All three are offered at IN Eternity Clinic, which makes the choice a clinical one rather than a sales one. Dr Sin Yong explains what each actually heats, how deep, and which faces each suits.
WhatsApp to Enquire →Key facts ↓Ultherapy and HIFU such as Ultraformer MPT both use focused ultrasound to heat small points at set depths, including the SMAS support layer; Ultherapy adds real-time imaging. Thermage FLX uses monopolar radiofrequency to heat the deeper skin more broadly. Ultrasound suits early sagging along the jaw and brow; Thermage suits crepey, loose skin texture.
Ultherapy and HIFU belong to the same family. Both converge ultrasound energy into small focal points under the skin, much as a magnifying glass concentrates sunlight. Each point is a tiny zone of heat at a fixed depth, while the skin surface is left intact. The depths used on the face are typically 1.5 mm and 3.0 mm in the dermis and 4.5 mm at the SMAS, the fibrous support layer that a surgical facelift lifts and repositions.
Thermage FLX works differently. It passes monopolar radiofrequency current through the skin, and the tissue’s resistance turns that current into heat. Rather than points, the heating is a broad, even volume through the deep dermis and the fibrous strands (septae) that tether skin to the fat below, while the surface is cooled with each pulse. It does not focus on the SMAS.
In practical terms, focused ultrasound is aimed at structural descent: the jowl line, the brow, the under-chin. Radiofrequency is aimed at the quality and tension of the skin envelope itself: crepiness, loss of snap, fine laxity across a broad area.
In a sense, yes. Ultherapy is a specific micro-focused ultrasound system with regulatory clearance for lifting the brow and the tissue under the chin and neck, and its defining feature is real-time imaging. Before each line of energy, the doctor sees the tissue layers on screen and can confirm the depth, avoiding bone and adjusting where soft tissue is thin.
Ultraformer MPT, the HIFU platform used at IN Eternity Clinic, places energy at the same family of depths without imaging, using fixed-depth cartridges chosen from anatomy and examination. Its MPT mode can spread energy as a fine line of micro-points rather than single dots, which many people find more comfortable, and it has deeper cartridges for body areas. The trade-off is the imaging: Ultherapy lets the operator see the layers, while HIFU relies on knowledge of where those layers sit.
Neither is simply a stronger or weaker version of the other. Ultherapy is chosen where seeing depth in real time matters, for example in thinner faces or along the jawline over bone; Ultraformer MPT is often chosen for its comfort profile and its flexibility across face and body.
“I ask what has changed in the face before I choose the energy. Descent and crepiness look similar in a selfie but need different tools.”
Thermage FLX suits a different complaint. A person whose jawline is still reasonably defined but whose skin looks crepey, slightly loose and less firm, on the cheeks, around the eyes or on the neck, often benefits more from bulk dermal heating than from point heating at the SMAS. Thermage also has a dedicated eye tip for the upper and lower eyelid skin, an area focused ultrasound does not treat directly.
It is usually done in one session, with a yearly or so maintenance session often discussed. Because the heat is spread through the tissue, it is sometimes combined with focused ultrasound in a staged plan: ultrasound for the structural layer, radiofrequency for the skin envelope. At IN Eternity Clinic, the VF Lift – Vertical Facelift protocol on Volnewmer is a further radiofrequency option that Dr Sin Yong may discuss for some faces.
| Ultherapy | Thermage FLX | HIFU (Ultraformer MPT) | |
|---|---|---|---|
| Energy | Micro-focused ultrasound | Monopolar radiofrequency | Focused ultrasound |
| Main target | SMAS and dermis, as points | Deep dermis and septae, as a sheet | SMAS and dermis, as points or lines |
| Imaging | Yes, real time | Not needed | No |
| Feel | Deep aches over bone | Heat pulses with vibration | Milder aches in MPT mode |
| Suits | Early jowling, brow, under-chin | Crepey, loose skin; eyelids | Early sagging; face and body |
The table simplifies. Settings, number of lines and the doctor’s plan matter as much as the platform.
Comfort varies between people and areas, so it is better described than ranked. Focused ultrasound at 4.5 mm is felt as short, deep aches, strongest along the jawline and over the cheekbone where energy lands near bone; superficial lines feel like quick prickles. Ultherapy at full settings is usually the most noticeable of the three, which is why numbing cream and sometimes oral pain relief are offered. Ultraformer MPT in line mode is generally better tolerated.
Thermage FLX is felt as a pulse of building heat, released quickly, with vibration and cooling designed to blunt the sensation. Most people find the forehead and jawline more sensitive than the cheeks. Afterwards, all three can leave mild redness, swelling or tender spots for hours to a few days; small bruises or temporary numb patches are uncommon.
The decision starts with the face, not the device. If the main change is descent along the jaw, a heavier lower face or a dropping brow, with reasonable skin thickness, focused ultrasound is usually considered first, with Ultherapy preferred where real-time imaging adds safety or precision. If the jawline holds but the skin looks crepey and less firm, Thermage FLX is often the better fit. Many faces have both, and a staged plan uses each for its own job.
Some faces suit none of them. Marked skin excess and heavy jowls respond poorly to energy devices, and a surgical opinion is more honest. Very thin faces with little fat can look gaunter after aggressive ultrasound to fat-bearing layers, so settings and depths are chosen conservatively or another route is taken. Lost volume is addressed with fillers or collagen stimulators, not heat.
Results build gradually over two to six months and vary with age, skin quality and lifestyle. They are reviewed with standardised photographs rather than judged in the mirror the next morning.
All three are non-invasive, but they are not trivial. Focused ultrasound can cause temporary swelling, tender lines or welts where energy was delivered, small bruises, and occasionally a patch of numbness or a weak nerve branch that recovers over weeks. These risks rise when energy lands too close to bone or a nerve, or in areas with little soft tissue. Real-time imaging with Ultherapy, careful cartridge choice with HIFU, and a doctor who maps the face before the first line are how they are kept low.
With radiofrequency, the main risk is surface heat injury if contact or cooling is poor, which shows as a small blister or a temporary mark. Thermage FLX checks contact with each pulse, and settings are adjusted to feedback during treatment. Implanted electronic devices and metal near the area are checked before radiofrequency is used.
In darker or sun-sensitive skin, any heat can occasionally trigger post-inflammatory pigmentation, so sun protection in the weeks around treatment is part of the plan. Pregnancy, active infection, open wounds and recent fillers or threads in the area are reasons to wait or change the plan. Anyone who has had fat-reducing procedures or significant weight loss is assessed for how much soft tissue is left before deep ultrasound is used.
Neither is better in general; they treat different problems. Ultherapy places focused ultrasound at the SMAS and dermis for early descent along the jaw and brow. Thermage FLX heats the deep dermis broadly for crepey, loose skin. Many faces have elements of both, and Dr Sin Yong will explain which matters more in yours.
They share the same principle of focused ultrasound at set depths. Ultherapy is a specific system with real-time imaging that shows the tissue layers during treatment. Ultraformer MPT is a HIFU platform without imaging that can deliver energy as dots or fine lines and has body cartridges.
Often, yes. Ultrasound addresses the structural layer and radiofrequency the skin envelope, so they complement each other. Dr Sin Yong sequences them, sometimes on the same day and sometimes weeks apart, depending on your skin, your comfort and how much heat the tissue can sensibly take in one visit. Each step is reviewed before the next.
It varies with age, skin quality, sun exposure and weight change. Collagen remodelling continues for several months, and many people consider maintenance about once a year. Daily sun protection and a stable weight help the result hold. Your plan and review schedule are set out at consultation.
Cost depends on the platform, the areas treated, the number of lines or pulses needed for your tissue, and whether a combination is planned. After assessment, Dr Sin Yong gives a written quote that lists each component, so you can see what each part of the plan involves before deciding.
Most people return to normal activities the same day. Mild redness, swelling or tenderness can last hours to a few days, and occasional small bruises or numb patches settle on their own. Heavy exercise and saunas are usually avoided for a day or two.
People with active skin infection or open wounds in the area, those who are pregnant, and people with certain implanted electronic devices for radiofrequency. Heavy skin excess usually needs a surgical opinion instead. Your medical history, medicines and any previous fillers or threads in the area are reviewed first.
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008.
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.