Ulthera Basics: Questions and Answers

Ulthera is a non-surgical lifting treatment that focuses ultrasound energy onto small points beneath the skin to tighten and gradually lift tissue. Unlike many similar devices, it shows a live ultrasound image of the layers under the handpiece, so the treating doctor can see where the energy will land. The heat triggers a healing response that builds new collagen over the following months. There are no incisions or injections, and most people return to normal activities the same day.

Yes. Ultherapy is the name of the treatment and Ulthera is the name of the system that delivers it, and patients in Korea and elsewhere use the two words interchangeably. Both refer to microfocused ultrasound with visualization from the same manufacturer, now Merz Aesthetics, and the newer generation of the system is called Ultherapy PRIME. Violacell Plastic Surgery offers both, as explained on the Ultherapy PRIME questions page.

MFU-V stands for microfocused ultrasound with visualization. "Microfocused ultrasound" describes the treatment energy: ultrasound concentrated onto a tiny point a set distance below the surface. "Visualization" means the same handpiece also images the tissue, so the skin, the fat, the deeper support layer (SMAS) and nearby bone can be seen on a screen before each line is delivered. That built-in imaging is the main thing that sets Ulthera apart from many other focused-ultrasound devices.

Ulthera is a form of focused ultrasound, so it belongs to the broad HIFU family, but it is not identical to every device sold under that label. Many HIFU devices deliver energy without showing the tissue underneath, while Ulthera displays a live ultrasound image before each pass. Dr. Kim has written that seeing the tissue on screen is what he considers its main advantage over other focused-ultrasound devices. Energy settings, transducer depths and point spacing also differ between brands.

In the United States, Ulthera has FDA clearances for three uses: lifting the eyebrow, lifting loose skin under the chin and on the neck, and improving lines and wrinkles on the décolleté (upper chest). Doctors also use it on other parts of the face, such as the lower cheek and jawline, based on clinical experience. Regulatory status differs by country, and a clearance describes what the device was tested for rather than promising any individual result.

Ulthera can reach three main levels: the SMAS and platysma (the deeper support layer and the neck muscle), the deep dermis with the top of the fat beneath it, and the superficial dermis. Each transducer focuses at one fixed depth, 4.5 mm, 3.0 mm or 1.5 mm, so treating several layers means switching transducers. Which layer actually sits at those depths varies by person and by area, which is why imaging matters, as explained on the design and depths page.

The SMAS (superficial musculoaponeurotic system) is a thin, firm sheet under the skin and fat that wraps the facial muscles and holds facial contours up. It is the same layer a surgeon tightens during a facelift. Ulthera can heat points within the SMAS without an incision, causing it to contract and remodel, which is why its effect is described as lifting rather than surface tightening. Whether the SMAS lies at the 4.5 mm depth in a given spot depends on that person's tissue thickness.

No. Ulthera is applied from the surface of the skin through a handpiece and a layer of gel, with no needles, incisions or stitches. The energy passes through the skin and is focused below it, so the surface is left largely intact. Some clinics add injected local anesthetic for comfort, but that is a pain-control choice rather than part of the treatment itself. Pain-control options are covered on the pain and recovery page.

It is mainly a lifting and firming treatment, with some effect on skin quality. Its deepest depth aims at the supporting layer that holds contours up, and its shallower depths act on the dermis, the collagen-rich part of the skin. Fine lines, texture and thinning skin usually respond better to radiofrequency devices or skin boosters. In his answers to patients, Dr. Kim notes that radiofrequency such as Thermage is better suited than focused ultrasound when fine wrinkles and elasticity are the main goal.

Ulthera has been in clinical use since the late 2000s. Its FDA clearance for lifting the brow dates from 2009, and clearances for the area under the chin and neck and for the décolleté followed in the early 2010s. That long track record means its typical effects and side effects are well described in published studies. Results still vary from person to person, and a well-known device does not remove the need for careful planning.

Commonly treated areas include the brow and forehead, temples, cheeks, the lower face and jawline, under the chin and the neck, plus the décolleté. Around the eyes, treatment is limited to selected areas outside the bony rim of the eye socket, with shallow depths. Each area has a different tissue thickness and different nearby nerves, so not every area suits every depth. Area-by-area planning is covered on the design and shots page.

Ulthera tends to suit people with early to mild sagging along the jawline, lower cheek or under the chin, whose tissue is still roughly in place. It fits those who want gradual change with little downtime and accept a modest result. It is less suitable when jowls are heavy, skin hangs in folds, or the main issue is lost volume or surface lines. Dr. Kim decides by examining which layer has changed before choosing a device, as described on why Dr. Kim for Ulthera.

There is no fixed starting age; the decision depends on how much the tissue has changed rather than on the number of years. Many people consider it between their mid-thirties and fifties, when early laxity appears along the jawline and under the chin. Younger people with little sagging may notice little benefit, while people with advanced sagging may find the effect too small. An examination tells you more than age alone.

It can still help in your sixties, but expectations need adjusting. Skin and support layers at that age often respond less strongly, and sagging is more likely to have gone beyond what a device can lift. Dr. Kim has written that energy devices rely on the body's own repair, so results tend to be weaker where regenerative capacity has declined. When sagging is advanced, he will explain whether surgery such as a facelift would be more effective, even though he does not perform surgery at Violacell.

Yes. Men have Ulthera for the same reasons as women, most often a softer jawline, loose skin under the chin or heaviness around the lower face. Male skin is usually thicker and the face larger, so the plan may involve more lines and a different balance of depths. As an illustration, Dr. Kim has cited depth proportions such as 5:3:2 in many men compared with 6:3:1 in many women, while stressing that each face is planned individually.

Ulthera is widely used in Korea and elsewhere in Asia, and focused ultrasound is generally considered compatible with all skin tones because it does not target pigment. Many Asian faces have a broader lower face, thicker soft tissue in some areas, prominent cheekbones and a strong chewing muscle, all of which change how energy is placed. Areas over bone and near nerves are treated more cautiously. Dr. Kim plans each treatment from the image and the examination rather than from a standard pattern.

Generally yes. Because Ulthera focuses energy beneath the surface and does not depend on pigment, darker skin does not carry the raised risk of pigment change that some lasers do. Surface marks and temporary darkening can still occur, especially if contact is uneven or energy is placed too superficially. Tell the doctor if you have a history of hyperpigmentation or keloid scarring so the plan can account for it.

Ulthera is usually avoided over open wounds, active infection or active acne, and during pregnancy. People with a pacemaker or another implanted electronic device, or metal implants near the area, need individual assessment. Bleeding disorders, blood-thinning medicines, recent fillers or threads, and conditions that affect healing should be discussed in advance. It is also not the right choice when the expected improvement is too small to be worth it, which an honest consultation should say.

Usually yes, but the doctor needs to know what was injected, where and when. Hyaluronic acid filler and collagen stimulators change how tissue looks on the image and how energy should be placed, and heat directly over recent filler is generally avoided. Many clinicians prefer an interval between filler and Ulthera in the same area. Order and timing are discussed on the combination treatment page.

Often yes, once healing is complete and the surgeon agrees. After a facelift the tissue planes and scar tissue are different, so the image and examination become even more important for choosing depths. Ulthera is sometimes used for maintenance in the years after surgery, when early laxity returns. It cannot stop the gradual aging that continues after a facelift, but it can firm tissue that is still in a reasonable position.

Yes, the neck and the area under the chin are among Ulthera's FDA-cleared uses. Loose skin and mild laxity along the neck can firm gradually, and the deepest depth can reach the platysma muscle where the tissue is thick enough. Pronounced vertical bands and hanging neck skin usually respond poorly to devices and may need surgery. Neck skin is thinner than facial skin, so depths are chosen carefully.

Yes, improving lines and wrinkles on the décolleté is one of Ulthera's FDA-cleared uses. The chest skin is thin and lies over bone in places, so shallower depths are generally used and energy is kept away from bony areas. Changes are gradual and usually modest. Sun damage, crepey texture and pigmentation on the chest often need skin-surface treatments as well.

The consultation starts with what bothers you, then moves to an examination of the face layer by layer: skin quality, fat, the supporting layer, bone contours and how the tissue moves. Dr. Kim designs Ulthera from the ultrasound image and from palpation, feeling tissue thickness, fat and bone edges by hand. He then explains which areas and depths he would treat, which he would avoid, and whether Ulthera fits at all. If another treatment or surgery would serve you better, he says so.

At Violacell, the clinic describes a typical treatment as taking about 20 to 40 minutes, depending on the areas treated. Numbing cream applied beforehand adds waiting time, and a full face and neck with several depths takes longer than a small area. Plan for a visit of roughly one to two hours including consultation, photos, numbing and a short rest afterwards. Exact timing is confirmed when you book.

Arrive with clean skin and, if possible, no makeup on the treatment area. Tell the clinic about any medicines, especially blood thinners, and supplements such as fish oil or vitamin E that can increase bruising, but do not stop a prescribed medicine without asking the doctor who prescribed it. Mention recent fillers, threads, laser or skin treatments, and any history of cold sores, keloids or nerve problems. If sedation or strong pain relief is planned, arrange for someone to take you home.

Usually one session is planned at a time, not a series. Because collagen remodeling continues for months, the effect of a single session is assessed over about 3 to 6 months before deciding on anything further. Some people choose lighter top-up treatments, and Dr. Kim has described a modest Ulthera session combined with Thermage as a good way to maintain results lightly. Intervals are discussed on the results and maintenance page.

Yes, and Dr. Kim encourages it. During treatment he shows patients the same ultrasound image he is working from and explains how an area is built and why a particular spot bulges because of where the fat sits. He has written that patients feel more involved and less anxious when they can see the reason for each step. You are welcome to ask about what the screen shows as the treatment goes on.

Often yes, because Ulthera needs no stitches and most people return to normal activities the same day. Redness and swelling usually settle within hours to a few days, so leaving a few days between treatment and a long flight is comfortable for most people. The result develops over months after you return home, so later review may happen remotely or on a future visit. Practical details for visitors are on visiting Violacell.

Yes, because the plan depends on examining your face. The areas, depths and number of lines are decided after looking at the image and feeling the tissue, so a fixed package chosen in advance may not match what your face needs. For visitors from abroad, sharing clear photos and your main concerns beforehand can help, but the final plan is set in person. You can contact the clinic on +82-2-518-9119 or by WhatsApp on +82-10-4788-5777.

Generally no. Ulthera is an elective aesthetic treatment, so it is not covered by Korean national health insurance and is usually not covered by private insurance elsewhere. Fees are set by the clinic and depend on the system used, the areas and the size of the treatment, so ask the clinic directly for current details. Check with your own insurer if you are unsure about your policy.

Bring a list of your medicines and supplements, and details of any previous fillers, threads, surgery or energy treatments with approximate dates. Photos of yourself from a few years ago can help show how your face has changed. Visitors from abroad should know how to reach the clinic, which is on the third floor at 138 Dosan-daero, Gangnam-gu, about four minutes' walk from Sinsa Station exit 1. Clothing that does not need to be pulled over the face is practical afterwards.

Ask which areas will be treated, at which depths and why, and which areas will be avoided or treated lightly. Ask how many lines are planned for each area rather than just the total, what pain control is offered, and what result is realistic for your face. It is also reasonable to ask whether another treatment or surgery would suit you better. A longer list is in questions to ask before Ulthera.

Yes. Ulthera can be limited to a single area such as under the chin, the jawline or the brow, and a smaller treatment needs fewer lines and less time. Treating one area is reasonable when the change is localized. The effect on overall contour may be smaller than a plan that also addresses neighboring areas, because sagging in one zone is often linked to the tissue around it. Dr. Kim will explain whether a focused treatment is likely to give the change you are looking for.