Hello. I'm the Head Doctor of DIORE Clinic, Gangnam.
"I'm looking into HIFU lifting—what exactly do the 1.5mm, 3.0mm, and 4.5mm tips target?"
"Ulthera, Shurink, and CoolSonic are all HIFU, but what's the difference between their handpieces?"
These are questions I hear every day. HIFU (High Intensity Focused Ultrasound) uses the same principle across all devices, but the depth of the tip and the treatment area completely determine the expected results. Today, I'll explain the expected effects by tip depth and the facial areas suited for each handpiece.
How HIFU Works: The Power of Thermal Coagulation Points
HIFU focuses ultrasound energy at specific depths within the skin, creating Thermal Coagulation Points (TCPs) at 60–70°C—much like a magnifying glass concentrating sunlight. These micro-injuries trigger the body's natural healing response, stimulating new collagen and elastin production while tissue contracts for lifting and tightening effects.
The key is that different depths stimulate different skin layers, producing different effects. That's why HIFU devices come with multiple cartridges (tips) for various depths.
Expected Effects by Tip Depth
1.5mm — Upper Dermis
The shallowest tip targets the upper dermis near the skin surface.
- Key Effects: Skin texture refinement, fine wrinkle reduction, pore tightening, tone improvement
- Best For: Eye area, forehead, around the lips—areas with thin skin
- Note: This depth provides skin renewal rather than lifting.
2.0mm — Mid-Dermis (Shurink Universe Exclusive)
An additional depth corresponding to the Eye Shurink tip.
- Key Effects: Periorbital tightening, under-eye wrinkle improvement
- Best For: Eye area and under-eyes requiring delicate care
3.0mm — Deep Dermis
The core mid-depth tip targeting the collagen-dense deep dermis.
- Key Effects: Skin tightening, collagen density enhancement, elasticity improvement, pore reduction
- Best For: Cheeks, jawline, forehead, neck
- Note: A 2025 study confirmed significantly increased collagen types I and III synthesis and elastin fibers after 3.0mm HIFU treatment.
4.5mm — SMAS Layer
The deepest tip, delivering energy to the SMAS layer—the same tissue layer surgeons target during traditional facelifts.
- Key Effects: Powerful lifting, jowl improvement, V-line contouring, double chin reduction
- Best For: Cheeks, jawline, neck—thick skin with noticeable sagging
- Caution: Using 4.5mm tips on areas with thin fat can cause volume loss. Precise anatomical judgment is essential.
Tip Depth Comparison Chart
| Depth | Target Layer | Key Effects | Best Areas | Pain Level |
|---|---|---|---|---|
| 2.0mm | Mid-Dermis | Eye tightening, fine wrinkles | Eye area only | Mild–Moderate |
| 4.5mm | SMAS Fascia | Strong lifting, V-line, sagging | Cheeks, jawline, neck | Strong |
HIFU Devices & Handpiece Comparison
Ultherapy
The world's first FDA-cleared HIFU device and the gold standard of ultrasound lifting.
- Transducers: 1.5mm / 3.0mm / 4.5mm
- Key Advantage: Patented DeepSEE™ real-time ultrasound imaging
- Results last: 12–18 months
- Backed by 110+ clinical studies
Shurink Universe
A second-generation Korean HIFU device by Classys, KFDA-approved.
- Handpieces: ULTRA F + ULTRA BOOSTER (pen-type) dual system
- Cartridges: 7 types
- Key Advantage: Pen-type for curved areas; MP mode creates ~400 thermal points per shot
- Results last: 3–6 months
CoolSonic
A next-generation Korean HIFU featuring virtually pain-free treatment.
- Handpieces: Line type + Pen type dual system
- Key Advantage: Patented ACC™ cooling instantly cools skin surface during energy delivery
- Results last: 6–12 months
Recommended Tip Depths by Facial Area
Forehead & Brow: 1.5mm + 3.0mm → Brow lift, forehead wrinkle smoothing
Eye Area: 1.5mm or 2.0mm → Fine wrinkle improvement, drooping eye corner lift
Cheeks: 3.0mm + 4.5mm → Sagging improvement, nasolabial fold reduction
Jawline & Double Chin: 4.5mm + 3.0mm → V-line contouring, volume reduction
Neck: 3.0mm + 4.5mm → Neck wrinkle improvement, skin tightening
In practice, multiple depths are combined for a multi-layer approach, which is why the practitioner's expertise matters greatly.
FAQ
Q1. Do I need all three depths?
Not necessarily. The optimal combination depends on your skin thickness, fat volume, and desired results.
Q2. Is Ultherapy better than Shurink or CoolSonic?
All three use the same HIFU principle. Ultherapy offers superior precision with real-time imaging and longer-lasting results. Shurink and CoolSonic offer less pain and lower cost for regular maintenance.
Q3. Can HIFU cause cheek hollowing?
Using high-energy 4.5mm tips on areas with thin fat may cause volume loss. Precise area selection is essential.
Q4. When do results appear?
Peak results appear 2–3 months after treatment as collagen regenerates.
Q5. Can I combine HIFU with Thermage?
Yes—an excellent combination. HIFU lifts the deep SMAS layer while Thermage tightens dermal collagen.
Q6. Is CoolSonic really painless?
Pain is significantly reduced. The ACC™ cooling system blocks heat sensation. Most patients require no anesthesia.
Results may vary depending on individual skin conditions. Please consult with a qualified aesthetic medical professional for accurate diagnosis and recommendations.
References
- Kim HJ, et al. J Cosmet Dermatol. 2025;24(2):e14506.
- MacGregor JL, Tanzi EL. Semin Cutan Med Surg. 2013;32:18-25.
- Ultherapy: 110+ clinical studies.
- Classys Shurink Universe: 7 cartridge system, KFDA approved.
- Fabi SG. Clin Cosmet Investig Dermatol. 2015;8:47-52.