Sofwave vs. Thermage: which one for which area

Anyone comparing skin tightening devices soon comes across Thermage, the original radiofrequency device for loose skin. Sofwave is newer, and since the two aim at the same problems, it is often explained by comparison with Thermage. They work on different principles, though, and the results differ when you look closely. This article covers what they share, where they differ, and which one suits which area.

Both heat the dermis

Sofwave and Thermage use different forms of energy, but both create a controlled heat injury in the dermis. As that injury heals, the skin makes new collagen and elastin. The end result is the same for both: softer fine lines and firmer skin.

Sofwave heals faster and is safer

Sofwave uses ultrasound to make many cylinders of heat at 1.5 mm, inside the dermis. The pattern is fractional: healthy tissue remains between them, so you are back to normal activity quickly. Right after treatment, there is no more than mild redness and swelling.

Because the heat stays inside the dermis, the risk of hollowed cheeks and nerve injury is low. With monopolar radiofrequency, the type Thermage uses, poor tip contact can cause a deep burn. Sofwave is unlikely to burn deeply even when the tip sits poorly. That makes it well suited to thin, curved areas such as the neck, the eye area, and the forehead.

In one clinical study, the depth of nasolabial folds and marionette lines decreased (Hongcharu 2023, PMID 36757157). In another, improvement in facial skin laxity held through 6 months (Gold 2024, PMID 38031530).

Thermage gives a more noticeable result

Thermage uses a 6.78 MHz electric field. The field reverses direction millions of times a second, and ions in the tissue vibrate with it, making heat where they are. The heat fills the deep dermis under the square tip and spreads down into the fibrous septa below (Suh 2020, PMID 32319176).

Thermage heats a larger volume with no gaps, and in our experience the result is more noticeable than with Sofwave. There is more swelling and redness, so recovery takes longer, and a burn is possible if tip contact is poor. That makes it well suited to broad, flat areas where the tissue is not too thin. The usual example is the mid and lower face, including the front of the cheeks.

In one study, skin samples taken 2 and 6 months after a single monopolar radiofrequency session showed higher collagen density (Suh 2020, PMID 32319176). Clinics usually tell you to expect the result to last about a year.

Have one, or use both on different areas

You can have just one of them. If you combine the two, we recommend giving each area the device that suits it better. Thermage, with its more noticeable result, goes on the mid and lower face, including the front of the cheeks. Sofwave, with its wider safety margin, goes on the forehead, the eye area, and the neck. Korean clinics sometimes call this combination Thermawave.

For how Thermage works, see How Thermage FLX tightens skin: broad heat below a cooled surface.

For how Sofwave compares with Ultherapy, see Sofwave vs. Ultherapy: which layer each one treats. For help choosing between devices, see Ultherapy, Sofwave, or Thermage: which skin tightening treatment is right for you?.

References

1. Hongcharu W, et al. (2023). The efficacy and safety of the high-intensity parallel beam ultrasound device at the depth of 1.5 mm for skin tightening. J Cosmet Dermatol. PMID 36757157 (opens in new window).
2. Gold MH, Biron J (2024). Efficacy and safety of high-intensity, high-frequency, non-focused ultrasound parallel beams for facial skin laxity. J Cosmet Dermatol. PMID 38031530 (opens in new window).
3. Suh DH, et al. (2020). Monopolar radiofrequency treatment for facial laxity: histometric analysis. J Cosmet Dermatol. PMID 32319176 (opens in new window).