Collagen is essential for a plump, youthful, elastic complexion. Unfortunately, the sun, free radicals, pollution, and even diet break down the protein found in the skin, joints, and tissues. As if that isn't enough, fibroblasts, which are responsible for creating collagen, become less active with age. As a result, the aggregate collagen and elastin fibers in the skin become fragmented and loose, giving way to wrinkles and laxity.
Collagen levels decrease at the rate of about one percent per year as we age, and the breakdown of collagen in the skin contributes explicitly to the development of fine lines and wrinkles. But just because we lose collagen doesn’t mean all hope is lost. On the contrary, professional collagen-stimulating treatments can tighten the skin and boost production. So, rather than downing palmfuls of supplements and powders with the expectations of achieving youthful, bouncy skin — because hope is not a strategy — leave it to science to proclaim the next best thing for collagen stimulation. Enter: Sofwave™.
Ultherapy vs. Sofwave: What’s the Difference?
The use of ultrasound for aesthetic purposes is nothing new. “The dermis layer contains most of our specialized structures, and we have learned that heating the skin with ultrasound stimulates collagen production," says Ava Shamban, MD, a board certified dermatologist in Santa Monica, CA. Ultrasound waves selectively injure the skin to trigger a natural healing response. “The dermis is stimulated to produce new collagen with the resulting tissue providing more support to the skin structure, thus making it visibly and structurally tighter and more toned,” she adds.
The original Ultherapy® device went through clinical trials in the early 2000s and first received approval from the United States Food and Drug Administration (FDA) around 2006. Ulthera (now known as Ultherapy®) is safe for all skin types and was introduced to tighten up saggy skin on the neck and face — sans surgery. Today, it is FDA-approved to lift the neck, chin, and brow and improve the appearance of lines and wrinkles on the upper chest.
A hit amongst dermatologists and plastic surgeons alike, ultrasound energy is highly effective, especially in those who are not ready for or interested in plastic surgery. Ultherapy® remains a go-to for non-surgical skin tightening, but, as with all non-invasive energy-based devices, something newer always comes along. Sofwave™ is the latest FDA-approved ultrasound treatment that boosts collagen production and targets facial lines and wrinkles. Here’s how it compares to Ultherapy®:
SIMILARITY: BOTH USE ULTRASOUND ENERGY
Unlike other collagen-stimulating treatments (think: lasers, radiofrequency, and microneedling), both Sofwave™ and Ultherapy® utilize ultrasound as the main proponent for prompting the creation of new collagen and rejuvenating the skin. However, there are some reasonably significant differences between the two comparable yet distinctive devices, including depth of penetration, the pain factor, and treatment areas, which leads us to...
DIFFERENCE: ENERGY IS DELIVERED AT DIFFERENT DEPTHS
Perhaps the most significant difference between Sofwave™ and Ultherapy® is how far each one delivers ultrasound energy beneath the skin. With Ultherapy®, ultrasound is delivered to three different layers — superficially to the dermis at 1.5 millimeters, deeper to the dermis at 3 millimeters, and deepest to the SMAS and platysma muscles at 4.5 millimeters.
Sofwave™ sends ultrasound to only one depth — 1.5 millimeters — just below the surface of the skin, where collagen is most abundant. This controlled depth creates a more uniform effect without damaging the outer layers of skin or the deeper tissues and muscles such as the bones, facial nerves, fat, and blood vessels. Samuel Lin, MD, a double board certified plastic and reconstructive surgeon in Boston, says that “because Ultherapy® delivers energy to deeper levels than Sofwave™, it can help tighten the muscle layer in addition to the skin.” Sofwave™, meanwhile, “only provides skin tightening,” he adds.
SIMILARITY: BOTH ARE UNCOMFORTABLE
The deeper depth of the delivered ultrasound energy makes Ultherapy® more painful than Sofwave™. Even so, Sofwave™ can be somewhat uncomfortable, but it's not downright unpleasant. Still, most doctors recommend using numbing cream (they remove it after about 20 minutes), especially on bony areas like the jawline and forehead. Next, a conductive gel is applied, which allows the handpiece to glide across the skin effortlessly. A full-face treatment is said to feel somewhat like a high-heat zing that lasts no more than a few seconds. Additionally, the Sofcool™ cooling component (it measures skin temperature) in the Sofwave™ handpiece helps make the treatment more comfortable.
DIFFERENCE: SOFWAVE HAS LESS RISK FOR FAT ATROPHY
Unfortunately, one of the downsides to Ultherapy® is the potential for fat loss. The claim is largely anecdotal and there is a lack of scientific data on the topic, but some experts feel that, when it is used too deep, Ultherapy® can cause fat atrophy. Due to the limited depth of Sofwave™, Dr. Shamban says it’s ideal for the patient and provider to ensure there is no fat or tissue disruption below the collagen and elastin layer. “Although seemingly small, the difference can significantly change the provider's actions or potential errors, patient results, overall discomfort, and even cost or time per treatment,” she shares.
SIMILARITY: BOTH IMPROVE LINES & WRINKLES
One of the many causes of fine lines and wrinkles is a loss of collagen coupled with a whole host of factors, like elastin breakdown, free radical damage, a loss of moisture, facial expressions, and so much more. Although both modalities help improve fine lines and wrinkles, Dr. Lin says that “Ultherapy® may be a better option for patients with deeper wrinkles and folds because it reaches a deeper level [of the skin].”
SIMILARITY: BOTH HAVE NO DOWNTIME OR RECOVERY PROTOCOLS
While neither device carries any downtime, one of the most significant benefits of using Sofwave™ over other collagen-stimulating technologies is how quick the treatment is. Sofwave™ sessions last 30 to 45 minutes with little to no swelling or redness and no aftercare thanks to its proprietary Synchronous Ultrasound Parallel Beam (SUPERB) technology. As Dr. Shamban explains, the dual beams work at a specific depth, bypassing the upper layers of the skin to induce collagen formation. “Ultherapy® uses micro-focused ultrasound to generate a thermal effect under the skin and is known to be more painful,” she adds.
Furthermore, the bigger handpiece addresses larger areas in less time. “Sofwave™ is a much faster procedure because it has a larger handpiece covering more surface area per pulse,” Dr. Shamban says. And Sofwave™ works after just one session, making it more effective for those who are short on time yet demand dramatic results. You can also do Botox®, fillers, and microneedling before or after treatment. “Sofwave™ is non-surgical and can be safely combined with other procedures, like neuromodulators, to bolster the amount of improvement in areas with wrinkles,” Dr. Lin says. “Facial filler presents an additional option for further improving facial volume in addition to the skin-tightening offered by Sofwave™.”
The Ideal Candidate for Sofwave
As we mentioned, collagen levels begin to deplete at a rate of about one percent per year starting as early as the mid-twenties. That means that by the time the effects of collagen loss have set in, it’s past time to put collagen restoration methods into overdrive.
Sofwave™ has both a corrective and preventative component to it. The treatment is beneficial for younger patients who wish to take a proactive approach to prevent aging or are showing early signs of it (think: minor laxity in the jawline) since Sofwave™ can help slow down collagen loss. But it's suitable as a rejuvenating procedure for more mature skin types, and it’s safe for all skin tones. Dr. Shamban likes to use Sofwave™ to treat early tissue laxity for those in their late-thirties and also to address moderate tissue sagging in patients in their late-fifties and sixties. It should be noted that “it's not ideal when there is tremendous tissue laxity,” she says.
Sofwave Target Areas & Results
Most dermatologists and plastic surgeons prefer to use ultrasound to tighten up slack skin on the face, chest, and neck and to target fine lines and wrinkles, too. In November, the FDA approved clearance of additional indications for lifting the eyebrow and lifting lax submental (beneath the chin) and neck tissue. Additionally, Sofwave™ is reportedly used off-label to tighten flabby, saggy skin on both the knees and the stomach.
The collagen rebuilding process takes upwards of six months, but immediate results can be seen as soon as one week after a Sofwave™ treatment. From there, the collagen production cycle continues, and, around the three-month mark, more noticeable improvements in skin tone and quality are evident. In terms of maintenance treatments, only one session is needed every eight to 12 months. From there on out, the skin will only continue to look better and improve.
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