“Thermage® FLX for thin faces, Ultherapy PRIME® for plump faces” – is it true?

Because when the thermal coagulation points created by ultrasound energy act on the fat layer, fat volume can decrease. Focused ultrasound like Ultherapy PRIME® creates micro thermal coagulation points of about 65–70°C in the tissue to induce contraction and collagen regeneration, but if this heat repeatedly reaches the depth of the fat layer, the fat can atrophy. On faces with ample fat, this becomes an advantage of slimming the face, but on faces with insufficient fat, it can lead to results that look older, such as hollow cheeks or depressions in the nasolabial area.

However, this does not mean 'ultrasound is forbidden for thin faces.' By designing the treatment depth (1.5, 3.0, 4.5mm), number of shots, and targeted areas to avoid regions with little fat, it can be used safely even on thin faces. Ultimately, the key is not the device but accurately diagnosing and designing based on individual fat distribution.

For a face with a lot of fat, it is reasonable to choose based on 'which layer the sagging originates from.' If the SMAS layer has descended under the weight of fat, ultrasound that pulls the deep layer (Ultherapy PRIME®) is considered first, and if double chin or deep cheek fat is the main issue, treatment design targeting the fat area or combining contour injection procedures is also reviewed.

Another criterion is the elasticity of the skin surface. If there is a lot of fat and the skin itself is also loose, ultrasound alone may leave surface laxity, so a combination that also tightens the dermal layer with radiofrequency like Thermage® FLX can be helpful. You can understand it as determining priorities by comprehensively considering fat volume, sagging depth, and skin elasticity.

Because even if faces look the same on the outside, the structures beneath the skin are completely different from person to person. A face that looks plump may actually be due to skin thickness or swelling, and a face that looks thin may have sufficient fat in certain areas. Sagging also has various causes, such as fat descent, reduced dermal elasticity, and bone loss, so a single piece of information like face shape cannot identify the cause.

Even for the same 'plump face,' the recommended treatment varies depending on the combination of the above factors, so face shape is only a reference and cannot be the deciding criterion.

In conclusion, the choice should be based not on the 'face-shape formula' but on the results of diagnosis by skin layer. When you comprehensively consider fat volume and distribution, the layer where sagging begins (SMAS or dermis), skin elasticity and thickness, and the desired change (pulling, tightening, or texture improvement), the priority between ultrasound and radiofrequency, or whether to combine them, naturally becomes clear.

In actual practice, designs that differ from the formula are common, such as using ultrasound on a thin face with limited areas, or combining radiofrequency and ultrasound in stages on a plump face. Please refer to "Thermage® FLX for thin faces, Ultherapy PRIME® for plump faces" as a starting point, but we recommend that the final choice be made through an in-person consultation with a dermatologist to suit your skin structure.