Can I Get Thermage® FLX and Ultherapy PRIME® Together?

The commonly recommended sequence is to receive Ultherapy PRIME® first, which targets deeper layers, followed by Thermage® FLX. This is because ultrasound must focus precisely on a target point at a specific depth in the skin; if the tissue has already been altered by radiofrequency, the accuracy of deep energy delivery could be affected.

Even when performed on the same day, the typical approach is to go from deep (Ultherapy PRIME®) to superficial (Thermage® FLX), working upward rather than going down through layers. Of course, if the main concern is reduced dermal elasticity, Thermage® FLX may be prioritized. The order can vary depending on the individual's aging pattern.

If they are not done on the same day, it is known that an interval of 2 to 4 weeks is often used. This is a recovery period to allow any swelling and thermal stimulation from the first procedure to subside and the skin to stabilize before the next treatment.

Rather than having a fixed absolute standard, the principle is to adjust the interval based on skin response speed and treatment intensity. It is safest to decide the next schedule after checking the skin condition following the procedure.

Because each layer has a distinct role, a broader improvement can be expected compared to a single procedure. Ultherapy PRIME® lifts the sagging SMAS layer to set the lifting axis, while Thermage® FLX helps remodel collagen in the dermis, refining skin surface elasticity and fine wrinkles. Since sagging and loss of elasticity usually occur together, addressing both layers tends to produce more comprehensive results.

However, it is difficult to quantify the degree of improvement, and effects appear gradually over 2 to 3 months as collagen regenerates, with individual variation. It is important to first diagnose the layer causing the sagging to determine whether both procedures are necessary or if one is sufficient.

When performed together, the total heat applied to the skin is used as a basis to more precisely distribute the energy and number of shots for each procedure compared to when they are done alone. Since deep and superficial stimulation overlap in the same area, it is important to design a plan that avoids excessive heat accumulation by allocating the focus of each procedure by area.

For example, for a sagging jawline or lower cheeks, more Ultherapy PRIME® shots may be concentrated, while for fine lines and elasticity concerns on the cheeks or forehead, a greater proportion of Thermage® FLX may be used. Energy levels are also adjusted based on skin thickness, fat volume, and pain sensitivity, so for combination treatments, customized planning and consultation with an experienced Dermatologist are important.