[With Case Studies] What Is Sofwave? A Thorough Explanation of When Results Appear and Possible Side Effects, with Images

Sofwave is a sagging treatment device that uses innovative ultrasound technology. It is also referred to as “the new sagging treatment of the century” and directly targets the mid-dermis, which has been difficult to address with conventional treatments. Its most distinctive feature is that it may provide effective lifting and skin-quality improvement at the same time while minimizing damage to the skin surface through this pinpoint action.

It has also been approved by the U.S. FDA, with its safety and efficacy scientifically established. Its formal approval for “improvement of facial and neck wrinkles” and “eyebrow lifting” particularly demonstrates its reliability.

SUPERB™—the core technology of Sofwave—is an abbreviation for Synchronized Ultrasound Parallel Beam. This technology makes it possible to deliver ultrasound energy intensively to the mid-dermis at approximately 1.5 mm beneath the skin.

A feature of SUPERB™ technology is that seven ultrasound transducers operate simultaneously, delivering thermal energy evenly to the dermal layer. By concentrating the delivered energy in the mid-dermis, approximately 0.5–2.0 mm deep, it effectively promotes collagen regeneration. This may improve skin firmness and elasticity and produce a natural lifting effect.

While conventional HIFU treatments deliver ultrasound in points, Sofwave delivers ultrasound in cylindrical columns measuring 1.5 mm in diameter and 4 mm in length. By simultaneously delivering seven cylindrical ultrasound beams in one shot, it can deliver thermal energy evenly and powerfully across a broad area of the dermis. This temperature range reaches 60–70°C and is considered optimal for collagen contraction and new collagen formation.

Conventional HIFU treatments, such as Ultherapy, primarily target the fascia known as the SMAS layer, whereas Sofwave targets the mid-dermis, where abundant collagen is present. This may help improve skin quality while reducing the risk of facial hollowing.

Sofwave can address various skin concerns, but it may be particularly effective for the following symptoms.

Let us look at them one by one.

Sofwave effectively targets sagging in the cheeks and around the chin that becomes noticeable with age. By applying thermal stimulation to collagen in the dermis, it contracts existing collagen fibers while promoting new collagen production.

This action may sharpen the facial contours and produce a tightening effect. It is particularly effective for mild to moderate sagging and gradually improves with repeated treatments. Results vary from person to person, but many people can feel an effect after a single treatment, with clearer results appearing approximately 3–6 months later.

The depth and visibility of nasolabial folds are concerns that many people become increasingly aware of with age. Sofwave directly targets the reduction of collagen in the dermis, which contributes to nasolabial folds.

By delivering thermal energy to the mid-dermis with SUPERB™ technology, Sofwave promotes collagen production around the nasolabial folds and may improve their depth. After treatment, the skin gradually lifts from within, making the folds less noticeable. It may be particularly effective for deep nasolabial folds that cannot be fully concealed with makeup.

Neck wrinkles, commonly known as “necklace lines,” have been difficult to address with conventional treatments. The skin on the neck is thinner than facial skin, and excessive thermal energy carries risks such as burns and hyperpigmentation.

Sofwave’s synchronized ultrasound parallel beam makes it possible to deliver appropriate energy even to the thin skin of the neck. This may help improve neck wrinkles safely. Because the neck is an area where signs of aging readily appear, treating both the face and neck can help restore a balanced, youthful impression.

Sofwave may improve overall skin quality as well as sagging and wrinkles. Activating collagen production in the dermis can refine skin texture and improve firmness and elasticity.

It may also improve the appearance of enlarged pores, resulting in smoother, more even-looking skin. As collagen—the foundation of the skin—increases, the skin may become more translucent-looking. Because skin quality gradually improves after treatment, the skin may develop a more youthful appearance over 3–6 months.

It has been shown to be particularly effective for crater-like acne scars with uneven texture.

Dermal collagen remodeling pushes up the depressed tissue of acne scars from within, smoothing unevenness. Conventional laser treatments can strongly stimulate the epidermis and carry a risk of hyperpigmentation, whereas Sofwave acts precisely on the mid-dermis. Its ability to treat while minimizing damage to the epidermis is a major benefit.

As collagen is gradually produced over 1–2 months after treatment, depressed acne scars may become shallower and the skin surface smoother. Although it may be difficult to completely eliminate scars, the ability to improve skin quality and treat acne scars at the same time may be a major benefit for people concerned about the deterioration in skin texture caused by acne scars.

Sofwave offers several clear benefits not found in conventional sagging treatments. Specifically, they include the following.

Let us look at each point in detail.

Sofwave has been formally approved by the U.S. Food and Drug Administration (FDA) for “improvement of facial and neck wrinkles” and “eyebrow lifting.” This approval means that its safety and efficacy have been scientifically established, demonstrating that it is a reliable treatment evaluated according to international standards.

In clinical trials, effects were confirmed in many subjects with few side effects, allowing treatment to be received with reassurance. FDA approval also clearly defines the usage and indications, allowing the treatment to be provided in a standardized manner.

One of Sofwave’s major advantages is its short downtime. With conventional laser treatments and lifting surgery, swelling and redness may continue for a long time after treatment. However, Sofwave is designed to minimize its effect on the epidermis, allowing you to return to daily life immediately after treatment.

In many cases, makeup can be applied immediately after treatment, and the low level of burden is why it is sometimes called a “lunchtime treatment.” Mild redness or warmth may occur, but it usually subsides within several hours to about one day. It is suitable for people who wish to undergo aesthetic treatment while continuing their social and professional lives.

Compared with other ultrasound-based treatments, Sofwave is designed to cause less pain. In particular, its mechanism of cooling the epidermis while delivering energy only to the dermis helps reduce discomfort.

Applying anesthetic cream before treatment can reduce discomfort further. During treatment, most people describe the sensation as mild warmth or stimulation and say that the pain is tolerable. It may be a relatively easy treatment to undergo even for people who are sensitive to pain.

Sofwave is characterized not only by its ability to improve sagging and wrinkles but also by its potential to improve overall skin quality. Promoting collagen production in the dermis may refine skin texture and provide comprehensive skin-quality improvement, including the appearance of tighter pores and improved firmness and elasticity.

In anti-aging care, this means that it can address both “improvement of shape” and “improvement of texture,” helping create a more natural, youthful impression.

Sofwave is equipped with a cooling function called contact cooling. This function cools the skin surface to approximately 7°C during treatment, helping prevent epidermal damage.

It makes it possible to deliver the necessary thermal energy to the mid-dermis while protecting the epidermis. This cooling function minimizes redness and inflammatory reactions after treatment and substantially reduces the risk of burns. It may be a relatively reassuring treatment even for people with sensitive skin.

Conventional HIFU treatments, such as Ultherapy, target the fascial layer known as the SMAS. Their effects on the fat layer and the risk of facial hollowing have therefore been noted. They have sometimes been considered unsuitable for lean people or those with little cheek fat because of the possibility of facial hollowing.

Sofwave, however, targets only the mid-dermis, and its thermal energy does not reach the deeper fat layer. It therefore has less effect on the fat layer, and there is less concern that fat loss will create an aged appearance. It is also considered to have little effect on the SMAS or fat layer, reducing concern about facial hollowing.

It is a treatment that can be received with reassurance even by people whose cheeks have naturally hollowed with age or who have little facial fat to begin with. It is particularly recommended for people concerned about “loose, paper-thin skin beneath the chin.”

There are various types of treatments for sagging, but Ultherapy and Thermage are particularly popular. Let us compare them with Sofwave in detail.

Like Sofwave, Ultherapy is an ultrasound-based treatment, but there are major differences in the layers targeted and the mechanisms of action.
Although both use ultrasound, they act on different layers and offer different expected effects. Sofwave may be suitable for people who also wish to improve skin quality or who prefer treatment with less pain.

HIFU delivers ultrasound in dots and fires 17–23 points in succession with one shot. Ultherapy delivers a series of small, point-like thermal emissions known as HIFU.

In contrast, Sofwave is characterized by its proprietary SUPERB™ three-dimensional, cylindrical thermal delivery. It delivers ultrasound in cylindrical columns measuring 1.5 mm in diameter and 4 mm in length, simultaneously delivering seven cylinders in one shot. Because the cylindrical delivery delivers greater thermal energy three-dimensionally over an area than point-like delivery, it may be particularly effective for lifting sagging three-dimensionally.

With Sofwave, seven SUPERB™ columns (seven cylinders measuring 2.0 mm in diameter × 4.0 mm) are delivered simultaneously in one shot, providing sufficient temperature and thermal energy to cause collagen remodeling across a broad area of the superficial dermis.

Although both use ultrasound, they act on different layers and offer different expected effects. Ultherapy is suited to focused treatment of sagging, accurately targeting three layers from the deep to superficial skin, including the SMAS fascia.

Sofwave, on the other hand, delivers effective heat across a broad area of the superficial dermis, making it effective not only for sagging but also for wrinkles. In terms of its action on the superficial layers of the skin, namely the dermis, it is stronger than other tightening devices such as Ultherapy and Thermage and may help improve skin texture and wrinkles and sagging in thin areas of skin.

Sofwave may be suitable for people who also wish to improve skin quality or who prefer treatment with less pain.

Thermage is a treatment that uses radiofrequency (RF), promoting collagen production through the thermal action of electrical energy.
Thermage approaches from the epidermis and may also help with concerns such as enlarged pores, whereas Sofwave precisely targets the mid-dermis to promote collagen production more efficiently. It is important to select the appropriate treatment according to your symptoms and desired effects.

Thermage uses radiofrequency (RF) energy to deliver electrically generated heat across a broad area. In contrast, Sofwave concentrates ultrasound energy into cylindrical columns for delivery.

Thermage uses monopolar RF to deliver heat broadly from the epidermis through the dermis to the superficial subcutaneous fat. Sofwave, on the other hand, concentrates ultrasound energy precisely in the mid-dermis (0.5–2.0 mm). The difference is not limited to whether heat is felt; the approaches themselves are also substantially different.

Both treatments have cooling functions, and the recommended treatment interval is approximately six months for both. Sofwave heats a shallower layer than Thermage. Sofwave is recommended when you want to tighten the surface of the skin, such as for wrinkle improvement or sagging caused by stretched skin, while Thermage is recommended when you want to tighten and reduce the appearance of the face.

It is important to select the appropriate treatment according to your symptoms and desired effects. The appropriate treatment varies depending on your age, skin condition, and preferences. Make your decision after consulting a specialist.

Sofwave treatment is generally performed in the following order. While the details may vary slightly between clinics, here is an overview of the basic procedure.

First, a physician performs an examination and consultation. Your skin condition and concerns are discussed in detail to determine whether Sofwave is suitable for you. The expected effects of treatment and precautions will also be explained.

At this stage, your previous treatments, medical history, and allergies will also be confirmed. Treatment may not be possible for people who are pregnant or breastfeeding or who have certain skin conditions. It is important to provide accurate information.

You will also discuss your desired lifting effect and treatment areas in detail so that an appropriate treatment plan can be prepared. Photographs may be taken before treatment when necessary.

Before treatment, cleansing and face washing are performed to remove makeup and sebum. Keeping the skin clean allows the energy to be delivered evenly and may maximize the effect. Specifically, removing dirt and excess sebum from the skin surface helps ultrasound energy travel smoothly and may enhance the treatment effect.

To reduce treatment discomfort, many clinics apply anesthetic cream before the procedure. Generally, the cream is left to take effect for approximately 30 minutes to 1 hour before treatment begins.

Some clinics may charge an additional fee if you request stronger anesthesia, so it is recommended that you confirm this in advance. If you are sensitive to pain, it is advisable to discuss this beforehand.

Once the anesthesia has taken effect, Sofwave treatment begins. The device head is placed against the skin, and ultrasound is delivered in sequence. You may feel mild warmth or stimulation during treatment, but in many cases it is tolerable.

Treatment focuses on areas of concern such as the facial contours, nasolabial folds, and forehead. Treatment of the entire face takes approximately 20–30 minutes, while treatment of a specific area takes even less time. A physician or staff member will continuously monitor your condition during treatment, so inform them immediately if the pain is strong.

You may feel a sensation like small popping or mild warmth during treatment, which indicates that the energy is being delivered properly.

After treatment, some clinics provide aftercare such as cooling or a facial pack. If redness or warmth is present, soothing treatment with cooling gel may also be provided.

You will also receive an explanation of precautions and restrictions on daily activities, but Sofwave generally involves no particularly strict restrictions. In many cases, makeup and face washing are permitted on the same day.

Because sun exposure can affect treatment results, you will generally be advised to avoid strong ultraviolet exposure and take thorough sun-protection measures for approximately two weeks after treatment. If another treatment is planned, the next appointment is often scheduled approximately 3–6 months later.

Sofwave results are characterized by appearing gradually. Let us look in detail at the course after treatment over time.

A glow may begin to be noticeable several days after treatment and continue for approximately 1–2 weeks. Because of immediate collagen contraction, some people may feel a tightening sensation immediately after treatment. Some people experience an immediate effect, saying that their skin feels tighter or that their marionette lines have improved.

Treatment examples have also reported cases in which the skin tightened and marionette lines improved immediately after treatment. However, it is also true that some people do not notice a major change immediately after treatment. At this stage, the dermal layer is beginning to recover from the effects of the treatment.

Mild redness or warmth may occur, but it usually subsides within several hours to about one day. Full-scale collagen regeneration has not yet begun at this stage, but some people may notice a slight tightening effect as existing collagen contracts in response to heat.

Fibroblasts in the dermis stimulated by heat begin producing collagen, but it takes approximately 1–2 months for the remodeling effect to appear. Firmness gradually begins to develop, and the effects become noticeable. This is the period when you may notice firmness from collagen production and improvement in skin quality.

At this point, new collagen begins to form in the dermis, causing changes from within the skin. More people begin to notice overall improvement in skin quality, such as refined texture and less visible pores. You may also gradually notice that nasolabial folds and sagging along the facial contours are less pronounced.

Conventional HIFU, Density, and Volnewmer may produce a lifting effect immediately after treatment. Sofwave, in contrast, may not produce a major visible change immediately after treatment. However, its full-scale effects begin to appear from this period onward.

The effects reach their peak and continue for approximately six months. This is when improvement in sagging and wrinkles and tightening of the facial contours are most pronounced. Treatment effects are expressed to their greatest extent during this period, and many people notice clear changes.

Treatment examples have confirmed that improved nasolabial folds can remain six months after treatment, indicating that sustained effects may be expected. You may notice comprehensive rejuvenation effects, including increased volume throughout the face and tighter contours.

This period marks the peak of the treatment effect, after which the effects gradually decline. However, the skin does not immediately return to its original state, and the collagen produced remains in the skin for a certain period.

Although Sofwave can produce noticeable effects after a single treatment, many people undergo two or three treatments when they want ongoing effects. It is recommended that treatments be spaced at least six months apart. The duration of the effects varies from person to person, with six months generally considered a guideline, and may change depending on skin condition and lifestyle.

Because the peak effect continues from approximately 2–3 months through about six months, many clinics recommend a second treatment six months or more after the initial treatment for people who wish to continue treatment. Receiving treatment regularly can help maintain a youthful skin condition.

In addition, through an approach different from HIFU, Density, and Volnewmer, Sofwave may also help improve “skin firmness” and “tightening of the facial contours” in a different way. Combining it with other treatments may provide further complementary effects.

Sofwave is a relatively safe treatment, but as with other medical procedures, it involves several possible side effects and risks. When considering treatment, it is important to make a decision after understanding these factors.

The following are common side effects that may occur after Sofwave treatment.

Most of these side effects are temporary and naturally resolve without special treatment. However, if side effects persist or symptoms are severe, consult a physician promptly.

To receive treatment safely, it is important to meet the appropriate treatment conditions. Sofwave may not be suitable, or caution may be required, for people in the following situations.

If any of these conditions apply to you, or if you have another medical condition or take medication, we recommend consulting your primary physician or a physician at an aesthetic clinic beforehand. An appropriate decision based on your individual circumstances is necessary.

To further enhance the effects of Sofwave, it is increasingly being combined with other treatments. Here are treatment combinations that may provide complementary effects.

Aqua Shine injections are a treatment originating in Korea that uses very fine needles to inject hyaluronic acid and other aesthetic ingredients into the skin. While Sofwave tightens the skin, Aqua Shine injections provide hydration and nutrients, allowing you to aim for more youthful, radiant-looking skin.

Sofwave acts on collagen in the dermis, while Aqua Shine injections target the epidermis through the superficial dermis. Because they work on different layers, they form an effective combination. This combination may be particularly suitable for people concerned about dryness or dullness.

Generally, Sofwave is performed first, followed by Aqua Shine injections after an interval of 1–2 weeks. This may provide both lifting and skin-beautifying effects.

Botox, which suppresses the movement of muscles that cause expression lines, and Sofwave, which addresses sagging, have complementary effects. This combination may be particularly effective for people concerned about wrinkles around the eyes or on the forehead.

Botox primarily helps improve “dynamic wrinkles” caused by excessive contraction of the facial muscles, while Sofwave may help improve “static wrinkles” and sagging caused by gravity and aging. Combining the two may provide comprehensive improvement regardless of the type of wrinkle.

In general, it is possible to receive both treatments on the same day. However, to maximize the effects, some providers may recommend first suppressing muscle movement with Botox and then undergoing Sofwave approximately two weeks later.

For people concerned about facial contours or volume loss, combining Sofwave with hyaluronic acid injections may be effective. Sofwave improves sagging while hyaluronic acid restores lost volume, helping recreate youthful facial contours with dimension.

This combination is considered particularly effective for improving hollow cheeks, nasolabial folds, and marionette lines. Sofwave can tighten the skin, but its ability to restore volume is limited. Combining it with hyaluronic acid can therefore help restore a youthful, dimensional appearance.

When combining the treatments, it is generally recommended to perform Sofwave first and inject hyaluronic acid 1–2 months later, once the lifting effect has stabilized. This order can help minimize the amount of hyaluronic acid required.

Through this combined approach, it is possible to achieve more sustained and effective lifting while taking advantage of the benefits of each treatment.

Sofwave is an innovative treatment that may help improve not only sagging and wrinkles but also overall skin quality. Compared with conventional sagging treatments, it involves less pain and downtime, and its high level of safety is another appealing feature.

While Sofwave can be effective on its own, combining it with treatments such as Aqua Shine injections, Botox, or hyaluronic acid injections may provide more comprehensive rejuvenation effects.

When considering treatment, we recommend first receiving a physician consultation at a trusted clinic and creating a treatment plan suited to your skin condition and concerns. By making use of Sofwave, you can aim for youthful-looking skin that gives you confidence.