"What's the best anti-aging procedure?"
This question is difficult to answer.
Because what matters most is which layer of your face has deteriorated first, rather than what is popular.
Even at the same age, the layers that begin to show signs of aging can differ.
Please take just one minute to read this.
The Face Ages in Layers
| Layer | What Changes | Visible Changes |
|---|---|---|
| Surface/Dermis | Collagen reduction, decreased skin texture | Fine lines, pores, lack of elasticity |
| Fat Layer | Volume loss and displacement | Hollowing, demarcation lines, gaunt appearance |
| SMAS Layer | Support structure relaxation | Jawline collapse, sagging |
These three layers do not age at the same rate.
For some, the surface may deteriorate first, while for others, the surface may be fine, but the jawline sags first.
Therefore, choosing a procedure name first can lead to a mismatch.
Different Layers are Targeted
Ultherapy uses ultrasound to deliver energy deep into the SMAS layer.
It approaches sagging caused by the relaxation of the support structure.
Thermage uses radiofrequency to widely treat the dermis, addressing surface elasticity and skin texture.
The two are not in competition but are procedures that work at different depths.
To use a building analogy, one is like repairing a leaning framework, while the other is like smoothing out the wall surface.
(※ The effects and reactions may vary depending on individual skin conditions, and the suitability of the procedure is determined through consultation with medical staff.)
You Don't Necessarily Need Both
While combining them can cover a wider range of layers, it is not the necessary combination for everyone.
- If you are only concerned about surface skin texture and fine lines, you may not feel a significant difference from deep layer procedures.
- If jawline sagging is your main concern, but only the surface is treated, you may not notice much change.
- If hollowing is a major concern, both procedures may be insufficient, and a filling approach may be needed in conjunction.
If performed on the same day, recovery responses can overlap, so it may be safer to space out the timing if you have important events coming up.
Criteria for Determining the Order
Address the most significantly deteriorated layer among the three.
If only the surface is treated while the support structure is relaxed, your original appearance may return within a few days. Conversely, if only the deep layers are treated while the surface skin texture is deteriorated, you may not feel a difference when looking in the mirror.
The change that first catches your eye when you look in the mirror is usually the layer with the greatest impact.
The reason why volume becomes a greater concern in your 40s was discussed in Skincare Procedures in Your 40s: Volume Balance Comes First.
Frequently Asked Questions
Which is better, Ultherapy or Thermage?
They target different layers. Ultrasound-based treatments may be suitable for SMAS layer sagging, while radiofrequency-based treatments may be suitable for surface elasticity and skin texture.
Do I need both?
While combining them can cover a wider range of layers, it is not the necessary combination for everyone. Depending on which layer is the main problem, a single treatment may be sufficient.
Can I receive both on the same day?
It may be possible in some cases, but recovery responses can overlap. If you have important events coming up, it may be safer to space out the timing.
How do I determine the order?
Address the most significantly deteriorated layer first. The change that first catches your eye in the mirror is usually the layer with the greatest impact.
What if I also have hollowing?
Elasticity treatments alone may be insufficient, and a filling approach may be needed in conjunction. The process of distinguishing between sagging and hollowing comes first.
Recovery and Downtime: Varies by Layer
Treatments targeting deep layers may cause more soreness, while treatments widely targeting the surface may cause more heat and redness.
If both are performed on the same day, the recovery responses will be compounded.
Elasticity changes appear over several weeks for both, so it is best not to judge immediately after the procedure.
How is the Cost Determined?
The cost is not determined by the procedure name.
It varies depending on which layer is treated, to what extent, whether it's a combination or a standalone treatment, and whether diagnosis and post-care are included.
For accurate costs, it is more precise to provide guidance after a consultation to assess the condition of each layer.
Visit and Consultation Information
O.N Clinic is conveniently located near Gangnam Station, making it easy to access by subway.
Before your visit, you can easily inquire about any questions you have by chatting with us now, and through consultation, you can coordinate your layer-specific priorities and appointment schedule.
It is more accurate to determine which layer to treat first after assessing your condition during an in-person consultation.
Author: Dr. Oh Seung-Min (Chief Director of O.N Clinic, graduated from Seoul National University College of Medicine, Academic Chairman of the Korean Laser Dermatology and Hair Society). For more details on his background, please refer to Meet Our Medical Team. First published: 2026-07-22 / Last reviewed: 2026-08-15
This article is for general informational purposes only, and appropriate treatment and results may vary depending on individual conditions.
