Can You Combine Ulthera and Thermage in One Seoul Visit?

Whether to combine Ulthera and Thermage in a single Seoul visit comes down to which layer your sagging starts in and how many days you have left before you fly home. Ulthera focuses ultrasound energy at fixed points 1.5, 3.0, and 4.5 mm deep, while Thermage FLX uses monopolar radiofrequency to heat the skin broadly wherever the electrode touches. Research on same-day combination is still limited to retrospective studies of a few dozen patients, so I decide whether to combine them, and how much, after an in-person diagnosis.

Hello, I’m Dr. Kim Yeonjin, director at our Gangnam clinic. When you’re researching anti-aging lifting treatments in Seoul, Ulthera and Thermage tend to come up together in the same search. If you’re only in town for a short stay, whether you can receive both in one visit can shape your entire schedule.

The basic choice between the two devices is already covered in our Seocho clinic’s article, Ulthera vs Thermage: How Seocho Decides in Consultation. Here, I want to walk through what I actually check before deciding whether to combine both in the same session.

Ulthera and Thermage Target Different Layers

Ulthera concentrates ultrasound energy into small points at a set depth. Marquardt and colleagues, writing in the Journal of Cosmetic Dermatology (2025), describe how the Ulthera transducer targets the superficial dermis at 1.5 mm, the deep dermis at 3.0 mm, and the SMAS (the facial muscle fascia layer) and platysma at 4.5 mm. The clinical trial protocol for the Ulthera system registered with the U.S. National Library of Medicine’s ClinicalTrials.gov states that the device is designed to visualize tissue down to 8 mm with built-in ultrasound imaging, so the treatment depth can be confirmed as it is delivered.

Thermage FLX is a monopolar radiofrequency device. Solta Medical, the device’s manufacturer, states that Thermage FLX has U.S. FDA clearance for the non-invasive treatment of wrinkles, and separately for wrinkles around the eyes, including the upper and lower eyelids. Where ultrasound gathers heat at individual points, radiofrequency heats the skin broadly along the surface the electrode contacts.

	Ulthera	Thermage FLX
Energy type	Focused ultrasound, with built-in imaging	Monopolar radiofrequency
How energy is delivered	Points at 1.5, 3.0, and 4.5 mm depth	Broadly, along the surface the electrode touches
U.S. FDA-cleared scope (per manufacturer)	Brow lift, submental and neck lift, décolletage wrinkles, abdomen and arm skin laxity, among others	Wrinkles, and wrinkles around the eyes including upper and lower eyelids
What I check in consultation	Whether sagging starts in a deeper layer	Whether fine lines and texture concerns are spread across the face

Merz Aesthetics announced the abdomen and arm indication for Ultherapy PRIME in November 2025. When I consider combining the two devices, it is not to increase overall intensity. It is because sagging sometimes sits across both the deeper layer and the dermis at once, and each device is built to address one of those layers.

What Same-Day Combination Research Actually Shows

A retrospective study by Khong and colleagues, published in the Malaysian Journal of Medical Sciences (2024), reviewed the records of 56 patients who received combined high-intensity focused ultrasound (HIFU) and monopolar radiofrequency treatment at an aesthetic clinic in Johor Bahru between June 2018 and May 2021. The average age was 47.7, and most patients were Fitzpatrick skin types III and IV. Using the Global Aesthetic Improvement Scale, 96.4% showed a clinically meaningful improvement in skin elasticity.

A separate retrospective study registered with KoreaMed compared 36 patients treated for wrinkles between August 2021 and August 2023: 20 received HIFU alone, and 16 received HIFU combined with monopolar radiofrequency on the same day. Automated skin analysis showed significant wrinkle improvement in both groups, while blinded physician photo assessments and patient satisfaction scores were higher in the combined group. The adverse effects observed, redness and swelling, were described as mild and self-resolving.

Both studies look back at existing records, and both involve only a few dozen patients. Neither abstract confirms whether the HIFU device used was the same as Ulthera, and neither addresses whether doing one device before the other makes a difference. I read this evidence as supporting same-day combination as something worth considering for the right candidate, not as a universal recommendation.

What to Tell Us Before Combining Treatments

Solta Medical states that it has not studied the Thermage system in patients in the following situations:

• Currently treated with filler in the area (lips, cheeks, facial wrinkles, or skin folds)
• Pregnant or breastfeeding
• Living with diabetes or an autoimmune condition such as lupus
• Living with oral or genital herpes
• Living with epilepsy
• Having permanent makeup or a tattoo in the area
• Under the age of majority

If any of these apply to you, please tell me during consultation. It is information I need to decide whether and how much to combine the two treatments.

For patients who have had filler or a neuromodulator like Botox alongside energy-based devices, Suh and colleagues, in Archives of Dermatological Research (2025), reviewed the records of 1,040 patients treated with focused ultrasound or monopolar radiofrequency together with neuromodulators or filler at two Korean dermatology clinics between June 2005 and December 2023. No infection, necrosis, burns, filler migration, or earlier-than-expected filler loss was reported. The researchers also noted that the retrospective design and the two-clinic setting limit how broadly the findings can be generalized, and the study did not separately analyze cases where both energy devices were given on the same day. If you have had filler, let me know when and where, along with the product name if you know it. It helps me make a more informed recommendation.

If You’re Staying Only a Few Days, Work Backward From Your Flight Home

Whether to combine treatments also depends on how much time you have left in Seoul. The redness and swelling reported in the Korean study above were described as mild, but how a given patient responds, and for how long, varies. Leaving time after arrival for diagnosis and consultation, and leaving a buffer after treatment to watch how your skin responds before you fly home, makes the decision easier on both sides.

I’ve laid out how to work backward from your departure date by response type in Short Seoul Stay: Working Backward From Your Flight Home by Treatment Response.

Visiting Our Gangnam Clinic for a Combination Consultation

Our Gangnam clinic is located inside UH FLAT SIGNATURE Gangnam (2nd and 3rd floors, WD Building, 13 Teheran-ro 8-gil). Because it operates as an on-site facility of the UHC hotel group, if you’re staying at this hotel, your room and the treatment space are in the same building. Treatments are given in a private room, and we have interpreting staff on site for Japanese, Chinese, and English.

Beyond Ultherapy PRIME and Thermage FLX, the lifting devices we work with also include Sofwave, Oligio, and Potenza. Because we design treatment after an individual skin diagnosis, if combining the two devices doesn’t fit your case, we look at the other options together. I graduated from the graduate school of Seoul National University and trained at Seoul National University Hospital. I serve as an Allergan (Juvederm, Botox) faculty member and as a Potenza and Ultherapy Z Key Doctor.

FAQ

Which is better for neck sagging, Ulthera or Thermage?

A randomized, evaluator-blinded trial comparing the two devices directly for neck laxity (Jones, Guiha, Goldman, and Wu, Dermatologic Surgery, 2017) found that both devices produced a significant improvement in investigator-rated neck laxity scores at 90 days, maintained through 180 days. There was no statistically significant difference between the two devices in laxity scores, patient satisfaction, or side effects, though patients reported more pain during the Ulthera procedure. Which one fits you depends on a diagnosis of your neck skin and the degree of laxity.

How is Ultherapy PRIME different from earlier Ultherapy devices?

Merz Aesthetics states that Ultherapy PRIME is a newer platform that received U.S. FDA clearance in 2024. A survey study published in PMC, the U.S. National Library of Medicine’s archive, found that participants who received facial lifting with Ultherapy PRIME reported significantly lower pain, redness, and swelling scores than with the earlier-generation device. The researchers also noted that the survey was conducted at a single site without blinding, which limits the findings.

Can Thermage be used around the eyes?

Solta Medical states that Thermage FLX has U.S. FDA clearance for the non-invasive treatment of wrinkles around the eyes, including the upper and lower eyelids. Whether it’s appropriate for you depends on an assessment of your periorbital skin and any previous treatments there, decided in consultation.

Are the oxygen chamber and IV drip both free?

UHC hotel guests can choose one complimentary option: a 30-minute oxygen chamber session or a vitamin IV drip. If you use both, the IV drip costs 55,000 KRW. Full terms are available on our promotions page.

If you’re weighing Ulthera and Thermage together, it helps to come to consultation with the areas of sagging that concern you most, your departure date, and any history of filler or previous treatments.

※ Individual skin response and recovery time vary. Please consult a physician for an accurate diagnosis and treatment plan.