Head-to-head comparison · 2026 Singapore prices

Thermage vs Ultherapy

/ˈθɜːrmɪdʒ/ vs /ʌlˈθɛrəpi/ Radiofrequency against micro-focused ultrasound for tightening the eyelids, face and neck

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.

Thermage vs Ultherapy: skin tightening comparison for eyes and face, with evidence grades and 2026 Singapore prices

Overview

Thermage and Ultherapy both tighten skin with heat but deliver it in different ways. Thermage FLX uses monopolar radiofrequency (RF) to heat a broad layer of skin and the tissue just beneath it, and its eye tip is cleared in the United States for the upper and lower eyelids. Ultherapy uses micro-focused ultrasound with built-in imaging to place points of heat at set depths of 1.5, 3.0 and 4.5 mm, the deepest reaching the muscle layer that a surgical facelift tightens. Ultherapy is cleared in the United States for lifting the brow and the tissue under the chin and on the neck, but not for the eyelids. The one randomised split-face trial comparing the two technologies on the face and neck found no difference at six months. For the eyelids and crepey under-eye skin, Thermage Eyes has the stronger evidence (Grade B) and costs S$1,200 to 3,000. For the jawline, jowls and neck, Ultherapy has the larger body of evidence and costs S$1,800 to 3,700 for a full face in Singapore in 2026, compared with S$3,200 to 5,500 for a full-face Thermage FLX session.

  • Thermage heats a broad layer with radiofrequency, Ultherapy places imaging-guided focused ultrasound points at set depths
  • Thermage Eyes cleared for the eyelids (Grade B), Ultherapy not cleared for them and advised against by its maker
  • No difference between the two technologies on the face and neck in a randomised split-face trial
  • Full face S$3,200 to 5,500 for Thermage FLX, S$1,800 to 3,700 for Ultherapy
  • One session each, with results building over 2 to 6 months and repeat treatment every 1 to 2 years
  • Rare burns and fat loss with Thermage, nerve irritation and eye injury near the orbit with focused ultrasound
Introduction

Thermage and Ultherapy are the two best-known non-surgical skin-tightening brands in Singapore and are often marketed as rivals, although the evidence favours each for a different part of the face. The sections below compare their mechanism, the evidence for the eyelids, jawline and neck, and 2026 prices.

Thermage vs Ultherapy at a glance

Thermage FLX Ultherapy (PRIME)
Technology Monopolar radiofrequency with surface cooling Micro-focused ultrasound with visualisation (MFU-V)
Where the heat goes Bulk heating of the dermis and the fibrous layer beneath it Separate points at 1.5 mm (dermis), 3.0 mm and 4.5 mm (the deep muscle layer)
Imaging during treatment None Built-in ultrasound image to about 8 mm
Eye area Eye tip used on the upper and lower lids, with an eye shield Brow lift, with under-eye treatment kept below the bony rim
US FDA clearance Periorbital wrinkles, including the upper and lower eyelids, and facial wrinkles Lifting the eyebrow, lax under-chin and neck tissue, and décolleté lines
Evidence grade, eyes B (eyelids and under-eye skin) B (brow lift), C (under-eye)
Evidence grade, face and neck B A
2026 Singapore price Eyes S$1,200 to 3,000, full face S$3,200 to 5,500 Under-eye S$420 to 1,200, full face S$1,800 to 3,700
Sessions One, repeated every 1 to 2 years One, repeated every 12 to 18 months
Pain About 7 out of 10 in one study of Thermage FLX About 5 out of 10, pooled across 42 studies
Downtime Redness and swelling for 1 to 2 days None to 1 day, with tenderness for a few days
Main risks Burns, rare fat loss, surface irregularity Welts, bruising and temporary nerve irritation, eye injury if focused near the eyeball

How Thermage and Ultherapy tighten skin

  • Thermage FLX Monopolar RF passes an electrical current through the skin from a treatment tip to a return pad on the body. The resistance of the tissue converts the current into heat across a broad volume, while a cryogen spray cools and protects the surface. The heat contracts existing collagen immediately, and new collagen forms over the following 2 to 6 months. Around the eyes, the 0.25 cm² eye tip delivers about 450 pulses over the upper and lower lids.
  • Ultherapy Ultrasound waves converge at a focal point, where their energy is absorbed as heat, creating tiny points of coagulated tissue at a chosen depth while the skin surface is left intact. Separate transducers treat at 1.5, 3.0 and 4.5 mm, and the deepest reaches the superficial muscular aponeurotic system (SMAS), the layer a surgical facelift tightens. The built-in image displays the tissue layers, so the operator can confirm the depth before each line is delivered. Ultherapy PRIME, the newer console, was cleared in the United States in February 2024.

Thermage heats a broad, relatively shallow volume suited to thin eyelid skin, whereas Ultherapy heats deep, targeted points suited to the heavier tissue of the jawline and neck.

Thermage vs Ultherapy for eyelids and under-eye skin

Only Thermage is designed and cleared to treat the eyelids themselves, so the two devices are not interchangeable around the eyes.

  • 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%, with no serious adverse events.
  • EvidenceEvidence for Ultherapy around the eyes, Grade B for brow lift and C for the under-eye. A rater-blinded study of 35 patients measured a mean brow lift of 1.7 mm at 90 days, which reduces upper-lid hooding indirectly because the raised brow lifts the skin that folds over the lid. In 25 Asian patients given a full-face and neck treatment, the brow rose 0.47 mm at 90 days and had returned to baseline by six months. The only lower-lid study, published in 2014, treated the lower lids of seven patients directly and measured a change of about 0.5 mm. The manufacturer’s instructions advise against treatment on the eyelids or within the orbital rim, the bony edge of the eye socket, so under-eye treatment is placed below it.

Ultherapy’s brow lift is a reasonable option for hooded eyes caused by a low brow, whereas Thermage Eyes is the better-supported choice for loose or crepey lid skin. 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. Neither device corrects ptosis. Surgical options are covered on Sagging eyelids treatment in Singapore and Sagging skin under eyes treatment.

Thermage vs Ultherapy for the face, jowls and neck

  • Head to head In a randomised, evaluator-blinded split-face trial, 20 patients received monopolar RF on one side of the face and upper neck and Ultherapy on the other. Both sides improved between day 30 and day 180, with no difference in laxity scores, satisfaction or side effects. A trial of 20 patients is, however, too small to exclude a modest difference between the devices. A 2025 meta-analysis of two randomised neck trials likewise found no difference between focused ultrasound and RF.
  • Ultherapy, Grade A A 2025 systematic review of 42 studies reported improvement in 89% of patients as rated by investigators and in 84% as rated by the patients themselves. Most of the pooled studies had no control group, and the authors cautioned that neutral responses may have been counted as improvement. In a study of 93 patients treated on the lower face and neck, blinded reviewers identified improvement in 58%, and results were poorer when body mass index exceeded 30, possibly because the modest tightening cannot support heavier facial tissue.
  • Thermage, Grade B The facial evidence comes mainly from prospective cohorts and a survey of 5,700 treatments, in which 92% of patients treated with the current multiple-pass method showed visible tightening at six months. A survey of this kind has no control group. No trial has tested Thermage FLX against Ultherapy PRIME, the current versions of each device.

Thermage vs Ultherapy price in Singapore (2026)

Area Thermage FLX Ultherapy
Eyes or under-eyes S$1,200 to 3,000 (about 450 pulses) S$420 to 1,200 (about 100 lines)
Full face S$3,200 to 5,500 (one clinic lists face and neck from S$2,000) S$1,800 to 3,700 (500 to 800 lines)
Full face and neck From S$4,500 From S$2,900 (face and upper neck, 500 lines)

Thermage is priced by pulses (often called shots) and Ultherapy by lines, so two quotes are comparable only when each states the number delivered and the area covered. Some clinics list Thermage under a generic name such as “RF Thermalift FLX”, and some prices exclude goods and services tax (GST).

Thermage vs Ultherapy pain, downtime and results

  • Pain Both treatments are uncomfortable. In one study of 46 patients treated with Thermage FLX, pain averaged about 7 out of 10 and was higher in younger patients, whereas a 2025 meta-analysis of 785 patients recorded an average of 4.85 out of 10 for Ultherapy. The figures come from different studies and are not a direct comparison.
  • Downtime Thermage causes redness and mild swelling for 1 to 2 days. Ultherapy usually causes no visible downtime, although the treated skin can feel tender or numb for a few days.
  • Results Both produce slight immediate tightening as existing collagen contracts, followed by gradual improvement over 2 to 6 months as new collagen forms.
  • How long it lasts Improvement after Ultherapy has been reported for up to one year, whereas Thermage trials have followed patients for six months. The one to two years that clinics quote for both is therefore longer than the published follow-up.

Thermage vs Ultherapy risks and side effects

  • 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, nerve pain and facial weakness. Modern settings of multiple passes at lower energy were introduced to reduce these risks, because they spread the heat over more pulses rather than concentrating it in a few.
  • Ultherapy Welts, bruising and temporary numbness are the common effects, and temporary nerve injury has also been reported. Case reports describe injury to the cornea, lens and iris after focused ultrasound was applied on or near the eyelids. Treatment is therefore kept outside the orbital rim, and eye protection is used.

Can you combine Thermage and Ultherapy?

Many Singapore clinics offer a combined session, typically with Ultherapy on the deeper layer of the jawline and neck and Thermage on the surface and the eyelids, on the reasoning that the two devices heat different depths. No published trial has shown that the combination outperforms either device alone (Grade D for the combination). The cost is roughly the sum of both, so a combined plan should state which device is applied to which area.

Thermage vs Ultherapy, which to choose for each concern

  • Loose or crepey eyelid and under-eye skin Thermage Eyes, the only one of the two cleared for the eyelids (Grade B).
  • Hooding from a low brow Ultherapy brow lift (Grade B), or a Botox brow lift as a shorter-term trial.
  • Jowls, jawline and neck Either device, with Ultherapy supported by more published studies and by imaging that confirms placement in the deep muscle layer.
  • Skin resting on the lashes, or heavy jowls Surgery, because neither device removes excess skin.

Generic high-intensity focused ultrasound (HIFU) devices are compared with Ultherapy on the Ultherapy vs HIFU page. Treatments for eye-bag fat, which neither device has been shown to reduce, are compared on Eye bag removal in Singapore.

Frequently asked questions about Thermage and Ultherapy

Which is better, Thermage or Ultherapy?


Neither device is better overall, because a randomised split-face trial found no difference on the face and neck. Thermage is better supported for the eyelids, whereas Ultherapy has more published studies for the jawline and neck.

Is Thermage or Ultherapy better for the eyes?


Thermage Eyes is better supported for the eyes, because it is cleared in the United States for the upper and lower eyelids and is backed by two multicentre studies (Grade B). Ultherapy lifts the brow but is not used on the eyelids themselves, as its manufacturer advises against treatment within the orbital rim.

Which is more painful, Thermage or Ultherapy?


Both treatments are uncomfortable. Published averages are about 7 out of 10 for Thermage FLX and about 5 out of 10 for Ultherapy, but the figures come from different studies, and numbing cream or pain relief is used for both.

How long do Thermage and Ultherapy results last?


Results from both build over 2 to 6 months. Published follow-up extends to six months for Thermage and about a year for Ultherapy, and clinics advise repeating either treatment every one to two years.

Can I do Thermage and Ultherapy on the same day?


Some clinics combine them in a single session, applying Ultherapy to the jawline and neck and Thermage to the eyes and skin surface. No study has shown that the combination outperforms either device 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. Dover JS, et al. Results of a survey of 5,700 patient monopolar radiofrequency facial skin tightening treatments. Dermatol Surg. 2007;33(8):900–907. doi:10.1111/j.1524-4725.2007.33191.x (PMID 17661932) — Survey; multiple-pass algorithm, 92% tightening at 6 months https://doi.org/10.1111/j.1524-4725.2007.33191.x
  4. 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
  5. 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
  6. 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
  7. Lu PH, et al. Quantitative Analysis of Face and Neck Skin Tightening by Microfocused Ultrasound With Visualization in Asians. Dermatol Surg. 2017;43(11):1332–1338. doi:10.1097/DSS.0000000000001181 (PMID 28945618) — 25 Asian patients, full face and neck; brow +0.47 mm at 90 days, back to baseline at 180 days https://doi.org/10.1097/DSS.0000000000001181
  8. Pak CS, et al. Safety and efficacy of Ulthera in the rejuvenation of aging lower eyelids: a pivotal clinical trial. Aesthetic Plast Surg. 2014;38(5):861–868. doi:10.1007/s00266-014-0383-6 (PMID 25099495) — 7 patients, lower lid treated directly; CT septal change about 0.5 mm; no adverse events https://doi.org/10.1007/s00266-014-0383-6
  9. Oni G, et al. Evaluation of a microfocused ultrasound system for improving skin laxity and tightening in the lower face. Aesthet Surg J. 2014;34(7):1099–1110. doi:10.1177/1090820X14541956 (PMID 24990884) — Prospective, 93 analysed; improvement in 58% by blinded review; poorer with BMI over 30 https://doi.org/10.1177/1090820X14541956
  10. Amiri M, et al. Microfocused Ultrasound With Visualization (MFU-V) Effectiveness and Safety: A Systematic Review and Meta-Analysis. Aesthet Surg J. 2025;45(3):NP86–NP94. doi:10.1093/asj/sjae228 (PMID 39540440) — 42 studies; 89% investigator-rated improvement; pooled pain 4.85/10 https://doi.org/10.1093/asj/sjae228
  11. Contini M, et al. A Systematic Review of the Efficacy of Microfocused Ultrasound for Facial Skin Tightening. Int J Environ Res Public Health. 2023;20(2):1522. doi:10.3390/ijerph20021522 (PMID 36674277) — 16 studies; improvement reported up to one year https://doi.org/10.3390/ijerph20021522
  12. 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
  13. 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
  14. Marr K, et al. Transient Nerve Damage After Microfocused Ultrasound With Visualization. Dermatol Surg. 2017;43(6):894–896. doi:10.1097/DSS.0000000000001032 (PMID 28498208) https://doi.org/10.1097/DSS.0000000000001032
  15. 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
  16. 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
  17. US FDA. De Novo DEN080006, Ulthera System, lift the eyebrow (2009); 510(k) K121700, submental and neck (2012); K134032, décolleté and DeepSEE imaging (2014); K233996, Ultherapy PRIME (2024) https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/denovo.cfm?ID=DEN080006
  18. Merz Aesthetics. Ultherapy PRIME Instructions for Use, 2025 — avoid “eyes, eyelids, and within the orbital rim” https://merzaesthetics.com/app/uploads/2025/11/ultherapy-prime-instructions-for-use.pdf
  19. 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/
  20. 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/
  21. 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/
  22. 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/
  23. 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/
  24. Ultherapy price: SL Aesthetic Clinic — Ultherapy PRIME full face up to 600 lines from S$2,400; up to 800 lines from S$3,120; under-eye up to 100 lines from S$720 (checked 2026-10-08) https://slclinic.com.sg/face/ultherapy-singapore/
  25. Ultherapy price: Halley Medical Aesthetics — full facelift with upper neck (500 lines) S$2,900; 800 lines S$3,700 (checked 2026-10-08) https://halley.com.sg/price-list/
  26. Ultherapy price: Halley Medical Aesthetics — under-eye S$420, before GST (checked 2026-10-07) https://halley.com.sg/blog/ultherapy-price/
  27. Ultherapy price: Ozhean Zoey — eye area (100–300 lines) S$400–1,200; full face (PRIME) from SOzhean Zoey — eye area (100–300 lines) S$400–1,200,800 (checked 2026-10-08) https://ozheanzoey.com/ultherapy-price-guide-to-lines-treatment-areas/
  28. Ultherapy price: Sozo Aesthetic Clinic — from S$3,000, full face and under chin, 500 lines (checked 2026-10-08) https://sozoclinic.sg/ultherapy-singapore/

Sagging Eyelids in Singapore: this series

Comparisons for sagging eyelids:

20

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.