Still Unsatisfied After Ultherapy or Thermage? What to Consider Before Your Next Treatment

Why you may still feel unsatisfied after a well-regarded lifting treatment, and what to check before choosing your next procedure.

Hello! I am Dr. Cho Young Min, director of Cheongdam ANZ Dermatology.

Many people who come to us for Ultherapy or Thermage have already undergone several lifting treatments at other dermatology clinics.

Some have visited well-known clinics, and they have not only looked for inexpensive treatments.

Yet some tell us that the results did not live up to their expectations.

Their skin may feel a little firmer, but their face does not look noticeably different. Their jawline may have improved, but the nasolabial folds seem unchanged.

This naturally leads them to ask themselves questions like these.

"Did I not get enough Ultherapy shots?"

"Should I add Thermage as well?"

"Should I go for a stronger treatment this time?"

Of course, that could be the case.

However, I believe there is something we should check before that.

Was the previous treatment truly the right choice for the concern you wanted to address?

Today, I would like to talk a little about that.

1. A treatment having an effect and your face looking more beautiful are two different things.

These two may seem similar, but they are somewhat different matters.

Ultherapy uses micro-focused ultrasound to deliver energy to tissue at a selected depth, while Thermage uses monopolar radiofrequency to induce tissue remodeling.

When used on appropriate candidates, both treatments can help improve skin laxity and elasticity.

However, facial aging cannot be explained by skin sagging alone.

For example, deepening nasolabial folds can result not only from skin laxity but also from changes in fat distribution, loss of volume, and structural changes in the face.

If volume loss is the main cause, tightening the skin alone may not deliver the result you want.

Conversely, the approach should also vary depending on whether a tired-looking face is caused by skin sagging, cheek hollowing, or shadows between contours.

That is why, during consultations, I do not look only at how much the skin has sagged.

I first try to understand which area bothers you most when you look in the mirror, and why that area looks the way it does.

Even if a previous treatment actually improved skin elasticity, the result may still differ from what you had hoped to see.

This does not necessarily mean the previous treatment was done incorrectly.

It may simply mean that the change you expected and the effect of the treatment you chose did not fully match from the start.

2. Why do you still look older if your skin feels firmer?

One thing I consider important in lifting is the continuity of facial contours.

When you think of a youthful, beautiful face, it is not defined by taut skin alone.

The line that flows from the cheek into the nasolabial fold, the contour that connects from below the cheek to the jawline, and the balance between volume and hollowing all appear natural.

However, as aging progresses, changes occur not only in skin elasticity but also in the distribution of fat and soft tissue and in the structures that support the face.

As these changes accumulate, hollowing and sagging appear in various parts of the face, and the contours begin to look uneven.

For this reason, I do not believe that pulling the skin as tight as possible is the only way to achieve good lifting results.

Instead, I think it is important to consider which areas of sagging need to be addressed so the lines of the entire face connect naturally, and which areas of volume should be preserved.

I believe a face where the transitions between hollow and sagging areas blend naturally is more beautiful than one that is uniformly tight.

This is the standard I prioritize when designing lifting treatments.

3. Will getting more Ultherapy change the result?

When Ultherapy results fall short, many people first think about the number of shots.

"I had 500 shots, so maybe I should have had 600."

That could be true, but it isn't necessarily so.

Ultherapy cannot be evaluated by shot count alone.

The treatment can differ considerably depending on which areas are treated, which depths are selected, and how the treatment lines are arranged.

Even with the same 500 shots, the actual treatment plans can be completely different.

When performing Ultherapy, I determine the treatment depth and area while checking the tissue layers on a real-time ultrasound screen.

This is because the areas that require caution differ depending on facial fat distribution and the pattern of sagging, and so do the areas that may need more focused treatment.

Of course, checking ultrasound images does not prevent all side effects or guarantee results.

However, confirming the anatomical structures and designing the treatment accordingly is an important step.

At Cheongdam ANZ Dermatology, we also record the tips and shot counts used in each treatment.

These records are not only meant to show how many shots were performed.

They are also useful information to refer to when assessing progress or planning future treatments.

In my view, care does not mean vaguely treating for longer or doing more.

It means being able to explain why a specific area is treated and why a particular depth is chosen.

I believe that is what care truly means.

4. So should you repeat Ultherapy or add Thermage?

The answer differs for each person.

The first thing to check is which treatment you received and when.

Because Ultherapy's effects develop gradually through collagen remodeling, results often become more noticeable over about two to three months after treatment.

Thermage may also require time before its effects appear.

Therefore, if it has not been long since your treatment, it may be more appropriate to allow enough time to observe the results rather than rushing to add another procedure.

On the other hand, if enough time has passed and you are still unsatisfied, it is worth reassessing your current facial condition rather than simply repeating the same treatment.

If skin sagging remains, additional lifting may be considered.

However, if your face lacks volume or hollowing is already prominent, additional tightening may not lead to the result you want.

Combining Ultherapy and Thermage can be helpful in some cases, but not every patient needs a combination treatment.

Cheongdam ANZ Dermatology uses a range of lifting devices, including Ultherapy PRIME and Thermage FLX.

However, having many devices does not mean we recommend every available treatment.

I believe that avoiding unnecessary treatments is just as important a clinical judgment as choosing the right ones.

5. What do we check when a patient comes in after an unsatisfying previous treatment?

First, I ask what treatments you have received before.

I check which device was used, which areas were treated, how many shots were given, and how much time has passed.

If you have records or photos from the previous treatment, they can be helpful.

But there is a more important question.

"Which part did you most hope would change?"

I would also like to ask one more thing.

"Throughout your treatments so far, what has disappointed you the most?"

In fact, hearing your answers to these two questions often makes it much clearer what result you are hoping for.

Next, I examine the current condition of your face.

I evaluate skin laxity, fat distribution, areas lacking volume, and the connection of facial contours together.

I also explain that some changes can be improved with energy-based lifting, while others are difficult to address with that method alone.

Rather than recommending the treatment you request without question, I believe the first step is to explain whether that treatment is truly necessary.

At Cheongdam ANZ Dermatology, the dermatologist in charge personally handles the consultation, treatment design, and the procedure itself.

This is so we can understand the changes you want and ensure that this intent carries consistently through to the actual procedure.

6. Three principles ANZ follows in lifting

Cheongdam ANZ Dermatology is a dermatology clinic located in Cheongdam, Gangnam, Seoul.

As a board-certified dermatologist, I have participated in Ultherapy-related clinical advisory and medical staff training activities in Korea, and I also have experience related to official Thermage training.

Based on these experiences, there are three principles I have come to value.

The first is precision.

The treatment area, depth, and energy delivery method should be determined by considering the facial structure and the treatment goal.

Rather than simply repeating a set number of shots, it is important to create a treatment plan that is appropriate for you.

The second is restraint.

Our brand book includes this line:

"If 100 is needed, we do only 95."

It means choosing naturalness over excessive change.

Of course, this does not mean we will provide less treatment than is needed.

It means that just because something can be done, it does not have to be done.

I believe that knowing when to stop at the right point is an important judgment for achieving a beautiful result.

The third is responsibility.

At Cheongdam ANZ Dermatology, "ANZ" stands for "A to Z."

It reflects our commitment to responsible care, from the moment we first meet you, through planning and performing the treatment, to monitoring your progress afterward.

We also maintain a privacy-conscious environment, including individual treatment rooms and separate patient flow.

We believe that care is not only needed at the moment of treatment.

We believe that attending carefully to small details, from the moment you walk into the clinic until the moment you leave, is also part of medical care.

7. What you may need may not be a better device, but a different perspective.

If you have already invested significantly in Ultherapy or Thermage and are still not satisfied, I would not automatically recommend a stronger treatment.

Instead, I first want to understand what treatments you have had, what results you were hoping for, and what concerns you have most right now.

A previous treatment may have produced some clear benefit, yet the area you cared about most may still not have improved.

There may also have been a gap between the results you initially expected and the changes the treatment could realistically deliver.

Or the next step may call for a different approach that considers overall facial balance, rather than simply pulling the skin tighter.

Without examining you in person, I cannot tell which of these applies.

However, I believe at least one thing is clear.

If you have already invested significant money and time in treatments, it is just as important to know why you need the next one as it is to know what it is.

That is why consultation matters, and why the physician's judgment in conducting that consultation matters.

Frequently Asked Questions

Q. Why didn't Ultherapy work for me?

Outcomes can vary depending on facial anatomy, the cause and degree of skin laxity, individual tissue response, treatment design, and expectations.

Because Ultherapy effects develop gradually, the time elapsed since treatment should also be considered.

If you are still unsatisfied after sufficient time has passed, it is advisable to reassess the cause.

Q. Why does my skin still look sagging after Thermage?

Thermage can help improve moderate laxity in skin elasticity and firmness, but it cannot resolve all structural changes associated with facial aging.

It is important to determine whether the remaining concern is skin elasticity or changes in soft tissue.

Q. If Ultherapy results were limited, should I increase the number of shots and repeat it?

Not necessarily.

The treated areas, depths, shot count, and time elapsed from the previous treatment should be reviewed, and your current facial condition should be reassessed.

Simply increasing the number of shots does not guarantee a better result.

Q. Can I add Thermage after Ultherapy?

For some patients, it is possible.

However, factors such as the previous treatment, current tissue condition, areas where energy would overlap, and the expected benefits and risks must be considered.

Not every patient needs a combination treatment.

Q. Can Ultherapy make my face look thinner?

There have been reports of unwanted changes in facial volume following micro-focused ultrasound lifting.

However, it is difficult to predict the exact risk for each individual.

Anyone who already has cheek hollowing should discuss this thoroughly before treatment, and if any new contour changes appear after treatment, they should be evaluated by a medical professional.

Q. I've already had Ultherapy or Thermage at another dermatology clinic. Can I get a consultation at ANZ?

Yes. Those with prior treatment experience can also receive a consultation to evaluate their current concerns and facial condition.

This is not intended to criticize previous treatments, but to understand your present condition and determine which approach is appropriate going forward.

Q. If natural-looking lifting results matter to me, how should I choose a dermatology clinic?

It is advisable to check whether the medical team considers not only skin laxity but also facial volume and contours, the limits of treatment, and your individual aesthetic goals.

Cheongdam ANZ Dermatology values natural facial balance through direct physician care and individualized treatment design.

A final word

Some of you may already know well what Ultherapy and Thermage are.

You may have visited well-known dermatology clinics, and high prices may not have been what held you back.

But if you are still unsatisfied, I hope you will consider asking a slightly different question next time.

Not which device is better,

"How does this doctor understand my face?"

"Why did they decide this treatment is necessary?"

"Is there an area that would be better left untreated?"

I believe a good lifting consultation is one where these questions can be answered.

Not every face needs the same treatment.

And not every change needs to be created through a procedure.

What we aim for is not to change your face into something entirely different.

It is to understand how the balance of your face has changed over time and to help you preserve, as well as possible, the natural beauty you already have.

Being able to explain it is what care means.

Cheongdam ANZ Dermatology works to uphold that principle.

Cheongdam ANZ Dermatology

6th–7th Floor, Emporia Building, 220 Dosan-daero, Gangnam-gu, Seoul

Website: https://anzclinic.com

If you are not satisfied with your previous Ultherapy or Thermage results, or are considering your next lifting treatment, you are welcome to book a consultation based on your treatment history and current concerns.

This article is intended to provide general medical information and does not replace individual medical care. The suitability, effects, and risks of any treatment vary depending on each person's condition, and a specific treatment plan is determined after examination.