When your face looks saggy, it's actually a signal from the SMAS layer.
If your face in the mirror looks more sunken than before and your nasolabial folds seem deeper, it might not just be a superficial skin issue. The first question patients often ask is, "Why do I suddenly feel like my skin is sagging?" The answer lies in the deepest layer of the skin: the SMAS layer.
Our skin consists of the epidermis, dermis, and fat layer, beneath which lies the SMAS layer, which significantly influences skin sagging. This is why Ulthera is so well-known for elastic lifting: it works by delivering high-intensity focused ultrasound energy to this SMAS layer, creating thermal coagulation, and boosting elasticity from within.
Skin sagging originates not from the surface but from the deepest SMAS layer, and directly stimulating this layer is reported as the core of lifting.
Especially if you have deep concerns about sagging that disrupt your overall facial line, such as nasolabial folds, sagging jowls, or a double chin, you might consider an active lifting treatment like Ulthera.
How long do Ulthera effects last?

For those considering elasticity improvement using laser devices, the most frequently asked question is, "How long do Ulthera effects last?"
Typically, changes begin to be felt gradually from 3-4 weeks after the procedure, and the effects tend to last for about a year. While there can be individual differences depending on the current skin condition, it is known to have a relatively longer duration compared to other lifting procedures.
Therefore, the treatment cycle is usually set at 1-2 times a year, and from the second session, it's important to plan according to your condition by adjusting the number of shots.

For example, if you initially had severe skin sagging and received more than 500 shots, you might expect satisfactory maintenance from the second session even with fewer shots than the first, depending on your condition. Designing the treatment to match your current state, rather than simply increasing the number of shots, is a more reasonable approach.
How Ulthera precisely targets deep layers
Ulthera yields good results in lifting not only due to its ability to apply powerful energy but also because of the technology it possesses.

Ulthera's unique ultrasound imaging technology, called 'DeepSee™ Technology', helps to meticulously check the skin condition visually and apply energy precisely to the necessary areas. The ability to perform the procedure while seeing the invisible layers makes a difference in the results.


Furthermore, different tips of 1.5mm, 3.0mm, and 4.5mm are used according to the depth of the SMAS layer. Thanks to this depth-specific approach, stable results in terms of duration and outcome can be expected.
If you are considering lifting for the first time, reviewing the Ulthera Prime Lifting Treatment Guide may help you understand the treatment depth and method.
Here's a simple summary of the layers targeted by each tip depth:
| Tip Depth | Primarily Targeted Layer | Expected Outcome |
|---|---|---|
| 1.5mm | Shallow layer beneath the epidermis | Fine lines, texture refinement |
| 3.0mm | Deep dermal layer | Elasticity, pores |
| 4.5mm | SMAS layer | Sagging, contour lifting |
For questions, inquire via chat consultation about Ulthera treatment depth and shot count
Upgraded version: Changes in Ulthera Prime

One welcome piece of news is that Ulthera Prime, an upgraded version of the existing device, has recently been introduced in Korea. The main changes are as follows:
- Enhanced DeepSee™ Technology performance with higher resolution makes skin layer confirmation clearer.
- The expanded screen size allows for more comfortable monitoring of the condition during the procedure.
- The overall operating speed of the device has increased, making the treatment flow smoother.
- The strengths of the existing Ulthera technology have been organized for more efficient application.
Ulthera Prime can be considered for those who wish to improve overall sagging, such as a double chin or wrinkles, as it can be performed according to individual conditions and situations, and its accuracy is enhanced even with a single treatment. Comparing it with radiofrequency-based Thermage FLX Tightening can also help in finding the right direction for you.
The skill of precise application is more important than the device

Even with a high-performance laser, if it cannot be applied appropriately to the necessary areas, it means the device is not being fully utilized. In the examination room, it is not uncommon to see that the quality of results differs significantly depending on which layer was targeted and how, even with the same device.
To improve facial sagging and wrinkles, and also to reduce the possibility of common side effects like cheek hollowing during the procedure, it is advisable to consider the following points:
- Does the practitioner clearly identify skin layers and differentiate depths during the procedure?
- Is the number of shots and depth designed to match your degree of sagging?
- Is there sufficient pre-treatment assessment and post-treatment care guidance?
- Is it thoroughly explained that treatment effects and duration can vary individually?
If volume enhancement or auxiliary elasticity is also needed, combining with Juvelook Collagen Booster or Rejuran Healer may be discussed. Since the optimal combination varies by individual condition, it is best to clarify through consultation.

We emphasize once again that you should receive treatment in an environment where skin layers can be accurately identified and safely applied.

Whether Ulthera or Ulthera Prime is right for you depends on your degree of sagging and lifestyle patterns.
💬 Consult NowChief Director Lee Sang-ju (MD, PhD, Yonsei University College of Medicine and Graduate School, Completed Dermatology Residency at Severance Hospital, President of the Korean Dermatological Association) Chief Director Lee Sang-ju's Profile First Published 2025-05-30 / Last Reviewed 2026-06-16 Treatment effects and duration may vary individually, and we recommend consulting with medical staff for an accurate diagnosis and treatment plan.
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