Last Updated on December 6, 2025 by Giorgia Guazzarotti
So you’re standing in front of the mirror doing that thing where you pull your face back with your hands to see what you’d look like with tighter, smoother skin. Don’t lie, we’ve all done it. Maybe you’re noticing your jawline isn’t as sharp as it used to be, or your neck is starting to look like your mom’s, or those lines around your eyes are getting deeper no matter how much retinol you slather on. And now you’re trying to figure out: do I go with ThermiSmooth or Ultherapy? The thermismooth vs ultherapy question is basically the non-surgical facelift version of “which diet actually works.” Everyone’s got opinions, but who’s actually telling you what the science says? In this article, I’m breaking down what these treatments really do based on actual clinical trials, which one actually lifts vs just tightens, how much pain you’re in for, what it costs, and whether they’re worth your money.
Thermismooth Vs Ultherapy: What Are They?
Here’s the thing nobody tells you upfront: these do completely different things.
Ultherapy uses ultrasound energy – yeah, like the thing they use to look at babies – but focused way deeper into your skin. It goes 4.5mm down to this layer called the SMAS, which is basically the scaffolding that holds your face up. The ultrasound heats tiny spots to 60-70°C (that’s hot as fuck), which pisses off your skin enough that it starts making a ton of new collagen to repair itself. One treatment, takes like an hour to 90 minutes, and then you wait 2-6 months for the collagen to build up and actually see your skin lift.
ThermiSmooth treatment is this warm wand thing they rub on your face with gel. Uses radiofrequency to heat up just the top layers of your skin – only goes about 2-3mm deep, gets to maybe 104°F. The heat shrinks existing collagen a bit (so you get some quick tightening) and tells your skin to make more collagen over time. But you need to go back 3-6 times over a couple months, each session is like 30 minutes. Results show up in 3-6 months.
Here’s what matters: Ultherapy goes deep enough to actually lift shit that’s sagging. ThermiSmooth works on the skin’s surface – good for wrinkles and texture but it’s not gonna lift your jowls or fix a saggy neck. If stuff is drooping, you need deep. If it’s just looking rough or crepey, surface is probably fine.
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How Many Treatments Do You Actually Need?
ThermiSmooth: 3-6 treatment sessions spaced 2-4 weeks apart. So. for best results, you’re looking at 2-3 months of appointments. Each session is about 30 minutes.
Ultherapy: One and done. One treatment session that takes 60-90 minutes depending on the size of the area, then you’re finished. A systematic review of Ultherapy studies found that 92% of patients showed improvement at 90 days after just that one treatment. Even better? The percentage of people with “moderate improvement” jumped from 36% at 90 days to 52% at 180 days.
This matters for your wallet and your schedule. ThermiSmooth might seem cheaper per session ($300-$800), but multiply that by 4-6 sessions and you’re spending $1,200-$4,800. Ultherapy runs $2,000-$5,000 for one treatment, but you’re done.
How Long Do The Results Actually Last?
ThermiSmooth: 9-12 months according to most clinical data. So you’re looking at treatments roughly once a year.
Ultherapy: 12-24 months. A study in Plastic and Reconstructive Surgery followed patients for a full year and found that 93% still had improvements at 6 months, with many seeing results last well beyond that.
When you factor in how long results last, an Ultherapy treatment might actually be more cost-effective even though it costs more upfront.
Do They Hurt?
ThermiSmooth: Feels like a warm massage. Seriously. They move this small wand in a circular motion over your face with a small amount of gel, and it’s actually pleasant. You might get mild redness for like 15 minutes to an hour. That’s it. Zero down time.
Ultherapy: Not gonna lie, it hurts. Most people describe it as an intense warming sensation that can get pretty uncomfortable. The bony parts of your face (where there’s less fat padding) hurt more. A lot of clinics offer numbing cream, nitrous oxide, or some local anesthetic to manage the pain. You might get mild swelling, tenderness, maybe some bruising for a few days. But nothing that keeps you from normal activities.
Here’s the trade-off: ThermiSmooth is comfortable but you need multiple sessions. Ultherapy sucks for an hour but then you’re done.
Related: Does Ultherapy Hurt? Everything You Need To Know About This Treatment
Which Areas Does Each Non-Invasive Treatment Work Best On?
ThermiSmooth works better for:
- Fine lines around eyes and mouth
- Skin texture issues
- Larger areas of the body (arms, abdomen, thighs)
- Delicate areas where you want gentle treatment
- Overall skin surface improvement
Ultherapy works better for:
- Saggy jawline and jowls
- Loose neck skin (“turkey neck”)
- Non-surgical brow lift
- Under chin tightening
- Décolletage wrinkles
- Anywhere with skin laxity where you need actual lifting, not just smoothing
Who Is A Good Candidate Fo Each Non-Surgical Treatment?
Get ThermiSmooth if:
- You’re in your 30s or early 40s with mild aging signs
- You want preventative maintenance
- You have fine lines but not actual sagging
- You can’t handle discomfort
- You’re okay with multiple appointments
- You want something for larger areas of your body
Get Ultherapy if:
- You’ve got visible sagging or lax skin
- You want actual lifting, not just tightening
- You’re willing to deal with one uncomfortable session
- You want the most scientifically proven option
- You prefer one treatment and done
A study on patients with mid and lower face sagging found that “at the end of 6 months, improvements were reported in 93% patients by blinded reviewers and 85% patients found the results to be satisfactory.” But one source noted that the best candidates for radiofrequency treatments are “aged 25-55 with skin of medium thickness” and that “patients with very thin skin, very thick oily skin, and some over age 65 tend to not get as good results.”
Neither one works if:
- You have severe sagging (you need invasive surgery)
- You’re expecting facelift-level results
- You have certain health conditions (talk to your doctor)
Can You Combine Them?
Yeah, actually. Some practices use both as your best treatment option: Ultherapy first to get the deep lift, then ThermiSmooth sessions to refine the skin surface and texture. You’re targeting different skin layers: Ultherapy hits those deeper layers for structural lift, ThermiSmooth works the surface for smoothing and tightening. According to some clinics, this combo approach gives you maximum results. The downside? You’re paying for both. But if you’ve got the budget and want comprehensive improvement, it’s an effective treatment combo.
The Bottom Line
Look, the thermismooth vs ultherapy debate isn’t that complicated once you cut through the marketing.
For actual lifting with proven science: Ultherapy wins. It’s the only FDA-approved device for non-surgical skin lifting. The clinical trials show measurable lifting, real collagen increases, and results that last over a year.
For gentle maintenance and surface stuff: ThermiSmooth is fine. It’s comfortable, works on all skin types, and if you’re just starting to see aging signs, it’s a reasonable first step.
But set realistic expectations. A systematic review of microfocused ultrasound found that while results are real, we’re talking about “mild to moderate improvement” for most people. The aging process keeps going, and these are tools to slow it down – not reverse 20 years. And seriously, go to someone qualified. Your face isn’t the place to bargain hunt. Find a provider who actually knows what they’re doing with these devices because technique matters a lot for your final results.