Combining Thermage and Ulthera: Why and How
Quick answer: Ulthera Prime uses focused ultrasound to lift the deep SMAS layer, while Thermage FLX uses radiofrequency to tighten the skin above it, so combining them treats sagging and skin quality together. Both can usually be done in one visit with minimal downtime. At Dernia Clinic Myeongdong, the Seoul Signature Lifting package with both starts from ₩1,290,000 (KRW, excluding VAT).
- Ulthera Prime: Micro-focused ultrasound to the SMAS and deep dermis
- Thermage FLX: Monopolar RF to tighten the dermis
- Same day: Usually possible, often Ulthera first
- Session time: About 2–3 hours including numbing
- Downtime: Minimal; mild redness, swelling or tenderness
- Results: Build over 2–6 months; repeat about yearly
- Package from: ₩1,290,000 (Seoul Signature Lifting)
Why combine them?
Facial aging happens in layers. The deep support layer, called the SMAS, loosens and lets tissue slide down into jowls. At the same time, the skin above thins and loses firmness. Ulthera Prime focuses ultrasound energy into the deep layer to lift, and Thermage FLX heats the dermis to tighten the skin itself. Using both in one plan treats structure and surface together, which is why the pairing is so popular in Seoul.
The two treatments at a glance
| Ulthera Prime | Thermage FLX | |
|---|---|---|
| Technology | Micro-focused ultrasound with imaging (Merz) | Monopolar radiofrequency (Solta Medical) |
| Main layer | SMAS and deep dermis | Dermis |
| Best for | Jowls, jawline, brow, under the chin | Crepey or thin skin, eyelids, overall firmness |
| Feels like | Brief deep zaps, strongest near bone | Deep heat balanced by cooling |
| Results build over | About 2–3 months | About 2–6 months |
| Typically lasts | About 12 months or longer | About 12–18 months |
| From | ₩390,000 (100 lines) | ₩990,000 (300 shots) |
See the full Thermage FLX vs Ulthera Prime comparison.
Who the combination suits
- Mild to moderate laxity plus thinning or crepey skin
- Early jowls and a softening jawline, usually from the mid 30s onward
- People who prefer one thorough session a year to frequent smaller ones
- Visitors who want a meaningful result from a single trip
It is less suitable for very slim faces with little fat, where energy needs careful adjustment, or for advanced sagging, where a thread lift or surgical opinion may help more.
Same day or separate days?
Most people have both on the same day. Many doctors perform Ulthera first, then Thermage, though some reverse the order or split the treatments across two visits for comfort. Your doctor decides based on your skin, the doses and how you tolerate the sensations.
Your combined session, step by step
- Consultation and mapping: your doctor marks the areas and agrees the lines and shots.
- Numbing: topical cream for about 30–40 minutes.
- Ulthera Prime: the doctor uses on-screen imaging to place energy at the right depth.
- Thermage FLX: RF passes over each area, with cooling and vibration for comfort.
- Soothing: LDM or a calming mask; the package includes LDM.
Allow about two to three hours in total. For comfort details, read does Thermage FLX hurt?
Downtime and aftercare
Expect pinkness for a few hours and, sometimes, mild swelling or tenderness along the jaw for a few days. You can usually wear makeup the same day and fly the next day. Skip saunas and intense workouts for a day or two, and keep skin moisturized and protected from the sun.
What it costs
| Option | From |
|---|---|
| Ulthera Prime, 100 lines | ₩390,000 |
| Thermage FLX, 300 shots | ₩990,000 |
| Seoul Signature Lifting(Ulthera Prime, Thermage FLX and LDM) | ₩1,290,000 |
Higher line and shot counts for full-face and neck coverage cost more. See the Ulthera Prime price and Thermage FLX price pages. Prices are in Korean won (KRW), exclude 10% VAT, and are confirmed at your consultation.
Results timeline
- Day 0: subtle tightening as collagen contracts
- Weeks 2–4: skin feels firmer
- Months 2–3: the deep lift from Ulthera is most visible
- Months 3–6: Thermage collagen remodeling peaks
- Months 12–18: time to plan your next session
See the Ulthera Prime results and Thermage FLX results timelines.
Planning it around a trip
Because the combination has little downtime, it fits easily into a short stay. Book it on your first or second day so your doctor can check your skin before you leave, and you can usually fly the next day. If you also want Botox or a skin booster, your doctor will advise whether to add it the same day or on another day; see combining treatments in one visit.
Maintaining results between sessions
- Daily broad-spectrum sunscreen to protect new collagen
- A skin booster such as Rejuran Healer every few months for skin quality
- An optional Korean HIFU top-up around six months, if your doctor suggests it
- A stable weight, good sleep and no smoking, which all help results last
Budget-friendly alternatives
Korean devices offer a similar pairing at a lower cost: Shurink Universe HIFU with Oligio X or Volnewmer RF. Results usually last a shorter time, so sessions are repeated more often. Compare Ulthera vs Shurink.
Safety
Thermage is not suitable with a pacemaker or implanted electronic device, and both are usually postponed during pregnancy or with active skin infection. Tell your doctor about recent fillers, threads or metal implants. Treatments at Dernia are performed by licensed medical doctors. To see whether the combination suits you, book a consultation or browse all treatments.
Not sure which treatment is right for you?
Tell us your concerns and your travel dates. A doctor examines your skin in person, explains your options in English, and confirms the plan and price before anything is done.
FAQ
Frequently asked questions
Straight answers from our medical team. Still unsure? Ask a doctor or browse all patient questions .
Can Thermage and Ulthera be done on the same day?
Yes, in most cases. Many doctors perform Ulthera first and then Thermage in one visit. Your doctor may split them if you prefer or if your skin needs it.
Which should I do first, Thermage or Ulthera?
When combined on the same day, Ulthera is commonly done first, then Thermage. The order matters less than the doses and placement, which your doctor tailors to your face.
How long do combined results last?
Many people enjoy results for about a year or longer, with Thermage effects often lasting 12–18 months. Most repeat the combination about once a year. See how long does Ulthera last?
Is the combination painful?
You will feel deep heat and brief zaps, mainly over bony areas. Numbing cream, cooling and energy adjustments keep it manageable for most people.
Is it worth paying for both?
If you have both deep laxity and thinning skin, combining treats both in one session. If only one is your concern, a single treatment may be enough. Your doctor will be honest about which you need.
Keep exploring
Related treatments, prices and guides
The treatments
- Ulthera Prime — deep SMAS lifting
- Thermage FLX — RF skin tightening
- LDM Water Drop Lifting — soothing after lifting
Reviews and compare
Concerns and guides
Plan your visit to Dernia Clinic Myeongdong
English consultations, clear prices in Korean won and treatment plans built around your time in Seoul. Tell us your dates and we will suggest a schedule that fits.
Individual results vary. Suitability, dosage and final price are confirmed by a licensed doctor at your consultation. Prices are in Korean won (KRW) and exclude 10% VAT. Medical disclaimer