HIFU vs Thermage comes down to the type of energy and the depth it reaches. HIFU (high-intensity focused ultrasound) sends focused ultrasound to points beneath the skin, while Thermage uses monopolar radiofrequency to heat the skin’s layers more broadly. Both aim to tighten skin by stimulating new collagen, both are non-surgical, and both build results gradually. LIV Clinic offers both, so a doctor can recommend the one that suits your skin.
In short
- HIFU: focused ultrasound energy placed at chosen depths; at LIV Clinic delivered with the Ultraformer III device.
- Thermage: monopolar radiofrequency energy that heats the skin’s layers to stimulate collagen.
- Both: no incisions, results that develop over weeks to months, and a plan set by a doctor after assessing your face.
- At LIV Clinic: a free consultation decides which one, or which combination, fits your goals.
HIFU vs Thermage: the main difference
The two treatments share a goal, firmer and smoother-looking skin, but they reach it in different ways.
How HIFU works
HIFU focuses ultrasound energy into small points at set depths under the skin, much like a magnifying glass focuses light. The surface is left intact while heat builds at the target depth, which triggers the skin to produce new collagen over the following weeks. LIV Clinic’s HIFU service is described as reducing wrinkles across the face, helping lift the eyebrows and tightening excess skin. The clinic also offers Ultraformer III, a HIFU device that uses focused ultrasound to help lift, tighten and define the facial contour.
How Thermage works
Thermage is a monopolar radiofrequency device made by Solta Medical, part of Bausch Health. According to the manufacturer, it uses radiofrequency energy to heat layers of the skin and stimulate collagen production, and it has been used in more than 5 million treatments worldwide. Its listed uses include non-invasive treatment of wrinkles, including those around the eyes.
Side-by-side comparison
| HIFU (incl. Ultraformer III) | Thermage | |
|---|---|---|
| Energy | Focused ultrasound | Monopolar radiofrequency |
| How heat is delivered | In focused points at chosen depths | Spread across the skin’s layers |
| Typical aim | Lifting and contouring, for example brows and jawline | Tightening and smoothing skin texture and fine lines |
| How results appear | Gradually, as new collagen forms | Gradually, as new collagen forms |
| How long results last | Varies; ask the doctor for your plan | LIV Clinic states results can last from 6 months to 2 years, depending on the person |
| LIV Clinic page | HIFU · Ultraformer III | Thermage |
Results from either treatment vary from person to person, which LIV Clinic notes on its services and case review pages.
Which one suits you?
There is no single winner; the right choice depends on what you want to change. These general patterns help frame the conversation with a doctor:
- You want a lifted look along the brows, cheeks or jawline: HIFU is often discussed first, because its energy is placed at defined depths for lifting and contouring.
- You want smoother, firmer-looking skin and softer fine lines: Thermage is often discussed first, because its radiofrequency energy heats the skin’s layers broadly.
- You want both lift and texture: the two can be planned together. A doctor decides the order and timing.
- Your skin sags noticeably: energy-based treatments are most suited to mild to moderate laxity. A doctor may also talk about a thread lift or other options, explained in the guide to non-surgical face lift options in Koh Samui.
At LIV Clinic, the free consultation includes a personal assessment of your facial structure and skin condition, so the recommendation is based on your face rather than on a general rule.
Can HIFU and Thermage be combined?
Yes, some clinics combine focused ultrasound and radiofrequency in one plan. A 2024 retrospective study of 56 patients in Malaysia, published in the Malaysian Journal of Medical Sciences, combined HIFU with monopolar radiofrequency and reported improvement in 54 of the 56 patients on a standard aesthetic scale, judged from photos taken straight after treatment. All patients had temporary redness straight after treatment and no serious side effects were recorded. The authors note that the study was small, from a single clinic, without a control group and without later follow-up photos, so it shows what is possible rather than what every patient will experience.
Whether a combination makes sense for you, and in what order, is a decision for your doctor.
What to expect on the day
- Consultation first: the doctor looks at your skin, asks about your medical history and agrees the treatment areas with you.
- Cleansing and marking: the skin is cleaned and the treatment areas planned.
- Treatment: the device is passed over the skin in sections. You may feel heat or brief discomfort; the doctor adjusts settings as needed.
- Afterwards: temporary redness is common. You can usually return to normal plans, and the doctor will give aftercare advice, including sun protection, which matters on a tropical island.
Getting HIFU or Thermage at LIV Clinic in Koh Samui
LIV Clinic’s main branch is at 1/63 Bophut, Koh Samui, open 11:00 to 20:00 and closed on Wednesdays. The clinic is led by Dr. Narathai Vichienkalayarut, M.D., with Dr. Suchakan Rotsaranrom, and Google reviewers rate it 4.9 from 318 reviews in Koh Samui.
How to book
To book a free consultation, call 065-996-4242 (Koh Samui), message LINE @Livclinic, or use the LIV Clinic contact page.
Frequently asked questions
Is HIFU or Thermage better?
Neither is better for everyone. HIFU places focused ultrasound at chosen depths and is often used for lifting and contouring, while Thermage uses radiofrequency to heat the skin’s layers and is often used for tightening and smoothing. A doctor’s assessment of your skin decides which fits your goals, and some patients benefit from both.
When will I see results?
Both treatments work by stimulating new collagen, so results develop gradually over the weeks and months after treatment rather than all at once. Some people notice a fresher look soon after, but the main change comes as collagen builds. Results vary from person to person.
How long do the results last?
It depends on the treatment, your skin and your age. For Thermage, LIV Clinic states that the results of a single treatment can last from 6 months to 2 years, depending on factors such as age, skin condition and lifestyle. For HIFU, ask the doctor at your consultation, who will also suggest when a maintenance session may help.
Does it hurt?
Most people feel heat or short moments of discomfort as the device passes over the skin. In the 2024 Malaysian study of combined HIFU and radiofrequency, 8 of the 10 patients whose pain was recorded rated it 5 out of 10. The doctor can adjust the settings during treatment to keep you comfortable.
Can I have HIFU or Thermage while on holiday in Koh Samui?
Many visitors do, because there are no incisions and normal plans can usually continue. Tell the doctor about your travel plans, sun exposure and any medicines at the free consultation, and follow the aftercare advice, especially sun protection.
LIV Clinic — “Live Your Life Young”
Doctor-led aesthetic and wellness clinic on Koh Samui and Koh Phangan, serving both international visitors and local residents.
Koh Samui (Bophut): 1/63 Thaweeratpakdee Rd, Bo Put, Koh Samui, Surat Thani 84320 · Tel 065-996-4242
Koh Phangan: 116/16 Moo 1, Koh Phangan, Surat Thani 84280 · Tel 093-254-5259
LINE: @Livclinic · Book a consultation
Explore our HIFU and Thermage services.
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This article is general information, not medical advice. Results vary from person to person. A doctor will confirm whether treatment is suitable for you at your consultation.
References: Bausch Health, Thermage FLX news release (5 Sep 2026) · Malaysian Journal of Medical Sciences (2024), HIFU and monopolar radiofrequency combination therapy, retrospective study · LIV Clinic, Services.