Thermage FLX and Ultherapy are both non-surgical collagen treatments, but they deliver different energy to different places. Thermage uses monopolar radiofrequency to warm a broad volume of skin evenly. Ultherapy uses micro-focused ultrasound to place small points of heat at set depths, mapped with live imaging. At Skin Art MD in Burnaby, a physician assessment decides which one fits a given face.
| Thermage FLX | Ultherapy Prime | |
|---|---|---|
| Energy | Monopolar radiofrequency (RF) | Micro-focused ultrasound (MFU) |
| How heat is laid down | Even, broad warming across the treated surface | Rows of small focal points at a chosen depth |
| Depth control | Set by tip type and energy level | Transducers at 1.5, 3.0 and 4.5 mm |
| Guidance during treatment | AccuREP™ checks skin impedance pulse by pulse | DeepSEE imaging shows tissue layers before each pass |
| Areas on Skin Art MD's pages | Eyes, face and jawline, neck, tummy, arms, above the knees | Brow, mid-face, lower face and jawline, under the chin, neck, décolletage |
| Comfort features | Cryogen cooling bursts and handpiece vibration | Comfort options agreed before treatment |
| How change appears | Gradual collagen renewal over the following months | Gradual collagen renewal over the following months |
Why are Thermage and Ultherapy compared so often?
They are compared because both aim at the same visible concern, skin that looks looser or less defined, and both do it by heating collagen-rich tissue without incisions or injections. That shared goal hides a real difference in method. Asking "which is stronger" is a little like asking whether a heating blanket is stronger than a set of hot stones; the more useful question is where the heat goes and how it is spread.
What does radiofrequency versus ultrasound mean in practice?
Radiofrequency heats tissue through its natural electrical resistance, while focused ultrasound concentrates acoustic energy into tiny points below an untouched surface. With Thermage FLX, the tip sits on the skin and each pulse warms a volume of dermis and deeper collagen-rich tissue fairly evenly. Existing collagen contracts with the heat, and the skin is prompted to build new collagen over the months that follow.
With Ultherapy Prime, the transducer focuses energy to a precise depth. Instead of a continuous warm zone, it leaves a line of small thermal points with untreated tissue in between, and those points act as the trigger for collagen renewal. Because the energy is focused, the practitioner chooses the depth before each pass rather than relying on how far heat spreads.
Which layers does each one reach?
Thermage reaches the dermis and the deeper collagen-rich tissue just beneath it, while Ultherapy can be set to three separate depths. Ultherapy's 4.5 mm transducer is aimed at the deeper supportive layer often called the SMAS, the 3.0 mm setting at the deep dermis, and the 1.5 mm setting at more superficial skin. Protocols may combine all three, depending on the area and the plan.
This is the main reason the two are described differently on Skin Art MD's own pages. Thermage is framed around skin tightening and texture across a surface, including thin eyelid skin and larger body areas. Ultherapy is framed around support and definition along specific lines, such as the brow tail, jawline and under the chin.
How does a visit for each one run at the Metrotown clinic?
Both visits begin with assessment and mapping, and after that the steps differ. For Thermage, the face is cleaned, a temporary grid is applied to guide even coverage, cool gel goes on, and the handpiece delivers a series of warm pulses with cooling bursts. The person treated gives feedback on heat throughout, so energy can be adjusted. Different tips are used for the eye area, the face and the body.
For Ultherapy Prime, treatment vectors are marked to match the face's anatomy and laxity pattern. DeepSEE imaging is then used to confirm the tissue layers on screen before energy is delivered, and lines are applied zone by zone at the planned depths. The number and direction of lines are planned per face, not taken from a fixed package.
Skin Art MD is at #101 – 4378 Beresford St in Burnaby, close to Metrotown SkyTrain Station on the Expo Line, and consultations are available in English, Mandarin and Cantonese.
How do they feel, and what happens afterwards?
Thermage is usually described as warmth with brief heat pulses, and Ultherapy as intermittent deep heat or tingling along each line. Sensation varies between people and between areas; bonier areas tend to feel stronger.
After either treatment, most people resume normal activities the same day. With Thermage, temporary redness or swelling is possible, and the clinic's aftercare asks people to avoid saunas and other intense heat for 48 hours. With Ultherapy, temporary redness and mild deep tenderness for a few days are possible. For both, change builds gradually as collagen renews, and how long it lasts varies with age, skin quality and lifestyle.
Which concerns tend to bring each one into the discussion?
Concerns about crepey eyelids, overall skin texture or larger body areas often bring Thermage into the conversation, while brow heaviness, a softening jawline and laxity under the chin often bring in Ultherapy. These are starting points for a discussion rather than rules. Many faces show a mix of both patterns, and some show volume loss as well, which neither device addresses directly because neither adds volume.
Very advanced laxity is a separate case. Skin Art MD's Ultherapy page notes that surgery may be discussed when laxity is very advanced, and both pages note that energy treatments give gradual, not surgical-level, change.
Can they be combined?
Yes, some treatment plans stage both, because they work at different depths and in different ways. A typical reason is a face that has both surface crepiness and loss of definition along the jaw. Plans may also sequence a device treatment with skin boosters, where the device treatment usually comes first. Timing and order are set by the physician after assessment, not in one standard package.
How is the choice made?
The choice is made at a physician assessment at Skin Art MD in Burnaby, where the face, the concern and the medical history are reviewed together. The assessment looks at the pattern of laxity, skin thickness, which areas matter most, and what has been done before, including fillers. It also checks for reasons to wait or avoid treatment: pregnancy or breastfeeding, active infection or inflammation in the area, and a pacemaker or metal implant near the treatment site. Dr. Charles Jiang is the clinic's Medical Director.
What else do people ask about Thermage and Ultherapy?
These are the shorter questions that come up most often at consultations.
Is one of them stronger than the other?
Neither is simply stronger. They use different energy and reach different layers, so the comparison that matters is fit to the concern, not power.
Does either one involve needles or incisions?
No. Both are non-surgical and needle-free; the energy is delivered through a handpiece resting on the skin.
How soon does a change show?
Some people notice a tighter feel early on, but the main change builds gradually over the following months as collagen renews. Results vary.
Can either be done when there are fillers in the face?
Usually yes. The injection history is reviewed at assessment and treatment zones are mapped around it.
Is Ultherapy used around the eyes, and Thermage on the brow?
Thermage has a dedicated small tip for the eyelid area, and Ultherapy is often planned near the brow tail. Which areas are treated is decided individually at assessment.
What are the clinic's hours?
Skin Art MD is open Tuesday to Sunday, 10:00 to 18:00, and closed on Mondays. The phone number is +1 (604) 639-2581.
Written by the Skin Art MD clinical team as general information about how these treatments work and what a visit involves. It is not medical advice; suitability is decided at a physician assessment.
