People often ask us how Ultherapy PRIME and Sofwave differ. PRIME is the latest generation of Ultherapy, the first ultrasound skin tightening device, cleared by the FDA in 2009. Sofwave followed in 2019 with a different approach. Both use ultrasound, but usually at different depths, so they suit different problems. This article sets out which layer each one heats and who each one suits.
They are used at different depths
Ultherapy PRIME makes points of heat at 1.5, 3.0, or 4.5 mm depending on the transducer (Liao 2026, PMID 41985490). The 3.0 and 4.5 mm transducers are used most, so its working area is the superficial fat, the fibrous septa, and the SMAS, the layer a facelift tightens. Sofwave makes cylinders of heat at 1.5 mm, inside the dermis, and each pulse coagulates far more tissue than a single point does.
Sofwave works in the dermis
Sofwave's main uses are fine lines, rough texture, and loss of firmness. These changes come from falling collagen and elastin in the dermis, and Sofwave heats that layer so both fibers rebuild. In skin samples taken after treatment, both fibers kept increasing for 10 months (Carruthers 2025, PMID 41405933). Because the heat stays inside the dermis, the risk of hollowed cheeks and nerve injury is low.
Ultherapy PRIME mostly works deeper
Ultherapy PRIME's main use is sagging: a jawline that has lost its definition and cheeks that have come down. Firming the skin alone does not fix that. Many devices heat the dermis. To coagulate the layers beneath it without a wound, only where intended, and with enough intensity, focused ultrasound is the only realistic option.
Among focused ultrasound devices, only the Ultherapy line shows the tissue on a live image and places each point of heat where it is intended. In a study that tracked those points in skin samples, mature collagen and new elastin had increased significantly by day 90 (Marquardt 2025, PMID 39545626).
Together they cover both depths
The two devices complement each other rather than compete. Ultherapy PRIME works deeper and Sofwave in the dermis, so together they tighten the face from the deep layers up to the surface.
For how Ultherapy works, see How Ultherapy tightens skin: focused heat at depth, guided by real-time imaging.
For how Sofwave compares with Thermage, see Sofwave vs. Thermage: which one for which area.
References
- Liao D, et al. (2026). Use of ultrasound in face and neck rejuvenation. Facial Plast Surg. PMID 41985490 (opens in new window).
- Carruthers J, et al. (2025). Synchronous parallel ultrasound induces long-term extracellular matrix remodeling of human skin. Dermatol Surg. PMID 41405933 (opens in new window).
- Marquardt K, et al. (2025). Microfocused ultrasound with visualization induces remodeling of collagen and elastin within the skin. J Cosmet Dermatol. PMID 39545626 (opens in new window).
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