Exploring Sofwave, Ultherapy, Thermage, and other energy-based technologies is a great introduction to the overall field of regenerative care. However, ideally a medical doctor will create a treatment plan on your behalf.

Dr. Jimmy C. Sung of New York’s Tribeca Aesthetics^® meets with each patient prior to any procedures to discuss their goals and budget. More importantly, he conducts a thorough analysis of their face or body part, often using a VISIA scan to visualize the deeper layers of the dermis. Not only do such insights guide the technologies he recommends, but also inform specifically how he’ll guide the devices to reach the beneficial layers and problem areas.

Understanding Facial Anatomy 

You can think of our facial soft tissue—meaning the tissue above the bone—as having three layers: the skin, the fat, and the muscle. However, the middle layer doesn’t consist merely of fat, as it also has fibers connecting the skin to the muscle, known as the fibrous septae. You can think of the fat as having springs running through it to connect the layers. 

On top of the muscle, there’s a very thin, film-like layer called the SMAS, that supports the face and helps prevent sagging. Muscle alone tears easily, but the SMAS helps reinforce it.

Get to Know Ultherapy

The only device that can reach the deepest layer, the SMAS, is Ultherapy. Ultherapy uses ultrasound to heat the SMAS layer to about 60–65°C, causing it to contract—similar to how a curling iron works on hair. Ultherapy harnesses micro-focused ultrasound energy to stimulate new collagen production in the deep dermal and subdermal layers, reaching further than treatments like Sofwave. 

Ultherapy is safe for deep layers because it uses focal ultrasound, which means the ultrasound waves converge only at the target layer, like using a magnifying glass to focus sunlight. There’s no heat in the layers above or below the focal point. 

Ultherapy pairs its increased depth capabilities with the unique ability to visualize the various layers of the dermis, empowering practitioners like Dr. Sung to strategically target areas with unparalleled precision. When the ultrasound is tactically targeted toward problem areas, the results can be a visibly lifted, defined shaping of the face and neck, as well as tightening of skin on various body parts. 

Dr. Sung of Tribeca Aesthetics^® chooses to use Ultherapy Prime over Ultherapy due to its enhanced visualization capabilities, enabling more accurate and effective energy delivery for optimized patient outcomes.

In about two to three months, recipients see tightening as new collagen forms. Importantly, loss of collagen is a major reason for facial laxity, so Ultherapy Prime addresses the root problem.

Learn more about Ultherapy Prime in New York >

Get to Know Sofwave

Sofwave uses planar ultrasound, which spreads energy out rather than converging it, to treat the more superficial layers of the skin. This technology targets tissue at a depth of about 1.5 mm, just above the fat layer where fibroblasts are located. Fibroblasts are essential skin cells responsible for producing collagen, so stimulating them helps reduce wrinkles and improve skin laxity at the surface. 

In contrast, treatments like Ultherapy use focal ultrasound, which concentrates energy at a single point. When used on the fat or skin layers, this focused energy increases the risk of fat loss or burns. Therefore, for these superficial layers, Sofwave is often more advantageous because it distributes energy more evenly, minimizing risks while effectively stimulating collagen production.

Additionally, because Sofwave doesn’t go deep and there are no critical structures at the targeted level, there’s no need for the visualization that Ultherapy offers. 

Sofwave is FDA-approved for numerous use cases, both on the face—for wrinkles and natural contouring—-and other body parts to address cellulite and sagginess. 

Learn more about Sofwave in NYC >

Get to Know Thermage

Now, let’s discuss the middle layer—the fat, which is interlaced with fibrous septae, like the springs in a mattress. Thermage uses monopolar radiofrequency (RF) to treat this layer, making it extremely well-suited for reducing fine lines and skin laxity, as well as covering larger areas. 

Thermage works through bulk heating. The RF energy preferentially travels through the fibrous septae because they have higher impedance, similar to how electricity travels through a wire. This heats and tightens the fibers, not the fat itself. Importantly, fat alone can’t provide lift, but tightening the fibrous septae can.

Take note, there are multiple variations of Thermage devices available. After great assessment, Dr. Sung chose to offer patients Thermage FLX, a newer edition that offers greater comfort and vibration dissemination. 

Learn more about Thermage FLX in New York >

Sofwave vs. Ultherapy vs. Thermage - the Results

Sofwave delivers noticeable improvements in skin texture and superficial wrinkles, especially in the upper layers of the skin. Ultherapy provides deeper lifting and tightening, particularly along the jawline, neck, and brow. Thermage is most effective for overall skin tightening and smoothing, especially in areas with mild to moderate laxity.

It’s important to note that results from these treatments are greatly dependent on your current levels of collagen production and skin laxity, which are often influenced by age. For example, Ultherapy Prime is typically better suited for individuals in their mid-30s and older, when the SMAS layer begins to loosen and collagen loss becomes more apparent. In contrast, younger individuals may benefit more from the “prejuvenation” effects of Sofwave, which helps maintain collagen levels and delay the onset of visible aging.

Dr. Sung often combines these technologies to address multiple layers of the skin for comprehensive, natural-looking results. By customizing treatment plans, he can maximize benefits and tailor outcomes to each patient’s unique needs.

Sofwave vs. Ultherapy vs. Thermage - the Costs

All three devices are priced similarly. The main factors influencing the total cost are the current condition of your skin or targeted body area, and the overall size of the area being treated.

Sofwave vs. Ultherapy vs. Thermage - the Treatment Experience

Dr. Sung uses the latest versions of Sofwave, Ultherapy, and Thermage to ensure the best possible patient experience. While mild discomfort is common during these procedures, most people find all three treatments to be very tolerable.

Sofwave vs. Ultherapy vs. Thermage - the Risks

All medical treatments carry some nominal level of risk. For energy-based devices like Sofwave, Ultherapy, and Thermage, these can include mild redness, swelling, temporary numbness, tingling, or, in rare cases, burns or changes in skin pigmentation. 

The Risks of Ultherapy Technology

Because Ultherapy reaches deeper levels of the dermis than the others, it does have inherently greater risk than the others. A major concern with facelifts is nerve injury, since the facial nerves are just beneath the muscle and, in some areas, come above it. Plus, if Ultherapy is aimed too shallowly, it can detrimentally dissolve fat.

However, due to the increased risks associated with Ultherapy technology, Ultherapy Prime devices provide practitioners with detailed visualizations of the facial layers. An experienced, medically licensed doctor can accurately interpret these images and safely direct the Ultherapy Prime’s focal energy to the optimal areas.

What You Can Do to Minimize Risks

There are two major contributors to the risks of these treatments that are within your control: the skill level of the provider and the specific type of device used.

Sofwave, Ultherapy, Thermage, and other energy-based treatments are all classified as medical procedures and, therefore, are ideally performed by a licensed medical doctor or a nurse practitioner. Not only do they bring an enhanced understanding of human anatomy, but they can treat any potential issues if they arise. While this is considered best practice regardless of where you are, New York State actually made it the law. Always confirm the medical licensing of the practitioner and confirm that they will be the ones to complete the procedure.

Additionally, during your consultation with the provider, confirm which generation of equipment they will use. Generally speaking, manufacturers evolve their technology with each new release. This can result in better, safer outcomes. For example, Dr. Sung ensured he was the first New York doctor to offer Ultherapy Prime—rather than Ultherapy—as the newer version offers improved visualization and precision for more targeted results.

Visit Dr. Sung at Tribeca Aesthetics^® in New York City 

Dr. Jimmy C. Sung is a board-certified plastic surgeon with extensive medical experience and a deep understanding of regenerative care. He is frequently invited to contribute to respected medical publications and to speak at national and international conferences on the latest advancements in non-surgical aesthetics. Dr. Sung’s commitment to patient safety and optimal outcomes is reflected in his careful, individualized approach to every procedure. Patients trust his expertise and dedication to delivering natural, long-lasting results.