Ulthera, Shurink, Sofwave Are All HIFU—Are They Really the Same Treatment?

When you’re getting a lifting consultation, you often hear, “Try HIFU once.” But when you ask, “Please show me the different types of HIFU treatments,” and see Ulthera, Shurink, Sofwave, and Linear Firm listed together, it starts to get confusing. If they work on the same principle, why is there such a big price difference, and why do the reviews sound so different?

Bottom line. HIFU* uses the same principle of “focusing ultrasound at one point to warm the skin from within,” but results differ depending on which depth is targeted, how precisely the points are placed, and whether the treatment is delivered while watching in real time. It’s similar to how the same camera can produce different photos depending on the lens and the photographer’s hand.

HIFU*(High-Intensity Focused Ultrasound): afocused heating method that concentrates multiple ultrasound beams at one point and heats only that spot to 65–70°C. The surrounding tissue passes through almost unchanged, and only the target depth is heated.

First, the misconception that “ultrasound just makes the surface tingle”

The word ultrasound is more familiar from pregnancy scans or physical therapy, so it gives the impression of only “gentle vibration.” Because of that, many people assume HIFU also just stimulates the surface.

In reality, HIFU is the opposite. It concentrates multiple ultrasound beams at one point and instantly raises only that tiny area to over 65°C. A point of thermal coagulation* forms there, while the intervening surface skin is barely affected. That means the downtime is short, yet deeper layers of the dermis can still be treated.

Thermal Coagulation Point*(TCP): asmall thermal injury site that forms at the exact point where the ultrasound converges. This area becomes a signal for collagen regeneration.

How precisely that coagulation point is placed at the intended depth, and how evenly it is distributed across depths, accounts for almost all of the effect.

Why separate the depths into 1.5 mm, 3 mm, and 4.5 mm?

HIFU devices usually divide depths using 1.5 mm, 3.0 mm, and 4.5 mm cartridges. These numbers indicate which skin layer is being targeted.

- 1.5 mm reaches the shallow dermis to refine pores, fine lines, and skin texture. - 3.0 mm goes into the deeper dermis to improve firmness. - 4.5 mm reaches the SMAS layer (superficial musculoaponeurotic system) to address sagging. This is the layer directly treated in surgical facelifts.

Even if you receive the same “HIFU lifting” treatment, what changes is whether 1.5 mm, 3 mm, or 4.5 mm cartridges are used, and how many shots are delivered. That’s what determines whether the result feels like “better texture” or “a more defined jawline.” If you’re only concerned about pores, the 4.5 mm layer is left untouched; if you’re only concerned about sagging, the 1.5 mm layer is left untouched.

Ulthera, Shurink, Sofwave — the differences, even though they’re all HIFU

The three devices work on the same principle, but there’s one crucial difference.

Ulthera is the only device that lets the doctor place treatment points while viewing real-time ultrasound images. Because the doctor can see on screen whether the 4.5 mm depth is truly reaching the SMAS layer, there’s less variation between “hit” and “miss.” That also makes it more expensive.

Shurink/Shurink Universe is a device made by the Korean company Classys, and it uses a method of rapidly switching depth-specific cartridges without image guidance. Because the points are placed quickly, more shots can be delivered in the same amount of time. However, the pattern is less about “precise SMAS targeting” and more about “even coverage by depth.”

Sofwave does not work point by point; instead, seven ultrasound beams simultaneously enter the dermis at a 1.5 mm depth in a band-like pattern. Since its concept is heating the dermal layer above the SMAS, it aims for changes closer to “skin texture and fine lines” than to “sagging.”

This difference is why one person may say, “I was satisfied with Shurink, but my friend says Ulthera was better.” They’re targeting different layers.

Three things to check before your consultation

First, clarify whether what you want to improve is “sagging” or “texture.” If it’s sagging, look first at devices that can reach 4.5 mm; if it’s texture or pores, look first at devices that offer 1.5 mm.

Second, ask whether image guidance is used. Around the cheekbones and jawline, the bone is close and nerves pass through the area, so if 4.5 mm is delivered without imaging, some shots may hit correctly while others miss. That’s one reason Ulthera costs more.

Finally, think through how many times you’ll receive it in the same area within a year. Since the collagen cycle of HIFU runs on a 3- to 6-month basis, many people see longer-lasting results when they time it well and have one thorough treatment rather than repeating it too soon.

This article summarizes general information, and the HIFU that’s right for your skin and degree of sagging should be confirmed directly with a medical professional.

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Frequently Asked Questions

Q. How long does HIFU last after one treatment?

A. It takes 2 to 3 months for new collagen to form, and the effect usually lasts 6 to 12 months. However, because the aging process itself doesn’t stop, many people choose to schedule it on a yearly basis.

Q. I’ve seen many reviews saying it hurts a lot— is that true?

A. At 4.5 mm depth, you may feel a heavy, deep ache in areas close to the bone (the jawline and the outer edges of the cheekbones). We recommend 3 mm. Devices with image guidance (Ulthera) have fewer off-target shots, so it’s easier to achieve the same effect with less pain.

Q. Can you treat pores and sagging all at once?

A. It is possible, but you’ll need to use cartridges for all depths, which increases the cost and time. If you set priorities in advance, you can proceed more safely within the same budget.