If you suddenly start looking saggy in your 40s,

now is the right time for Ulthera

Please check this before you read

Q. Isn’t it too early

or too late if you’re in your 40s?

A. To be honest, the early to mid-40s

is the period when Ulthera works best.

It’s the key stage to support the SMAS layer

just as it starts to weaken.

Q. Isn’t Shrink enough?

Do I really need Ulthera too?

A. It varies by case,

but if fat sagging has started,

the treatment depth is different, so the approach is different.

I’ll explain in detail in the main text.

Ulthera vs. Shrink: the key difference in your 40s

Ulthera is a lifting procedure that delivers

ultrasound energy precisely to the SMAS layer

at a depth of 4.5 mm to directly contract the fascia.

People often confuse it with Shrink,

but while Shrink is also in the HIFU category,

its main depth is around 1.5–3.0 mm.

Simply put, if Shrink focuses on tightening

the dermis and fat layers,

Ulthera grasps the fascia layer underneath and

holds the tissue itself upward.

Why do you suddenly look saggy starting in your 40s,

do you know?

Director Wi Young-jin’s key insight

After your 40s, the SMAS layer connections weaken

as fat sagging becomes more pronounced,

so Ulthera’s fixed lifting effect is especially effective.

There are so many cases like this

that I’ll note one down separately.

Last month, a 47-year-old woman came in,

and she said, “Until last year I was fine,

but this year the area under my cheekbones

suddenly collapsed.”

She held up a mirror and gently lifted it with her hand,

saying, “If it could just go up this much,” and

that is exactly the typical complaint of people whose

SMAS layer has weakened.

This is a point many people misunderstand,

but sagging in your 40s is not because the skin gets thinner.

The real cause is that the SMAS layer

(superficial musculoaponeurotic system) becomes looser.

This layer acts like a hammock that

holds facial fat up in place,

but once you enter your 40s, the collagen and elastin bonds

weaken rapidly.

So the buccal fat and jowl fat sitting on top of it

begin to sag downward.

That is the essence of line changes in your 40s.

This is why Ulthera is especially

effective at this stage.

The 4.5 mm transducer accurately reaches the SMAS layer

and creates a thermal coagulation point (TCP) at 65–70°C,

causing the fascia to contract immediately,

and then over the next 3 to 6 months, collagen is reorganized,

which re-secures the tissue.

That 47-year-old patient came back

three months after one treatment,

and had almost recovered to the position

she had lifted with her own hand.

But that doesn’t mean it’s always perfect.

Ulthera can be quite painful during the procedure,

and if you have thin fat, your cheeks may

temporarily look more hollow after treatment.

Still, in the early to mid-40s,

when the SMAS layer has started to weaken

but fat and skin volume are still intact,

it remains the most proven option.

Director Wi Young-jin’s key summary

Sagging in your 40s is not because the skin becomes thinner,

but because the SMAS layer connections weaken,

causing fat to slide downward.

Ulthera is almost the only non-surgical device that

reaches that SMAS layer (4.5 mm) directly,

so it works best at this stage.

So, is Ulthera right for me?

If you have a thin face,

reducing the number of shots or distributing the depth

is much safer.

Last week, a 53-year-old patient came in with a similar case,

and instead of going all in with full shots,

we adjusted it while checking her fat volume,

so the line was improved without the cheeks hollowing out.

If you’ve read this far,

you’re probably wondering this

Q1. Once you get Ulthera,

how long does the effect last?

This is a bit tricky,

so it’s hard to say exactly, “It lasts for X months.”

Right after the procedure, there is an immediate contraction effect for about a month,

and over the next 3 to 6 months,

many people gradually improve more

as collagen regenerates.

On average, you can think of it as lasting 8 to 12 months,

but there are big differences depending on your aging speed.

Q2. Please be honest about the cost and

the proper number of sessions

To be honest,

the standard recommendation for people in their 40s is once a year.

The price varies depending on the number of shots,

but around 300 shots is a reasonable full-face standard.

First-time patients often ask, “Wouldn’t two or three sessions in a row be better?”

but Ulthera doesn’t work that way.

You need to give enough time after one stimulation

for collagen to build back up before the next one becomes meaningful.

Q3. Are there any side effects or precautions?

But when you actually see patients in the clinic,

the most common thing is a feeling like muscle soreness

for a few days after the procedure.

In rare cases, there can be temporary bruising, or

in areas with thin fat,

the volume may look slightly reduced.

One important thing I must mention:

if it is shot incorrectly along a nerve pathway,

there is also a risk of temporary facial paralysis,

so it is really important to be treated by a doctor

who understands anatomy precisely.

In the next article, I’ll talk about “the real changes seen in the clinic during the first two weeks after Ulthera in your 40s.”

I’ll show with cases why the point at which people feel the effect differs.

If you’re unsure about the number of shots or the depth,

please send a side-view and front-facing photo on WhatsApp.

This has been Wi Young-jin.

Also read

• Ulthera 300-shot effect: should you only do the cheekbones? [Seoul National University specialist]

• Ulthera for the cheekbones: does it work if you do the whole face?

• Are you only looking for the lowest Ulthera price? Here’s why that actually costs you more