the consultation and procedure. A clinic’s device inventory, the model used that day and checking a genuine tip are different matters. Ask how authenticity is checked and see the consumables intended for your treatment.

If the explanation is incomplete, take the quote away and allow time to decide. For a cheaper device, first ask whether it addresses the same goal in the same area. Do not treat Shurink or another radiofrequency device as an identical substitute with a different name.

Sources: Ulthera System PRIME: US Instructions for Use / Thermage: safety information

What should I ask during the consultation?

• What is the main issue to address, and how did you distinguish sagging from volume deficiency?
• What should I expect from Ultherapy alone, and which concern would remain?
• Which area should change further with Thermage, by what measure and how much?
• How will existing cheek hollows and volume I want to preserve affect the plan?
• Which models, tips, shots per area and treating clinicians are planned?
• What are the separate total prices for one and both treatments, including VAT, anesthesia and aftercare?
• Why have both on one day? If I start with one, when and what will we assess before adding the other?
• Do recent treatments or persisting discomfort mean the plan should change?
• Who should I contact for insufficient change or new symptoms, and how will follow-up work?

Where should I start in my situation?

Related questions

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Sources and check dates

Underlying evidence checked 2026-10-24. US manufacturer instructions are not presented as Korean regulatory authorization. Original clinic and review materials may be in Korean.

1. Resum Plastic Surgery Clinic: Ultherapy and Thermage combination
2. Beautystone Clinic: treatment order and timing for Thermage and Ultherapy
3. Ulthera System PRIME: US Instructions for Use
4. Thermage: safety information
5. American Academy of Dermatology: skin tightening
6. Secret Plastic Surgery Clinic: thin faces and Ultherapy
7. Alhaddad et al. (2019): monopolar radiofrequency versus MFU-V (PMID 30531187)
8. Ultherapy UK: timing and duration of patient results
9. Beautystone Clinic: realistic Ultherapy experience and consultation case