A personalized match from our full cosmetic menu — built around your specific concerns, preferences, and medical profile.
Medically reviewed by Christine Stanko, MD, FAAD · Reviewed September 3, 2026
Three treatments. All of them promise firmer, smoother skin. All of them get talked about in the same breath at a cosmetic consultation. And nothing in the names tells you which one is meant for your face.
That is the real decision most patients arrive with. The useful thing to know up front is what these treatments have in common: none of them adds volume to your face. Each one asks your own skin to make new collagen, and the differences come down to how the signal is delivered, how deep it goes, and what kind of concern it answers best.
Sofwave is an ultrasound-based device. It delivers energy from side-by-side transducers into the middle layer of your skin. When researchers looked at treated skin under a microscope, they found more collagen and elastin fibers in that middle layer afterward.
Ultherapy also uses ultrasound, but a different kind: microfocused ultrasound with visualization. It creates small points of heat at set depths, and your skin responds by making new collagen and remodeling elastin. It also has the longest regulatory track record of the three. It was first FDA-cleared in 2009 for lifting the brow without surgery. Later clearances covered lifting the neck and under the chin, improving lines and wrinkles on the décolletage, and treating the cheeks and jowls.
SkinPen microneedling takes a mechanical route instead of an energy-based one. Very fine needles make tiny, controlled injuries, and your skin's repair response does the rest. The American Academy of Dermatology explains that microneedling stimulates your body to make collagen, which is why it is also called collagen induction therapy. It is also minimally invasive and safe for all skin tones, which matters more than patients expect when choosing between options.
Different tools, same underlying request: build me more collagen.
The first thing to reset is the timeline. Collagen is not a same-day result. With collagen-stimulating treatment, results build gradually: you may see improvement within a few weeks, and it usually takes several months before you see full results. If you are treating ahead of an event, count backward by months, not weeks.
Sessions differ. Microneedling is generally done as a course rather than a one-off: for concerns like acne scarring, the AAD describes 3 to 5 treatments performed every 2 to 4 weeks. At Bryn Mawr Dermatology, a SkinPen course is typically three treatments spaced about four weeks apart. Sofwave and Ultherapy are usually planned as two treatments, also about four weeks apart, with the exact plan decided at your consultation based on the area being treated and what you want to change.
Recovery is where microneedling is easiest to describe honestly. Plan on one to two days of downtime after SkinPen: redness on lighter skin tones, or darker shades on deeper skin tones, usually fades within a few days. Sofwave and Ultherapy have no downtime, so you can go straight back to your day.
Comfort is worth asking about directly at your visit. What a treatment feels like depends on the device, the area, and your own tolerance, and your dermatologist can tell you what to expect before you commit to a plan.
On cost, compare full plans rather than single visits. Microneedling is priced as a course of several sessions, while Sofwave and Ultherapy are priced by the treatment area and the number of sessions in your plan. Ask for the complete figure for each option at your consultation so you are comparing like with like.
If your skin is starting to lose a little firmness, and your goal is maintenance rather than correction, an ultrasound treatment that works in the middle layer of the skin is a reasonable place to start. The point is to keep building structure while you still have plenty to build on. If you want more detail, we have written about Sofwave separately.
If the concern is more established — a jawline that has softened, looseness under the chin or along the neck, a brow that has dropped — the conversation usually shifts. It moves toward the treatment with the longest clearance history for lifting in those areas. It helps to read up on Ultherapy before your consultation, so you arrive with better questions.
If what bothers you is the surface of your skin rather than its support structure — texture, enlarged pores, acne scarring — microneedling is the more direct answer. It is the option the AAD describes for treating acne scars over a course of several sessions.
And plenty of patients do not choose at all. Laxity and texture are separate problems, and treating one does not fix the other. The AAD notes that microneedling is often paired with another treatment to improve results — for example radiofrequency, a chemical peel, or platelet-rich plasma. The same logic applies to pairing a resurfacing treatment with a tightening one.
These three are not the whole menu, and pretending otherwise would narrow your options unfairly.
Poly-L-lactic acid injectables belong to a category called collagen stimulators. They do not work like a conventional filler. They are chosen when the goal is a gradual change in the skin itself, and your dermatologist can explain how that timeline differs from an injectable that works straight away.
Radiofrequency microneedling combines needling with heat delivered deeper in the skin. That pairing fits the AAD's observation that microneedling is often used together with radiofrequency to improve results. Our guide to radiofrequency microneedling goes into more detail.
Radiofrequency skin tightening aims for the same goal as the ultrasound devices, but uses heat energy rather than ultrasound to get there. Our guide to radiofrequency tightening has more.
Calcium hydroxylapatite fillers sit in a different category again. Whether they belong in your plan depends on whether the underlying issue is volume, collagen, or a combination of the two.
Which is the honest conclusion here: the right answer is frequently a combination, sequenced over time, rather than a single winner picked from a list.
Both use ultrasound, but not in the same way. Sofwave delivers energy from side-by-side transducers into the middle layer of the skin, where collagen and elastic fibers have been shown to increase. Ultherapy is microfocused ultrasound with visualization, which creates points of heat at set depths to start new collagen and elastin remodeling. Matching the depth to your concern is the job of the consultation.
Microneedling is priced as a course rather than per visit, because results depend on completing the full series. The total depends on the number of sessions in your plan and the area being treated, and our team will give you a course price at your consultation.
Because these treatments rely on collagen your own body produces, longevity varies from person to person. What is consistent is the build: improvement may appear within a few weeks, with full results usually taking several months. Maintenance intervals are planned individually rather than set by a fixed rule.
Combining treatments is common practice — the AAD notes that microneedling is often used along with another treatment to improve results. Whether to combine a resurfacing treatment with an energy-based tightening treatment, and in what order, is a decision to make with your dermatologist based on your skin and your schedule.
The right choice depends on your skin, your concern, and your timeline — which is exactly the kind of thing worth a conversation. Bryn Mawr Dermatology's board-certified dermatologists see patients by appointment in Villanova, Collegeville, and Wayne/Chesterbrook. You can use our matcher to narrow down the options, or book an appointment online.
This article is for general educational purposes and is not a substitute for individualized medical advice. Cosmetic treatments carry risks and are not appropriate for everyone. Please consult a board-certified dermatologist about your own skin, medical history, and treatment options.
Published By: Bryn Mawr Dermatology
Medically Reviewed By: Christine Stanko, MD, FAAD
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