HIFU vs. Sofwave: Goals, Limitations and Consultation Questions

HIFU and Sofwave both use ultrasound energy to treat sagging skin, but they are not the same treatment. HIFU (high-intensity focused ultrasound) concentrates energy at points in deeper tissues. Sofwave uses SUPERB™ ultrasound, which delivers parallel beams that mainly heat the dermis.

Neither option is better for everyone. The more useful question is which tissue your concern involves and what change you want. HIFU is often discussed for contour-related concerns such as the jawline, while Sofwave is often discussed for firmness, fine lines and wrinkles in the skin. Your skin, facial volume, treatment history and treatment area also affect the choice.

This guide compares HIFU and Sofwave on the same terms at MATSURIKA CLINIC GINZA in Tokyo: the devices we use, suitability by area, pain, recovery, fees and limitations, plus questions to ask when both are suggested.

HIFU and Sofwave: What Are You Comparing?

A fair comparison starts with naming the specific devices. “HIFU” describes a type of technology, and different HIFU devices have different imaging, depth settings and treatment modes.

Why the Specific HIFU Device Matters

We offer three HIFU treatments, and each has a different treatment design.

• Ultherapy PRIME: HIFU with DeepSEE real-time ultrasound imaging, which allows the physician to visualize tissue while treating. A physician performs the treatment and considers where to treat, which depths to target and how to distribute the shots.
• Ultherapy: the previous Ultherapy system, also performed by a physician with selectable shot counts.
• ULTRAcel Zi: HIFU with a dot mode and a linear mode in one cartridge. The dot mode targets deeper supporting layers, while the linear mode heats a wider area and is used for localized fullness such as under the chin.

When you compare quotes, confirm the device name, not only the word “HIFU.”

The Treatment Goals to Discuss for Sofwave

Sofwave delivers ultrasound to the dermis, centered at a depth of about 1.5 mm, while a contact cooling system, Sofcool™, cools the skin surface. Because it focuses on the dermis, it is commonly discussed for skin firmness, fine lines and wrinkles rather than for deeper contour changes.

Comparison point	HIFU (Ultherapy PRIME / Ultherapy / ULTRAcel Zi)	Sofwave
Energy delivery	Focused ultrasound concentrated at points	SUPERB™ parallel ultrasound beams
Main target tissue	Deeper layers, including the SMAS and fat layer, depending on depth and mode	Dermis, centered at about 1.5 mm
Concerns usually discussed	Jawline contour, the lower face, under-chin fullness	Firmness, fine lines, wrinkles of the face & neck
Japanese regulatory status	Not approved in Japan (see the regulatory information below)	Approved in Japan for moderate to severe wrinkles of the face & neck

Regulatory information: Ultherapy PRIME and Ultherapy are FDA-cleared in the United States for their respective cleared uses. FDA clearance does not mean that every treatment purpose has been cleared, and it does not constitute approval in Japan. The Ultherapy PRIME, Ultherapy and ULTRAcel Zi devices used at our clinic have not been approved under Japan’s Pharmaceuticals and Medical Devices Act. Ultherapy PRIME is obtained through Cynosure Japan / Syneron Candela K.K., Ultherapy through JMEC Co., Ltd., and ULTRAcel Zi through Jeisys Medical Japan, Inc. ULTRAcel Zi is approved by the Ministry of Food and Drug Safety in South Korea. Sofwave is approved in Japan for improving moderate to severe wrinkles of the face and neck by heating the dermis; this approval does not cover every lifting purpose or guarantee results.

Comparing Suitability for Your Treatment Area

Suitability depends on what is happening beneath the area you want to treat. Your physician examines the skin, fat and facial volume before suggesting either option.

Skin, Fat and Volume Assessment

The examination helps clarify which tissue your concern mainly involves.

• Mainly the skin: fine lines, crepey texture or reduced firmness may lead to a discussion of Sofwave.
• Deeper support and contour: heaviness along the jawline or lower cheeks may lead to a discussion of Ultherapy PRIME or Ultherapy.
• Localized fullness: fullness under the chin may lead to a discussion of HIFU settings for that area, or other options for fat.
• Low facial volume: if your cheeks are already hollow or sunken in the treatment area, neither Ultherapy nor Sofwave is performed in that area. Your physician may discuss other approaches, such as volume restoration.

Many patients have more than one concern. In that case, your physician may suggest one option, a combination, or a different approach, and explain the reason.

Full Face, Jawline and Neck Coverage

The available treatment areas differ by device. Compare plans that cover similar areas.

• Ultherapy PRIME and Ultherapy: full face including under the chin, with 348, 464 or 760 shots, or full face including under the chin plus the neck, with 764 or 1,060 shots.
• ULTRAcel Zi: dot mode for the full face, including around the eyes, with or without the neck; linear mode with 300 shots for the cheeks and under the chin, the cheeks only, or under the chin only.
• Sofwave: full face; full face and under the chin; full face, under the chin and neck; or under the chin and neck.

Comparing Pain, Recovery and Costs on Equal Terms

Pain, recovery and cost differ by device, area and settings. Compare them using the same area and provider.

Pain Management and Aftercare

Both treatments can cause heat-related discomfort. With HIFU, some patients describe a deep ache or a sensation that seems to resonate near the bone, especially in areas close to bone. With Sofwave, patients often describe heat in the skin. Sensitivity varies from person to person.

• Ultherapy PRIME and Ultherapy: we use a massage gun during treatment to provide vibration that helps reduce discomfort. Ask your physician which additional anesthesia options can be used for your plan.
• Sofwave: topical anesthetic cream is available at no additional charge. Cryo cooling and a massage gun are also used. Nerve block anesthesia costs ¥5,000 (tax included), and prescription painkillers are available on request for an additional fee.

After Ultherapy PRIME, Ultherapy or Sofwave, you can wash your face, bathe and apply makeup, but avoid rubbing the treated skin. We recommend avoiding activities that raise your body temperature or blood flow for 2–3 days, moisturizing well and protecting your skin from the sun. Wait 2 weeks before light-based or laser treatment. After ULTRAcel Zi, muscle-like aches, redness, stinging, swelling and a burning sensation can occur.

Potential risks and side effects for these treatments include redness, swelling, tenderness, mild bruising and temporary changes in sensation, such as numbness or tingling. Burns and nerve-related complications are also possible with energy-based treatment. Redness usually settles within a few hours to a few days, and other symptoms usually settle within a few days to a few weeks.

Device, Coverage, Provider and Quote Conditions

The table below compares fees for a full face plan including the area under the chin. All prices are in Japanese yen and include tax.

Treatment	Area and quantity	Provider	Price
Ultherapy PRIME	Full face including under the chin, 348 shots	Physician	¥277,820
Ultherapy PRIME	Full face including under the chin, 464 shots	Physician	¥347,270
Ultherapy	Full face including under the chin, 464 shots	Physician	¥315,700
Sofwave	Full face + under the chin	Physician	¥308,000
Sofwave	Full face + under the chin	Nurse	¥210,000
ULTRAcel Zi	Dot mode, full face including around the eyes, 500 shots	Ask at consultation	¥100,000

The table is not a ranking. A plan with more shots or a different device is not equivalent to another plan with the same area name. For nurse-performed plans, a physician examines you first and decides the treatment area, and a nurse then performs the treatment. When Ultherapy PRIME or Ultherapy is combined with Sofwave in a single session, a combination discount applies to eligible plans; the 348-shot plans of Ultherapy PRIME and Ultherapy and the under-the-chin-and-neck Sofwave plan are not eligible. Consultation and examination without treatment cost ¥11,000 (tax included). Some fees differ for appointments that require language support. Cosmetic treatment at our clinic is self-pay and is not covered by Japanese public health insurance. Please review our English price list and confirm the full estimate before treatment.

Treatment Limitations and How to Read Case Photos

Each option has limits. Understanding them in advance helps you set realistic goals and read case photos more accurately.

What Each Option May Not Address

• HIFU: may not change crepey skin texture or fine lines as much as you hope. Ultherapy PRIME and Ultherapy are not performed where the cheeks are already hollow or sunken.
• Sofwave: mainly treats the dermis, so it may not change contour concerns that involve deeper support or fat.
• Both: cannot reproduce the change of a surgical facelift and do not restore lost facial volume. Significant tissue descent or excess skin may need a surgical consultation.

Checking Photo Conditions and Combined Treatments

Before-and-after photos show one patient’s change under specific conditions. When comparing HIFU and Sofwave cases, check the device, area, shot count, follow-up timing and listed risks. Photos taken immediately after treatment may include temporary swelling. Also check whether other treatments were performed during the same period. Our Sofwave page lists the procedure, age group, follow-up timing, risks and cost for each case. Fees shown with past cases may differ from current prices, and results vary by individual.

Questions to Ask When Choosing HIFU or Sofwave

These questions can help you compare the two options with your physician.

1. Is one option always better than the other?

No. HIFU concentrates energy in deeper layers at selected depths, while Sofwave mainly heats the dermis. Which is more appropriate depends on whether your concern involves contour, skin quality or both, as well as your facial volume and treatment history.

2. What should I ask if both are suggested?

Ask which concern each treatment is meant to address, which areas and depths will be treated, who performs each treatment and what the complete fee will be. Also ask what would remain unchanged if you chose only one. If combining them, confirm whether the combination discount applies to your plan.

3. Which hurts more, HIFU or Sofwave?

Neither consistently hurts more; the sensation differs. HIFU may feel like a deep ache near bone, while Sofwave is often felt as heat in the skin. Pain management options also differ by treatment, so ask which options can be used for your plan.

4. Can I have HIFU and Sofwave together?

Yes, in many cases, because they deliver heat to different layers. Ultherapy PRIME or Ultherapy can be combined with Sofwave in a single session, and a combination discount applies to eligible plans. Your physician will decide whether a combination suits your skin and goals.

5. Can I have HIFU or Sofwave if I recently had other treatments?

It depends on what you had and when. We are unable to provide treatment if you have received HIFU or radiofrequency (RF) treatment within the past three months, a skin or laser treatment at another clinic within the past month, or significant sun exposure or sunburn within the past month. Recent filler or Botox injections in the treatment area can also affect eligibility. Please tell us about all previous treatments, including those received outside Japan.

Summary: Comparing HIFU and Sofwave by Treatment Goal

HIFU and Sofwave both use ultrasound, but HIFU concentrates energy in deeper layers, while Sofwave mainly heats the dermis. Compare them by your main concern, the specific device, the treatment area, the provider and the complete fee, rather than by the technology name alone.

At MATSURIKA CLINIC GINZA, our physicians examine your skin, fat and facial volume, then explain whether Ultherapy PRIME, Ultherapy, ULTRAcel Zi, Sofwave, a combination or another approach fits your goal, along with the limitations of each.

We have English-speaking physicians and staff, and we can use translation tools to support communication. Patients who do not speak English or Japanese are encouraged to attend with a professional medical interpreter, who should bring documentation of their credentials. If you need language support, please book through the dedicated option for non-Japanese speakers. We allocate additional consultation time for these appointments. If you have questions or concerns after returning home, you can contact MATSURIKA CLINIC GINZA by email or LINE. For symptoms that may need urgent care, such as severe pain, sudden swelling, bleeding, fever or signs of an allergic reaction, please seek medical care promptly at a local healthcare facility.

To compare HIFU and Sofwave for your concern, book a consultation with MATSURIKA CLINIC GINZA.

References and Official Sources

• MATSURIKA CLINIC GINZA Ultherapy PRIME (HIFU): device features, precautions and regulatory disclosure
• MATSURIKA CLINIC GINZA Ultherapy (HIFU): pain management, precautions and regulatory disclosure
• MATSURIKA CLINIC GINZA ULTRAcel Zi (HIFU): dot and linear modes, treatment areas and regulatory disclosure
• MATSURIKA CLINIC GINZA Sofwave (SUPERB): treatment areas, pain management, precautions and case information
• MATSURIKA CLINIC GINZA English price list: fees, anesthesia options and consultation fee as of October 2026
• Pharmaceuticals and Medical Devices Agency (PMDA). Sofwave System package insert: approved use in Japan, contraindicated areas and adverse events
• American Med Spa Association: Ultherapy PRIME FDA clearance update (November 2025): U.S. cleared indications
• American Academy of Dermatology. Many ways to firm sagging skin: what non-surgical tightening can and cannot do