Ulthera, Thermage, Oligio, HIFU: How They Differ

The face-lifting devices people ask about most fall into two energy groups: focused ultrasound (Ulthera and HIFU), which sends heat as deep as the SMAS layer at around 4.5 millimeters, and radiofrequency (Thermage FLX, Oligio, Volnewmer), which spreads heat through the dermis at roughly 2-4 millimeters. Different layers, different concerns — which is why no single device suits everyone.

How Many Types of Face-Lifting Device Are There, and How Are They Grouped?

By energy type there are three main groups: focused ultrasound, needle-free radiofrequency, and radiofrequency delivered through microneedles. All three share the same goal, which is heating tissue to the level that stimulates the formation of new collagen (neocollagenesis), but they differ in how the heat is carried down and which layer it lands in.

Focused ultrasound works like a magnifying glass concentrating light: it gathers sound-wave energy at a small point beneath the skin until a tiny heat point forms, called a thermal coagulation point, at a temperature of about 60-70 degrees Celsius. The top layer of skin is not damaged, because the energy passes through it on the way down. The advantage is precise depth selection, reaching as deep as the SMAS, the musculoaponeurotic layer that surgeons use as a reference in a facelift, although the degree of result is not equivalent to facelift surgery.

Radiofrequency (RF) does not focus into a point. It heats by volume (volumetric heating), spreading through the dermis at roughly 2-4 millimeters. The devices used for face lifting are usually monopolar at a frequency of about 6.78 MHz, with a surface cooling system to protect the top layer of skin while energy is delivered.

Radiofrequency through microneedles is a different group, because tiny needles are inserted and the radiofrequency is released directly at the needle tips, so the depth can be set precisely. This group leaves small pinpoint marks and has more downtime than the first two.

What Is Ulthera, and How Does It Differ from HIFU in General?

Ulthera is the trade name of the Ulthera System from Merz Aesthetics, which uses micro-focused ultrasound with visualization (MFU-V). What sets it apart from other focused-ultrasound devices is the built-in imaging transducer, which lets the doctor see tissue layers as deep as about 8 millimeters before deciding to deliver energy.

Ulthera treatment tips deliver energy at depths of 1.5, 3.0, and 4.5 millimeters, covering everything from the superficial dermis down to the SMAS layer, creating heat points at a temperature of about 60-70 degrees Celsius. The device first received 510(k) clearance from the US FDA in 2009 for brow lifting, and later added indications for the submental area, the neck, and lines on the upper chest. In 2024, Merz launched a newer platform called Ultherapy PRIME, with an upgraded processing system and image quality.

In Thai, the name is written two common ways that refer to the same device. The point that most often causes confusion is that many people think Ulthera and HIFU are different technologies. In reality, both belong to the same focused-ultrasound family. What separates them is the real-time imaging system, the transducer design, and each brand’s body of research. The clinic does not have an Ulthera device. The information in this section is market context to help inform your decision.

What Is HIFU, and Which Devices Does the Term Cover?

HIFU stands for High-Intensity Focused Ultrasound. In Thai the term is written two common ways that mean the same technology. In Thai marketing, the word is generally used for focused-ultrasound devices that do not have built-in real-time imaging, and one family often seen is Ultraformer from Classys of South Korea.

The principle is the same as Ulthera: concentrating sound-wave energy to create small heat points at a set depth. Treatment tips usually come in several levels, namely 1.5 millimeters for the superficial dermis, 3.0 millimeters for the deep dermis and part of the fat layer, and 4.5 millimeters for the SMAS layer. Technically, some models in this family combine two kinds of focusing: micro-focused for skin tightening, and macro-focused, which has a wider focal point but raises the temperature less, for care of the subcutaneous fat layer. Manufacturers call this combination MMFU.

A systematic review in the Aesthetic Surgery Journal in 2025 reported that focused ultrasound produces measurable skin-tightening results, particularly in the lower face, the neck, and around the eyes. The figures reported come from individual studies, and the degree of response differs from person to person.

The HIFU device the clinic uses is Ultralift. For details on the treatment tips and shot counts, ask the clinic.

How Do Thermage FLX and Oligio Differ?

Both are monopolar radiofrequency at a frequency of about 6.78 MHz, spreading heat through the dermis to stimulate collagen. The differences therefore lie in the details of each device rather than in the basic principle.

Thermage FLX from Solta Medical (now part of Bausch + Lomb) is the 4th generation of the Thermage family. It comes with technology the manufacturer calls Comfort Pulse Technology (CPT) to help with comfort during treatment, and AccuREP, which automatically adjusts energy delivery for each shot. The manufacturer states that measurable results usually appear over 2-6 months after a single session and may last around 1-2 years, depending on skin condition and each person’s aging process. One session takes about 30-90 minutes, depending on the area.

Oligio from Wontech of South Korea also works at a frequency of about 6.78 MHz. The points the manufacturer highlights are sensors that measure skin temperature, pressure, and contact of the return pad in order to keep energy delivery consistent, along with surface cooling and a vibration system to help improve comfort during treatment. Oligio began to gain recognition in Korea around 2022.

The sensation during treatment is similar for both, namely brief hot pulses shot by shot across the area, unlike ultrasound, which usually feels like a sharp, deep tingling at individual points. The doctor can adjust the energy level to suit each person’s tolerance.

The clinic does not have a Thermage device; the information in this section is market context to help inform your decision.

What Are Volnewmer and Morpheus8, and How Do They Differ from the Others?

These two names are appearing more often lately, and both tend to be filed under “lifting,” but they work in different ways.

Volnewmer is a monopolar radiofrequency device at a frequency of 6.78 MHz from Classys of South Korea, which received 510(k) clearance from the US FDA in April 2024. What the manufacturer emphasizes is continuous water cooling combined with a vibration system, to maintain the temperature of the top layer of skin while energy is delivered to the deeper layers. In principle it belongs to the same group as Thermage and Oligio, spreading heat through the dermis.

Morpheus8 from InMode is bipolar radiofrequency delivered through microneedles, adjustable from roughly 0.5 to 8 millimeters, with needles insulated along their length that release energy at the tip. It has received 510(k) clearance from the US FDA for soft-tissue contraction and remodeling of the subcutaneous fat layer. The difference worth knowing is that this group leaves small pinpoint marks on the skin, with redness and a few days of downtime, unlike needle-free radiofrequency and ultrasound, after which most people carry on with daily life as usual the same day. It also usually requires a course of several sessions rather than a single session per yearly cycle.

The clinic does not have Volnewmer or Morpheus8. The information above is presented to give an overview of the options on the market when you are comparing prices and technologies from several places.

Face-Lifting Device Comparison Table

The table below summarizes the technical and experiential differences between each group of devices. The figures shown are typical values from manufacturer information and academic reviews. Actual results depend on skin condition and the doctor’s assessment.

Note: Volnewmer from Classys belongs to the same group as Thermage FLX and Oligio, namely monopolar radiofrequency at 6.78 MHz that heats the dermis, so in practice it is compared on the same criteria as those two.

Choosing the Face-Lifting Device That Suits You

The simple rule is to look at which layer your concern sits in and then choose the energy that reaches that layer, rather than choosing by model name or price.

Cases where doctors often consider focused ultrasound (Ulthera or HIFU — the clinic has HIFU):

• A double chin under the chin or jaw that is becoming noticeable
• A facial contour and jawline that look less defined than before
• Cheeks and nasolabial folds that look like they are sagging with gravity
• Wanting to address deep laxity without surgery

Cases where doctors often consider radiofrequency (Thermage FLX, Oligio, or Volnewmer — the clinic has Oligio):

• Skin that looks tired, lacks elasticity, and is loose across the whole face
• Fine lines on the forehead, at the outer corners of the eyes, or around the mouth
• Pores that look wider and skin that is not as smooth as it used to be
• Wanting to care for overall skin quality alongside firmness

Other factors a doctor always weighs are the thickness of the fat layer, because people with thick subcutaneous fat often respond to deep energy differently from people with thin skin; age and the rate of collagen loss, which affect how quickly the skin responds; tolerance for the sensation; and budget and how often you can realistically repeat, because these devices are ongoing care rather than a one-and-done treatment.

In practice, many people have mixed concerns in both the deep layers and the dermis, so doctors often plan to use two kinds of energy together rather than choosing one or the other. And when skin laxity is severe or there is clearly excess tissue, external energy alone often does not address everything, because these devices do not remove excess skin. An in-clinic assessment therefore matters more than choosing from reviews on the internet.

When Will You See Results, and How Long Do They Last?

Every device in this article works gradually rather than producing a result on the day of treatment, because the mechanism is stimulating your body to build collagen itself, which takes months.

The common timeline is that the skin may look slightly firmer at first, from the contraction of existing collagen and from temporary swelling. The result from newly formed collagen then appears gradually over roughly 2-6 months, which is the period in which some people start to notice a change in the jawline or in the smoothness of the skin. The manufacturer of Thermage states the same 2-6 month timeline after a single session, while academic reviews of focused ultrasound report assessable results over a similar period.

Results generally last around 1-2 years, depending on age, the rate of collagen loss, sun protection, smoking, weight changes, and genetics. The results are not permanent, because skin aging carries on as usual. The repeat frequency is therefore usually about 1-2 times per year, per the doctor’s assessment. Treating more often than the doctor sets out is not advised, because repeated heating in too short a span may not add to the result and increases the chance of skin irritation. There is no guarantee of results, and results vary by individual.

Who Should Be Cautious, and How to Care Before and After

These devices are a non-surgical option, but they are not suitable for everyone. There are health conditions and skin conditions you should tell the doctor about beforehand so that your suitability can be assessed.

• People who are pregnant or breastfeeding
• People with an implanted electronic device, such as a pacemaker, which is a precaution for radiofrequency treatment
• People with metal or non-dissolvable filler in the area to be treated
• People with an infection, an open wound, an inflamed rash, or severe inflamed acne in the area to be treated
• People with hypertrophic scars or keloids
• People who have recently had filler, thread lifting, or another procedure in the same area, who should tell the doctor the type and the timing
• People taking oral vitamin A derivatives or medications that make the skin sensitive to light

Before treatment, tell the doctor your health history, your medications, and the products you currently use; stop retinol products and exfoliating acids for the period the doctor advises; and come with clean skin. After treatment, keep the skin well moisturized, apply sunscreen consistently, and avoid intense heat such as saunas or steam rooms in the initial period. There may be redness, warm skin, mild swelling, or tenderness for a short while, which usually settles on its own. Side effects that are uncommon but worth knowing about include temporary numbness or temporary abnormal facial-muscle function in areas related to the nerves, which in most reports resolves on its own. If you have anything unusual, or it does not settle, go back to the doctor at the clinic for an assessment.

Which Devices Does Onnyx Clinic Have, and What Do They Cost?

Onnyx Clinic has 2 lifting devices, covering both focused-ultrasound energy and radiofrequency: HIFU skin tightening and Oligio RF skin tightening. The prices below are the clinic’s prices.

HIFU (Ultralift)

Oligio

Every Oligio package comes with a complimentary HIFU at the shot count you choose — for example, Oligio 300 shots with complimentary HIFU 300 shots — so you can plan care for both the dermis with radiofrequency and the deeper layers with ultrasound in a single course. The shot count that suits each person depends on the area to be treated and the plan the doctor assesses; more is not always better.

The clinic does not have Ulthera, Thermage, Volnewmer, or Morpheus8. If you are comparing prices with other places, the information in this article helps show that price differences are usually explained by the type of energy, the number of shots, the treatment-tip model, and who performs the procedure.

What to Ask a Clinic Before You Decide

Price differences of several times over between clinics can usually be explained by a few questions. Clinics that give straightforward information can usually answer them right away.

• The device model and the manufacturer, for example Oligio from Wontech, or the HIFU model used
• The origin of the treatment tip, and a new tip being unsealed in front of you before treatment begins
• The number of shots stated in the package versus the number you actually receive, including complimentary shots
• The depth of the tip used in each area
• Who assesses and oversees the procedure
• The repeat plan and when you are advised to come back for an assessment

These questions help you compare offers from several clinics more fairly, and make it clearer what you receive in each package.

Consult the Onnyx Clinic Medical Team

If you are still unsure whether your skin should start with focused ultrasound, radiofrequency, or both together, the most direct way is to have a doctor assess your degree of laxity, the thickness of your fat layer, and your goals first, then plan the shot count and the areas to suit your actual skin condition. The experienced medical team at Onnyx Clinic is glad to give advice and answer questions before you decide. Ask questions or book an appointment via LINE: @onnyxclinic

Read more about our services at Oligio RF skin tightening and HIFU skin tightening.

References

• Merz Aesthetics — Ulthera System Instructions for Use (manufacturer, PDF): merzaesthetics.com
• Pavicic T. et al. — Microfocused ultrasound with visualization: Consensus on safety and review of energy-based devices (J Cosmet Dermatol, 2022): pubmed.ncbi.nlm.nih.gov
• A Systematic Review of High-Intensity Focused Ultrasound in Skin Tightening and Body Contouring (Aesthetic Surgery Journal, 2025): academic.oup.com
• Solta Medical — Thermage FLX (manufacturer): thermage.com
• Wontech — Oligio RF device information (manufacturer): wtlaser-en.com
• CLASSYS — Volnewmer and Ultraformer MPT (manufacturer): classys.com
• American Academy of Dermatology — Many ways to firm sagging skin: aad.org

This content is for general information only and is not a diagnosis or individual medical advice. Results vary by individual. Please consult a doctor for an assessment suited to you.