Thermage
Thermage heats the deeper layers with radiofrequency. The tip is stamped across the area.
← All comparisons
Dermapedia / CompareProcedures
Thermage vs HIFU
Thermage is the better choice for skin quality. It heats a block of skin with radiofrequency, it is comfortable enough that most people need no medication, and it is the one used on crepey eyelids. HIFU is the better choice for a dropping jawline. Focused ultrasound places heat much deeper, in the layer a surgeon tightens in a facelift, and that depth is what makes it hurt. Both are one session, both take months to show, and neither replaces surgery.
At a glance
| The difference | Thermage | HIFU |
|---|---|---|
| What it is | Radiofrequency heat through the skin | Ultrasound focused to a point |
| What it feels like | A hot flick, over and over | Sharp, deep pulses of heat |
| How long until it works | Two to six months | Two to three months |
| Downtime | None | None, but you may be sore |
| Cost | Priced per treatment tip and area | Priced per area, and brands differ a lot |
HIFU
HIFU focuses ultrasound at a set depth under the skin. The handpiece is moved in lines.
Side by side
The differences that matter
What it is
Thermage
Radiofrequency heat through the skin
Current passes through the tissue to a pad on your back. The skin's resistance to that current is what makes the heat.
HIFU
Ultrasound focused to a point
Sound energy is focused so it does nothing until it reaches the chosen depth, where it makes a tiny spot of heat.
Where the heat goes
Thermage
A block of tissue, not a plane
Warmest in the upper skin, spreading down. It cannot be aimed at one layer.
HIFU
Whatever depth is dialled in
Usually about 1.5, 3 and 4.5 mm. The deepest setting is under the fat, in the layer that holds the lower face up.
What you should see
Thermage
Firmer, better-quality skin
Crepey texture, fine wrinkles and mild slackness, including thin skin around the eyes.
HIFU
Some lift along the jaw and neck
Jowls, a heavy jawline, a loose neck, a drooping brow. Firmer skin as well, but lift is the point.
What it will not do
Thermage
It does not lift a dropped jawline
HIFU
It does little for surface texture
What it feels like
Thermage
A hot flick, over and over
The tip is stamped across the area, with a spray of coolant before and after each pulse. Uncomfortable, rarely unbearable.
HIFU
Sharp, deep pulses of heat
Numbing cream is standard and many clinics add oral pain medicine. Thin areas like the brow and neck are the worst of it.
How long until it works
Thermage
Two to six months
Collagen contracts slightly on the day, then rebuilds slowly.
HIFU
Two to three months
Occasionally a small lift on the day, but the real change is the collagen.
How long it lasts
Thermage
About one to two years
HIFU
About a year, sometimes longer
Downtime
Thermage
None
Redness and slight swelling for a few hours.
HIFU
None, but you may be sore
Swelling and tenderness for a few days. Patchy numbness along the jaw can last a week or two.
Cost
Thermage
Priced per treatment tip and area
HIFU
Priced per area, and brands differ a lot
The at-home or drugstore version
Thermage
Home radiofrequency wands are far weaker
They warm the top of the skin a little. The clinic device drives current through the full thickness with a return pad on your back, which is a different scale of heating.
HIFU
There is not one
Home ultrasound wands do not focus. They spread a fraction of the power across the surface and never reach the depth this treatment works at.
Who each suits
Thermage
- Best for — Crepey texture, fine lines and thin skin, including the eye area.
- The trade-off — Very little lift, and a result that depends on how many pulses are used.
HIFU
- Best for — Jowls, a soft jawline and a slack neck.
- The trade-off — A painful hour, and nothing for the surface of your skin.
Depth is the whole argument
Thermage
Thermage cannot pick a depth. It heats a volume. If your complaint is the texture and thinness of the skin itself, that is fine, because the skin is what you want warmed.
HIFU
HIFU can pick a depth, and its deepest setting is the reason people book it. That is the fibrous sheet below the fat which a surgeon pulls on in a facelift.
HIFU is a category, not one machine
Thermage
Thermage is one named device with one maker. When a clinic says Thermage you know what is in the room.
HIFU
"HIFU" covers many devices with very different reputations. Ultherapy is the original and has the longest published record. Ultraformer and a long list of other machines use the same principle.
So ask which HIFU machine will be used. The word alone tells you almost nothing about what you are buying.
The risks worth knowing
Thermage
Thermage's rare problems come from heat concentrating too much. Burns and blistering are uncommon. So is fat loss under the skin, which leaves a small dent.
HIFU
HIFU's rare problems come from working deep. Temporary numbness or tingling along the jaw is the usual version. Rarely a nerve is irritated enough to cause a few weeks of weakness or a drooping lip, and it recovers. In a very slim face, deep heating can also thin the fat and leave a hollow look.
Common questions
Questions Patients Ask
Which is better, Thermage or HIFU?
They answer different complaints. Thermage is better for crepey, thin, poor-quality skin. HIFU is better for a jawline or neck that has started to drop, because it reaches the deep layer that holds them up.
Which one is more painful?
HIFU, clearly. It delivers sharp bursts of heat several millimetres down and most clinics offer numbing cream plus oral pain medicine. Thermage is uncomfortable but usually manageable with nothing at all.
Is Ultherapy the same as HIFU?
Ultherapy is one brand of HIFU, and the one with the longest published record. Many other machines use the same principle, so it is worth asking which one a clinic actually owns.
Can you have Thermage and HIFU together?
Yes, and some clinics offer them as a pair because one works on skin quality and the other on depth. Space them out, and ask what the second treatment is meant to add.
How long before I see anything?
Thermage builds over two to six months. HIFU peaks at two to three months. Neither gives much on the day, so book at least three months before any event.
Will either fix jowls?
HIFU may soften them. Neither removes skin. If a fold lifts freely when you pinch it, surgery is the honest comparison and a fair clinic will say so.