Home/Choosing a treatment/Thermage FLX vs Ultherapy vs EndyMed
Choosing between tightening platformsThese three are often described interchangeably as skin tightening, and they do different things. Thermage firms broadly. Ultherapy lifts from depth. EndyMed Intensif resurfaces from inside the dermis. The right one follows from whether your complaint is tone, position or texture.
Firming, lifting and resurfacing are three different jobs. A clinic with one platform has to answer every one of these with the same machine.
| Thermage FLX | Ultherapy | EndyMed | |
|---|---|---|---|
| Energy | Monopolar radiofrequency | Micro-focused ultrasound | Multi-source phase-controlled RF |
| Chinese name | 第五代热玛吉 | 超声刀 | 黄金微针 (Intensif) |
| Delivery | Broad, even dermal heating | Discrete points at set depths | Non-invasive, or from needles inside the dermis |
| Depth | Through the dermis, volumetric | To the SMAS and above | Selectable by setting and needle depth |
| Primarily does | Firms | Lifts | Resurfaces and tightens |
| Best for | Overall laxity, skin quality, eyelids, body | Jawline, under-chin, neck, brow | Acne scarring, pores, texture |
| Sessions | Usually one | Usually one | A course, typically three |
| Visible | Two to six months | Two to three months | Across the course |
| Downtime | None | None | None for 3Deep; days for Intensif |
| Comfort | Warm, well tolerated | Felt at depth; analgesia used | Topical anaesthetic for Intensif |
This is the distinction most often missed. Skin that has lost tone looks dull and slack but has not moved — the outline of the face is where it always was. Skin and soft tissue that has descended has changed the outline: the jaw border has softened, there is fullness under the chin, the brow sits lower.
Broad dermal heating improves tone. It cannot reposition anything, because the layer that holds position is deeper than the energy reaches. Focused ultrasound can place heat at the SMAS, which is the layer a surgeon repositions, and contraction there is what produces lift.
The corollary is that Ultherapy is often the wrong choice for thin, crêped skin with good position — there is nothing to lift, and the complaint is quality. Treating in the wrong category is the most common reason a patient says a device did nothing.
EndyMed Intensif is grouped with these because it is radiofrequency, but it belongs to a different category of problem. Insulated needles place the energy inside the dermis, combining mechanical injury with heat, which is what makes it effective on scars and texture rather than on laxity.
It also has a specific advantage: radiofrequency is not absorbed by melanin. In darker skin types, where laser resurfacing carries a meaningful risk of post-inflammatory pigmentation, RF microneedling is generally the more predictable route to the same textural goal.
There is a degree of laxity past which no non-surgical device produces what the patient is imagining. Energy treatment improves tissue; it does not remove it or re-drape it. Where the gap between the expectation and what a device can deliver is large, saying so at the assessment is more useful than a session that disappoints at three months.
Equally, none of these treat volume loss. A hollow midface does not become full because the skin over it is firmer — that is an injectable question, and the two are frequently planned together.
Questions
Neither; they treat different problems. Thermage heats the dermis broadly and firms skin that has lost tone. Ultherapy places heat at discrete depths including the SMAS and lifts tissue that has descended. If your outline has changed, that points to Ultherapy. If your skin has simply lost its tone, that points to Thermage.
They are sometimes used in a planned sequence rather than at the same appointment, because they address tone and position separately. Spacing them makes it possible to tell what each one contributed.
For laxity and early jowling, Ultherapy, which works at the depth where position is held. If the fullness under the chin is fat rather than lax tissue, that is a different problem and neither device is the answer.
EndyMed Intensif, which delivers radiofrequency from insulated needles inside the dermis. Tethered rolling scars usually need subcision first. Thermage and Ultherapy do not treat scarring.
All three are safe in darker skin, because radiofrequency and ultrasound are not absorbed by melanin the way laser light is. For textural and scarring work in deeper skin tones, RF microneedling is generally preferred over laser resurfacing for that reason.
All three work by stimulating collagen, so the result is subject to continued ageing rather than being permanent. Thermage and Ultherapy are commonly repeated after about a year, depending on the response.
Whether your concern is tone, position or texture determines which of these applies. That is the first thing the consultation establishes.
