[With Case Studies] Common Traits of People Who Regret Sofwave | How to Choose Treatment to Avoid No Results or Hollow Cheeks

Sofwave is a lifting treatment that uses SUPERB, a proprietary ultrasound technology featuring synchronized parallel ultrasound beams. It delivers cylindrical thermal energy to the mid-dermis at a depth of 0.5–2.0 mm, promoting the production of collagen and elastin.
In addition to U.S. FDA 510(k) clearance, Sofwave received regulatory approval in Japan in April 2025 as an ultrasound irradiation device intended to improve facial and neck wrinkles. Because it can heat only the necessary layer while protecting the epidermis through cooling, its short downtime is another characteristic.
For more information about Sofwave, please also refer to the article below.

The word “regret” can sound emotional, but breaking down the reasons behind it makes things easier to understand. Looking at the complaints that are actually reported, the causes generally fall into the following five categories.

Many disappointing outcomes can be avoided simply by knowing about them in advance. Let’s examine each one in detail.

Dissatisfaction with the results is the most common issue. Sofwave is a treatment that gradually promotes collagen production over time; it is not the type of treatment that produces dramatic changes immediately after the procedure. The effects begin to emerge after 1–3 months and peak at around 3–6 months.
Nevertheless, if you look in the mirror the day after treatment and decide that “nothing has changed,” you may miss out on the satisfaction you could otherwise have achieved. People who imagined immediate effects like those of HIFU are particularly likely to feel that there were no results. Many regrets are caused by evaluating the treatment before the effects have appeared.

Because Sofwave delivers energy while cooling the epidermis, it is generally considered less painful than HIFU. Even so, some people feel a strong sensation of heat or prickling in areas close to the bone or where the skin is thin. In one physician’s treatment report, the person described experiencing severe pain during irradiation and being able to complete the treatment only after combining a nerve block with numbing cream.
There are significant individual differences in how pain is experienced, and people who have not confirmed their anesthesia options in advance are more likely to feel surprised by the gap between their expectations and the experience during treatment.

Sofwave is an elective treatment not covered by insurance and tends to be more expensive than other treatments for sagging. The typical price for the full face is said to be approximately 100,000–350,000 yen per session, which is not an amount most people can spend casually. The reasons for the cost may include the newness of the device, its proprietary ultrasound technology, and the expense of consumables required for treatment.
For this reason, regret can grow when the changes achieved do not feel worth the amount paid. Satisfaction is especially likely to fall when a clinic is chosen based only on price and the number of shots or treatment area is smaller than expected.

Concerns that “Sofwave caused hollow cheeks” are frequently seen in online searches. In conclusion, Sofwave is designed to be unlikely to cause hollow cheeks. It acts on the dermal layer rather than reaching the fat layer, so it is unlikely to cause the face to look hollow due to fat reduction.
Many of these concerns arise from confusion with HIFU, which acts on the fat layer. People who have previously experienced fat reduction from another treatment, or who are naturally slim and have little facial fat, may become unnecessarily worried if they undergo treatment without receiving a sufficient explanation.

The final pattern relates less to the treatment itself than to how it was provided. If expectations regarding possible changes and the number of sessions are not sufficiently aligned during the consultation, or if treatment proceeds without a clear diagnosis of your sagging, you may be left feeling that “this was not what I expected,” regardless of the actual results.
If you choose based only on low cost or convenience, you may proceed with treatment without receiving an adequate explanation. To avoid regret, where and by whom you receive treatment can be a greater deciding factor than the technology itself.

The quickest way to ease your concerns is to accurately understand how the treatment works. Once you understand the principles, you can distinguish for yourself which concerns discussed online are genuine and which are misconceptions. You will also gain a clearer understanding of the reasons behind comments about hollow cheeks and no results.

At the core of Sofwave is a proprietary ultrasound technology called SUPERB. It delivers multiple ultrasound beams in a cylindrical pattern in a single shot to the dermal layer at a depth of 0.5–2.0 mm, heating it to 60–70°C and promoting collagen production and contraction.
Contact cooling protects the epidermis and keeps the skin surface cool during treatment. Because the necessary layer can be heated while protecting the layer that needs to be preserved, the treatment is designed to reduce the risk of burns and hyperpigmentation and to involve little downtime.

Comparing Sofwave with HIFU is essential when considering concerns about hollow cheeks. HIFU focuses ultrasound in a point-like pattern and targets the SMAS fascia and fat layer deeper than the dermis. While it can provide powerful lifting from the foundation, it acts on the fat layer, and concerns have been raised that slim people may appear to have hollow cheeks if their cheek fat is reduced.
Sofwave, on the other hand, acts only on the dermal layer, which is shallower than the fat layer. Because it does not act in a way that reduces fat, its structural risk of causing hollow cheeks is low.

Dissatisfaction with results is the most common reason for regret. That is why correctly understanding how Sofwave works can have a significant impact on satisfaction. If you approach it with the same expectations as a treatment that produces immediate results, a gap may arise between your expectations and the outcome.

The effects of Sofwave appear as new collagen is produced. Although the skin may feel tighter immediately after treatment, the main changes begin to emerge after 1–3 months. The effects peak at around 3–6 months and then gradually settle.
For this reason, Sofwave is a treatment that can easily feel ineffective if it is evaluated too quickly. Rather than judging the results the next day based on expectations of immediate effects, it is important to allow time for the skin to remodel from within.

Sofwave is not a treatment that transforms you into a different person after a single session. Many people who were dissatisfied overlap with those who expected a major change from one session. Depending on the degree of sagging, multiple treatment sessions or regular maintenance may be necessary.
The effects generally last approximately six months to one year, and treatment once or twice a year is a guideline for maintaining them longer. Knowing the general number and frequency of sessions in advance can help prevent disappointment after receiving treatment only once.

Sofwave is a treatment that is particularly suited to acting on the dermal layer. Conversely, when skin sagging has progressed and lifting from the level of the fascia is necessary, Sofwave alone may feel insufficient.
For sagging in deeper layers, HIFU, Thread lift, or surgical lifting may be more suitable. It is difficult to determine from appearance alone whether your sagging is at the dermal or fascial level, so a physician’s diagnosis is essential when selecting the most appropriate treatment.

Because this is a frequently searched concern, it is worth addressing carefully. Let’s take the discussion of the mechanism one step further and clarify whether there is an actual risk and, if so, under what circumstances. Some people deliberately choose Sofwave because they want to avoid hollow cheeks. With a correct understanding, most of the concern should be possible to let go.

As mentioned above, Sofwave acts on the dermal layer and does not reach the fat layer. Because it is not a treatment that applies heat in a way that reduces fat, its structure makes it unlikely to cause the cheeks to look hollow due to loss of cheek fat.
In fact, Sofwave is often considered as an option for slim people or those with little facial fat, even in situations where HIFU may be considered unsuitable because of the risk of a hollow appearance. It may also be recommended to people who have previously experienced hollow cheeks after HIFU.

It cannot be said that absolutely no changes will occur. If treatment coincides with the timing of natural age-related fat loss, you may feel that a change unrelated to treatment was caused by Sofwave.
If you are very concerned, ask directly during the consultation whether the amount of fat in your face creates a risk of hollow cheeks. If the physician can provide a well-founded explanation of the treatment area design and adjustments to the energy level, you should be able to let go of excessive worry.

Along with results and hollow cheeks, pain and cost are factors that can easily trigger regret. For both, preparing in advance can make a significant difference compared with becoming anxious on the day of treatment. Let’s look at the points to prepare for, one by one.

If you are particularly concerned about pain, confirm whether a nerve block can be used together with numbing cream. Many clinics offer options such as topical anesthesia and nitrous oxide sedation for people concerned about pain.
Combining anesthesia with the cooling function generally allows even people who are sensitive to pain to undergo treatment calmly. The experience after treatment can be very different depending on whether you endure the pain or have it alleviated. There is no need to hesitate to tell the clinic that you would like more extensive anesthesia.

At our clinic, we offer a wide range of anesthesia options, including numbing cream, nitrous oxide sedation, nerve blocks, and intravenous anesthesia, and strive to provide treatment with as little pain as possible.
Before treatment, we conduct a thorough consultation and answer your concerns and questions, so you can undergo treatment with confidence.

The key to avoiding regret over cost is not to choose a clinic based solely on a low advertised price. What you should compare is the total amount, including the initial consultation fee and anesthesia fee, as well as the number of shots for the treatment area. Even when treating the same area, fewer shots can limit the results achieved. In general, treating a larger area at once is less expensive than dividing it into smaller areas and repeating treatment.
Clearly confirming at the estimate stage how much you will pay, how many shots will be used, and which areas will be treated can greatly help prevent a mismatch between cost and results.

When taken to its conclusion, all of the measures discussed above come together in one place: the consultation. It would not be an exaggeration to say that whether you will regret the treatment is largely determined during this time, before you get on the treatment bed.

The most important point for increasing satisfaction is to align your expectations with the physician.

Simply confirming these points verbally can greatly reduce regret after treatment. Rather than proceeding with uncertainties, asking questions until you are satisfied is the quickest way to move toward satisfactory results.

The way to identify a good consultation is simple. See whether the physician speaks frankly not only about the benefits, but also about cases in which results may be difficult to achieve, risks, and situations where the treatment is not suitable.
A physician who prioritizes the patient’s interests over sales and tells you, “This other treatment is more suitable for your sagging than Sofwave,” is worthy of trust. If the physician evades your questions or pressures you to make an immediate decision, you may need to pause and reconsider.

Feeling more afraid of something unfamiliar is a natural human response. Learning specifically about downtime and side effects can greatly reduce vague anxiety. Knowing in advance what may occur can help you avoid excessive worry after treatment.

Because Sofwave delivers energy while protecting the epidermis, it generally involves little significant downtime, and you can wear makeup from the day of treatment. Redness, heat, swelling, and temporary dryness may occur after treatment, but redness and heat generally subside within several hours to one day, while swelling and wheals usually settle within several days to one week.
In rare cases, burns or hyperpigmentation may occur. After treatment, moisturize thoroughly and take proper measures to protect your skin from ultraviolet radiation. If any unusual sensation persists, consult the clinic promptly.

Although this treatment has a high level of safety, it is not suitable for everyone. People who are pregnant or breastfeeding, those who have undergone a Thread lift or surgical facelift within the past year, those with metal implants or a pacemaker in the face, people prone to keloids, those with skin conditions or infections, people with diabetes, and those taking anticoagulants may be unable to receive treatment or may require careful assessment. If you have an underlying condition or take medication, do not make your own decision; be sure to inform the physician during your consultation.

Most regrets related to Sofwave arise from undergoing treatment with misaligned expectations without understanding how it works or the characteristics of its effects. Understand that the effects develop gradually, clear up misconceptions about hollow cheeks, prepare for pain and cost, and above all, discuss everything thoroughly with your physician during the consultation. Simply following these steps can prevent many regrets.
At LIVELY CLINIC, we examine the condition of your sagging and honestly explain whether Sofwave is suitable for you. If you would like to make a choice you will not regret, please feel free to consult us.