Head-to-head comparison · 2026 Singapore prices

HIFU vs Thermage

/ˈhaɪfuː/ vs /ˈθɜːrmɪdʒ/ Focused ultrasound against monopolar radiofrequency for tightening loose skin around the eyes

Dr Joy Koh, Editor-in-ChiefWritten by Dr Joy Koh, MBBS, Editor-in-Chief · Updated

Independent review: evidence graded A to D, 2026 Singapore prices from published clinic lists, sources listed at the end of the page.

HIFU vs Thermage: sagging eye skin tightening comparison of depth, evidence grade and 2026 Singapore prices

Overview

High-intensity focused ultrasound (HIFU) and Thermage both tighten skin with heat but deliver it to different layers. HIFU concentrates heat into small points at a fixed depth, 2.0 mm with the eyelid cartridge and up to 4.5 mm on the face, and leaves the skin surface intact. Thermage applies monopolar radiofrequency (RF) to heat a broad layer of skin, and its eye tip is cleared in the United States for the upper and lower eyelids. Around the eyes, Thermage Eyes has the stronger evidence (Grade B, from two multicentre studies of 72 and 86 patients), whereas HIFU on the eyelids rests on a single study of 34 women (Grade C) that measured about 1 mm of tightening. On the face and neck, studies comparing focused ultrasound with radiofrequency have found no difference in outcome. HIFU is the less expensive option in Singapore in 2026, at S$300 to 800 for the eye area and S$590 to 2,000 for a full face, compared with S$1,200 to 3,000 for Thermage Eyes and S$3,200 to 5,500 for a full-face Thermage FLX session. The energy from both devices must be kept away from the eyeball itself, and in Singapore HIFU devices are supplied only to registered doctors.

  • HIFU heats separate points at a set depth, Thermage heats a broad layer of skin
  • Eyelid evidence Grade B for Thermage Eyes, Grade C for HIFU
  • No difference between focused ultrasound and radiofrequency on the face and neck in controlled trials
  • Eye area S$300 to 800 for HIFU, S$1,200 to 3,000 for Thermage Eyes
  • One session each, with results building over 2 to 6 months
  • Rare eye injuries reported after focused ultrasound near the eye, Thermage applied over an eye shield
Introduction

HIFU and Thermage are the two non-surgical tightening treatments most often offered in Singapore for drooping eyelids and loose under-eye skin, and a Thermage Eyes session costs roughly four times as much as eye-area HIFU. The sections below compare heat delivery, eyelid evidence, eye safety and 2026 prices.

HIFU vs Thermage at a glance

HIFU (e.g. Ultraformer MPT, Ultherapy) Thermage FLX
Energy Focused ultrasound Monopolar radiofrequency with surface cooling
Where the heat goes Separate points at 2.0 mm (eyelid cartridge) and 1.5 to 4.5 mm on the face Broad heating of the dermis and the layer beneath it
Eyelids Small eyelid cartridge used outside the eye, one study (n=34) Eye tip cleared in the United States for upper and lower eyelids, used with an eye shield
Evidence grade, eyes C (eyelids), B for Ultherapy brow lift B
Evidence grade, face and neck B (generic HIFU), A (Ultherapy) B
2026 Singapore price Eye area S$300 to 800, full face S$590 to 2,000 Eyes S$1,200 to 3,000, full face S$3,200 to 5,500
Sessions One, repeated about yearly One, repeated every 1 to 2 years
Pain About 4 out of 10 (pooled studies) About 7 out of 10 in one Thermage FLX study
Downtime None to 1 day, with mild redness for 3 to 4 days after eyelid treatment Redness and swelling for 1 to 2 days
Main risks Temporary numbness and welts, rare eye injury if focused near the eyeball Rare burns, fat loss and surface irregularity

How HIFU and Thermage tighten sagging eyes

  • HIFU An ultrasound beam is focused into tiny points of heat at the depth set by the cartridge, and the skin surface above them is left intact. The heat contracts the collagen at each point, and the healing response that follows lays down new collagen over 2 to 3 months. Around the eyes, a shallow 2.0 mm eyelid cartridge is applied to the upper and lower lids, with every line placed outside the eye itself. Ultherapy is a branded HIFU device with built-in ultrasound imaging, and generic devices are compared with it on the Ultherapy vs HIFU page.
  • Thermage Monopolar RF passes an electrical current through the skin, and the resistance of the tissue converts it into heat across a broad volume while a cryogen spray cools and protects the surface. The 0.25 cm² eye tip delivers about 450 pulses over the upper and lower lids, with a plastic shield placed over the eye. The heat contracts existing collagen immediately, and further tightening follows over 2 to 6 months as new collagen forms.

HIFU vs Thermage for droopy eyelids and loose under-eye skin

  • EvidenceEvidence for Thermage Eyes, Grade B. In a multicentre study of 86 patients given a single treatment around the eyes, blinded reviewers recorded an improvement of at least one point on a wrinkle scale in 83% of treated areas, and 62% of brows were raised by at least 0.5 mm. A second multicentre study, in which the eye tip was applied directly to the lids of 72 patients, reported upper-lid tightening in 88% and lower-lid tightening in 71 to 74%.
  • EvidenceEvidence for HIFU on the eyelids, Grade C. A 2026 prospective study treated 34 Korean women with one session of Ultraformer MPT using a 2.0 mm cartridge. At 12 weeks, the distance from the brow to the upper-lid margin had shortened by 0.94 mm, 76% of patients reported improvement, and blinded clinicians identified improvement in 59%. The study had no control group, and one author is employed by the device manufacturer. Ultherapy’s brow lift carries separate Grade B evidence for upper-lid hooding caused by a low brow.
  • HIFU vs Thermage head to head, Grade D for the eyes No study has compared the two devices on the eyelids. On the face and upper neck, a randomised split-face trial of monopolar RF against Ultherapy found no difference between the technologies, and a meta-analysis of two neck trials reached the same result.

Both devices produce about 1 to 2 mm of tightening at best, which is too little to correct the two eyelid problems that require surgery. A lid edge that sits low over the iris indicates ptosis, which most often results from stretching of the tendon of the muscle that raises the lid, and excess skin resting on the lashes can only be removed surgically. Surgical and non-surgical options are compared on Sagging eyelids treatment in Singapore and Sagging skin under eyes treatment.

HIFU vs Thermage price in Singapore (2026)

Area HIFU Thermage FLX
Eyes or under-eyes S$300 to 800 S$1,200 to 3,000 (about 450 pulses)
Full face S$590 to 2,000 S$3,200 to 5,500
Face and neck S$1,800 to 2,000 From S$4,500

HIFU is priced by shots or lines and Thermage by pulses, so two quotes are comparable only when each states the device and the number of shots, lines or pulses delivered. Some clinics advertise HIFU without naming the machine, which conceals whether the device has built-in imaging or published evidence behind it. Some listed prices also exclude goods and services tax (GST).

HIFU vs Thermage pain, downtime and how long results last

  • Pain Pooled studies of HIFU on the face report an average pain score of about 4 out of 10, whereas one study of 46 patients treated with Thermage FLX recorded an average of about 7 out of 10. The figures come from different studies and are not a direct comparison.
  • Downtime HIFU usually requires no recovery time, although redness lasted 3 to 4 days after eyelid treatment. Thermage causes redness and mild swelling for 1 to 2 days.
  • Results and durability Results from both devices build over 2 to 6 months as new collagen forms. Published follow-up extends to 12 weeks for eyelid HIFU and 6 months for Thermage, so the one to two years of durability that clinics quote for both has not been measured in eyelid studies.

HIFU and Thermage safety around the eyes

  • HIFU Case reports describe corneal scarring, cataract requiring surgery and iris damage after focused ultrasound was applied on or near the eyelids, where the focused energy can pass through the thin lid into the eye. Treatment is therefore kept outside the eye, and protective eye shields are used. In Singapore, the National Environment Agency instructs suppliers not to sell HIFU devices or class 4 lasers to anyone who is not a registered doctor.
  • Thermage In the 86-patient study around the eyes, second-degree burns occurred in 0.36% of RF applications, and three patients had small scars at six months. A series of 290 patients also reported rare fat loss and nerve pain. The current protocol of multiple passes at lower energy was introduced to reduce these risks, because it spreads the heat over more pulses rather than concentrating it in a few.

Can you combine HIFU and Thermage?

Some clinics combine the two devices, applying HIFU to the deeper layer of the face and Thermage to the skin surface and the eyelids, on the reasoning that each heats a different depth. A Korean split-face study found slightly greater wrinkle reduction when RF was given before HIFU than after it, although no study has shown that the combination outperforms either device alone (Grade D). The cost of a combined session is roughly the sum of both treatments. Thermage is compared with branded focused ultrasound on the Thermage vs Ultherapy page.

HIFU vs Thermage, which to choose for sagging eyes

  • Loose or crepey eyelid skin Thermage Eyes, which has Grade B evidence on the eyelids against Grade C for HIFU.
  • Mild laxity on a lower budget HIFU, which costs less but rests on a single eyelid study of 34 women.
  • Hooding from a low brow Ultherapy brow lift, which has Grade B evidence for raising the brow, or a Botox brow lift as a shorter-term trial.
  • Skin resting on the lashes or a low lid edge Surgery, because neither device removes excess skin or raises a lid edge lowered by ptosis.

Frequently asked questions about HIFU and Thermage

Is HIFU or Thermage better for sagging eyelids?


Thermage Eyes has stronger evidence for the eyelids (Grade B, two multicentre studies) than HIFU (Grade C, one study of 34 women). Both produce modest tightening of 1 to 2 mm, and neither corrects ptosis or a large fold of excess skin.

Is HIFU safe for the eyes?


Case reports describe rare but serious eye injuries, including corneal scarring and cataract, after HIFU was applied near the eye. The eyelid cartridge must be used only outside the eye with protective shields in place, and in Singapore HIFU devices are supplied only to registered doctors.

Why is Thermage more expensive than HIFU?


Thermage is a single branded system priced by the pulse, whereas HIFU is offered on many generic devices across a wide range of prices. In Singapore in 2026, Thermage Eyes costs S$1,200 to 3,000, compared with S$300 to 800 for an eye-area HIFU session.

How long do HIFU and Thermage last?


Results from both build over 2 to 6 months. Clinics quote a duration of one to two years for both, whereas published studies have followed patients for only 3 to 6 months.

Can I do HIFU and Thermage together?


Some clinics combine them in one plan, with HIFU on the deeper facial layer and Thermage on the surface and eyelids. No study has shown that the combination outperforms either treatment alone, and the cost is roughly the sum of both.

General information, not medical advice. A registered medical practitioner should be consulted before any treatment. Dark Eye Circles Singapore does not sell treatments.

Sources and price references (checked 8 October 2026)
  1. Fitzpatrick R, et al. Multicenter study of noninvasive radiofrequency for periorbital tissue tightening. Lasers Surg Med. 2003;33(4):232–242. doi:10.1002/lsm.10225 (PMID 14571447) — Multicentre prospective, 86 patients, one periorbital treatment; 2nd-degree burns 0.36% of applications https://doi.org/10.1002/lsm.10225
  2. Biesman BS, et al. Monopolar radiofrequency treatment of human eyelids: a prospective, multicenter, efficacy trial. Lasers Surg Med. 2006;38(10):890–898. doi:10.1002/lsm.20452 (PMID 17163476) — Prospective multicentre, 72 patients, 0.25 cm² eye tip https://doi.org/10.1002/lsm.20452
  3. de Felipe I, et al. Adverse reactions after nonablative radiofrequency: follow-up of 290 patients. J Cosmet Dermatol. 2007;6(3):163–166. doi:10.1111/j.1473-2165.2007.00322.x (PMID 17760693) — Case series, 290 patients; burns, fat atrophy, neuralgia https://doi.org/10.1111/j.1473-2165.2007.00322.x
  4. Wang Y, et al. Evaluation of the Effect of Laterality and Age on Pain Perception in Monopolar Radiofrequency Facial Therapy. Clin Cosmet Investig Dermatol. 2026;19. doi:10.2147/CCID.S577283 (PMID 41924292) — 46 Thermage FLX patients, VAS 6.6 to 7.1 https://doi.org/10.2147/CCID.S577283
  5. Alam M, et al. Ultrasound tightening of facial and neck skin: a rater-blinded prospective cohort study. J Am Acad Dermatol. 2010;62(2):262–269. doi:10.1016/j.jaad.2009.06.039 (PMID 20115948) — Rater-blinded cohort, 35 patients, mean brow lift 1.7 mm at 90 days https://doi.org/10.1016/j.jaad.2009.06.039
  6. Alhaddad M, et al. A Randomized, Split-Face, Evaluator-Blind Clinical Trial Comparing Monopolar Radiofrequency Versus Microfocused Ultrasound With Visualization for Lifting and Tightening of the Face and Upper Neck. Dermatol Surg. 2019;45(1):131–139. doi:10.1097/DSS.0000000000001653 (PMID 30531187) — Randomised split-face, 20 subjects, no difference at 180 days https://doi.org/10.1097/DSS.0000000000001653
  7. Modena DAO, et al. Systematic review and meta-analysis — microfocused ultrasound treatment for sagging skin. Lasers Med Sci. 2025;40(1):169. doi:10.1007/s10103-025-04424-9 (PMID 40167815) — Meta-analysis of two neck RCTs, no difference between HIFU and RF https://doi.org/10.1007/s10103-025-04424-9
  8. US FDA. 510(k) K052936, ThermaCool system: periorbital wrinkles and rhytids including upper and lower eyelids (2007); K170758, Thermage FLX (2017) https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K170758
  9. Thermage full face price: SL Aesthetic Clinic — RF Thermalift FLX face from S$4,000; face and neck from S$4,500; eyes from S$3,000 (checked 2026-10-08) https://slclinic.com.sg/rf-thermalift-flx-singapore/
  10. Thermage full face price: Lux Medical Aesthetic Clinic — Thermage face S$3,200 (900 shots), eyes S$1,500 (450 shots), before GST (checked 2026-10-08) https://luxaestheticclinic.com/price-list/
  11. Thermage full face price: illumia Medical — Thermage for face and neck lift from S$2,000 (checked 2026-10-08) https://illumiamedical.com/price-list/
  12. Thermage full face price: Dr Daniel Chang — S$3,500–5,500 face; S$1,200–2,000 eyes (checked 2026-10-05) https://drdanielchang.com/aesthetic-treatment-price-singapore/
  13. Thermage Eyes price: Cutis Medical Laser Clinics — S$1,620–1,900 (eyes, upper and lower lids, 450 pulses) (checked 2026-10-05) https://www.cutislaserclinics.com/blog/how-much-does-doctor-led-rf-skin-tightening-cost-in-singapore/
  14. Ayatollahi A, et al. Systematic review and meta-analysis of safety and efficacy of high-intensity focused ultrasound (HIFU) for face and neck rejuvenation. Lasers Med Sci. 2020;35(5):1007–1024. doi:10.1007/s10103-020-02957-9 (PMID 32026164) — 17 studies, 477 participants, mixed devices; pain 4.2/10 https://doi.org/10.1007/s10103-020-02957-9
  15. Kim JS, et al. Three-dimensional Analysis of Lifting Effects after High-intensity Focused Ultrasound (Ultraformer-MPT). Plast Reconstr Surg Glob Open. 2024;12(10):e6203. doi:10.1097/GOX.0000000000006203 (PMID 39372881) — 50 patients, immediate 3D lift by facial unit https://doi.org/10.1097/GOX.0000000000006203
  16. Hwang Y, et al. Efficacy of high-intensity focused ultrasound for treating upper and lower eyelid sagging. JPRAS Open. 2026;48:147–154. doi:10.1016/j.jpra.2025.10.036 (PMID 41438879) — Prospective cohort, 34 women, Ultraformer MPT 2.0 mm; one author employed by Classys https://doi.org/10.1016/j.jpra.2025.10.036
  17. Roditi E, et al. Cataract induced by eyelid cosmetic treatment with intense focused ultrasound. J Cataract Refract Surg. 2020;46(12):e27–e29. doi:10.1097/j.jcrs.0000000000000357 (PMID 32818362) https://doi.org/10.1097/j.jcrs.0000000000000357
  18. Marafon SB, et al. Cornea opacity, uveitis with iris atrophy and lens damage following cosmetic high-intensity ultrasound of the face. BMC Ophthalmol. 2023;23(1):230. doi:10.1186/s12886-023-02947-9 (PMID 37217891) https://doi.org/10.1186/s12886-023-02947-9
  19. Liu J, et al. Micro-Focused Ultrasound Treatment for Periocular Skin Leading to Corneal Leukoma With Iridocyclitis: A Case Report. J Cosmet Dermatol. 2025;24(12):e70601. doi:10.1111/jocd.70601 (PMID 41367308) https://doi.org/10.1111/jocd.70601
  20. HIFU price: SL Aesthetic Clinic — Ultraformer MPT face from S$1,500; face and neck from S$2,000 (checked 2026-10-08) https://slclinic.com.sg/face/hifu-treatment-price-singapore/
  21. HIFU price: Lux Medical Aesthetic Clinic — HIFU full face S$1,980, before GST (checked 2026-10-08) https://luxaestheticclinic.com/price-list/
  22. HIFU price: Become Aesthetics — Ultracel Q+ HIFU full face and neck S$1,800 per session (checked 2026-10-08) https://www.becomeaesthetics.com.sg/price-list/
  23. HIFU price: Halley Medical Aesthetics — HIFU face tightening treatment S$590 (checked 2026-10-08) https://halley.com.sg/price-list/
  24. HIFU eye area price: Lux Medical Aesthetic Clinic — S$300–800 (HIFU eye lift), before GST (checked 2026-10-05) https://luxaestheticclinic.com/treatment/hifu/eye-lift/
  25. HIFU eye area price: Medical Aesthetics (medical-aesthetics.sg) — S$327 (HIFU brows / droopy eyelids, single session) (checked 2026-10-05) https://www.medical-aesthetics.sg/hifu-treatment-singapore
  26. HIFU eye area price: Sozo Aesthetic Clinic — from S$300 for smaller areas (Ultraformer MPT) (checked 2026-10-05) https://sozoclinic.sg/dark-eye-circles/treatment/
  27. Choi WJ, et al. Comparative Study of Monopolar Radiofrequency and High-Intensity Focused Ultrasound for Facial Rejuvenation: A Split-Face Approach. Dermatol Surg. 2025;51(9S):S49–S53. doi:10.1097/DSS.0000000000004794 (PMID 41405928) — Order of RF and HIFU; RF first gave slightly better wrinkle reduction https://doi.org/10.1097/DSS.0000000000004794
  28. National Environment Agency, Singapore. Radiation safety information for apparatus used in the beauty and medical aesthetic industry — class 4 lasers and HIFU apparatus not to be supplied to non-doctors (updated 20 August 2026) https://www.nea.gov.sg/our-services/radiation-safety/radiation-safety-information-for-apparatus-used-in-beauty-and-medical-aesthetic-industry

Sagging Eyelids in Singapore: this series

Comparisons for sagging eyelids:

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Dark Eye Circles Singapore

Independent reviews of eye-area concerns and treatments in Singapore. Evidence graded, 2026 prices compared, sources listed.

© 2026 Dark Eye Circles SingaporeGeneral information, not medical advice. Prices checked October 2026.