Expert Insights on Medical Aesthetics

Ultimate Guide to the Best Non-Surgical Face Lifting in Singapore: Fotona5D vs Fotona4D vs Thermage FLX vs Ultherapy vs HIFU

Notice that your face is looking saggier of late? We feel you.

Saggy skin is one of the biggest bugbears we as aesthetic doctors have to deal with in our daily practice. Correspondingly, non-invasive skin tightening and face lifting treatments are increasingly popular as people become more savvy about looking their best as they age. 

Fotona5D Laser Lift is the latest non-invasive skin lifting and tightening treatment in the market. It is a revolutionary treatment pioneered by aesthetic doctors in SL Aesthetic Clinic, improving upon the original Fotona4D protocol. Unlike conventional laser treatments which only improve our skin’s surface, Fotona5D does much more than that. 

In an aesthetic world already crowded with numerous skin tightening treatments, it is only natural to feel confused. I will share with you the key differences between these treatments and explain which is the most suitable treatment for you. 

Before proceeding with the rest of the article, you may wish to read up on Fotona5D Laser Lift and 5 Interesting Facts About Fotona5D.  

Fotona5D vs Fotona4D

Fotona4D has been Fotona’s signature skin tightening and lifting treatment since 2017. By itself, Fotona4D is an excellent treatment using 4 unique and complementary lasers which is suitable for almost all skin types. We have further improved the protocol by adding a 5th tightening laser (hence 5D) and also expanded the areas treated.

The 5th laser utilizes a Fotona’s proprietary Er:YAG SMOOTH® mode which is ideal for skin tightening. The intense, controlled superficial skin heating powerfully and safely stimulates collagen remodeling and initiates neocollagenesis (collagen formation). The effect is an overall improvement of laxity and elasticity in the treated areas. 

While the Fotona4D protocol only includes the face and front of the neck, our Fotona5D protocol expands the treated areas to include the frontal hairline and back of the neck. Tightening the skin over the frontal hairline has a lifting effect on the eyebrows. Tightening the skin over the back of the neck improves the appearance of the front of the neck as well. This enlarged treatment area results in tighter skin from our face to our entire neck. 

Fotona5D vs Thermage FLX

fotona5d vs thermage flx

Thermage FLX is the 5th generation skin tightening treatment from Solta, USA. It utilizes Mono-polar Capacitive Radio-frequency energy to deliver heat into the skin layers to stimulate collagen. 

In my opinion, Thermage FLX is more suitable for crepey, thinner Caucasian-type skin rather than saggier, heavier Asian-type skin. This is mainly because the Radiofrequency energy does not penetrate as deeply into the skin as compared to the Long-pulsed Nd:YAG laser used in Fotona5D. 

Thermage FLX protocol includes the face and neck, but does not include the back of the neck. Laxity at the back of the neck will aggravate neck lines and make our neck skin appear more loose. 

As with all the other non-Fotona skin tightening treatments, Thermage FLX does not improve the skin clarity. The last step of Fotona4D and Fotona5D is a superficial laser which improves skin texture and polishes away surface imperfections. This additional benefit gives a nice pearly finish to the skin, in addition to the tightening and lifting effect.

Fotona5D is a more comfortable treatment compared to Thermage FLX when performed at the recommended settings. It does not require numbing cream and does not feel as hot or painful as Thermage FLX. However, we would recommend applying numbing cream for all skin tightening treatments for better comfort. 

Fotona5D vs Ultherapy

Ultherapy is a skin-tightening treatment from Merz Aesthetics, USA. It uses ultrasound energy to lift and tighten the dermis and underlying fibromuscular layer that holds the skin in place. The ultrasound energy is delivered deep into the skin, heating up the specific skin layers to 60 to 70 degrees Celsius. At this temperature, thermal coagulation of proteins occurs and collagen is stimulated.

Ultherapy is suitable for all skin types, including Asian type saggy skin. However, the layers treated are very distinct i.e. 3 mm and 4.5 mm below the skin’s surface. The intervening skin layers are not treated as the ultrasound energy is only precisely deposited at the particular depth. On the other hand, Fotona5D tightens skin through the entire thickness of skin, including the mucosa lining in our cheeks and externally. 

Just like all the other non-Fotona skin tightening treatments, Ultherapy does not improve the skin’s surface. The last step of Fotona4D and Fotona5D is a superficial laser which improves skin texture and polishes away surface imperfections. This additional benefit gives a nice pearly finish to the skin, in addition to the tightening and lifting effect.

The standard Ultherapy protocol includes the face and neck, but does not include the areas adjacent to the mouth, back of the neck and the central part of the neck in front of our windpipe. This is so as not to damage nerves or other important structures under the skin. Hence, Fotona5D tightens a much larger area of skin compared to Ultherapy. 

Fotona5D is a more comfortable treatment compared to Ultherapy when performed at the recommended settings. It does not require numbing cream and does not feel as painful as Ultherapy. Ultherapy is more uncomfortable over bony areas such as along the jawline and forehead. 

Fotona5D vs HIFU

HIFU (High Intensity Focused Ultrasound) is the name of a group of aesthetic devices that use ultrasound energy to tighten skin, similar to Ultherapy. There are many brands on the market, such as Ultraformer 3, Doublo and Sygmalift. The machines originate from different countries, depending on the brand and manufacturer. 

The differences between Fotona5D and HIFU are similar to that of Ultherapy. However, the key difference is that while Ultherapy only needs to be done once a year, HIFU treatments typically require multiple sessions a year for similar results. HIFU machines also do not have the real-time ultrasound visualization of the skin layers like Ultherapy. This makes it less accurate as visualization helps the physician determine if the energy is being deposited in the right layers of the skin for optimal results. 

This table below compares the key differences between Fotona5D, Fotona4D, Thermage FLX, Ultherapy and HIFU:

Fotona5D Fotona4D Thermage FLX Ultherapy HIFU
Key Technology Erbium and Long-pulsed Nd:YAG laser  Erbium and Long-pulsed Nd:YAG laser Mono-polar Capacitive Radio-frequency Ultrasound Ultrasound
Skin texture and radiance ★★★ ★★★ 0 0 0
Lifting ★★★★☆ ★★★☆☆ ★★☆☆☆ ★★★☆☆ ★★☆☆☆
Tightening ★★★★☆ ★★★☆☆ ★★★☆☆ ★★☆☆☆ ★★☆☆☆
Treatment areas Whole face including frontal hairline and whole neck including back of neck Whole face and front of neck Whole face and front of neck Face and front of neck (excluding areas next  to mouth and central part of neck) Face and front of neck (excluding areas next  to mouth and central part of neck)
Pain level + + +++ +++ +++
Treatment Regime Once a year Once a year Once a year Once a year Two to three times a year
Downtime Slight redness over the treated areas for a day with very mild peeling Slight redness over the treated areas for a day with very mild peeling Slight redness over treated areas for a few hours with no peeling Slight redness over treated areas for a few hours with no peeling Slight redness over treated areas for a few hours with no peeling
Cost From $2000 From $1600 From $3000 From $2500 From $1800

And finally, a few words about ‘Fotona6D’ introduced at other clinics soon after we introduced Fotona5D. When it comes to this treatment, it’s not about how many D’s you name in the treatment nor is this a case of the more lasers the better. While we truly use 5 different lasers in our Fotona5D treatment, other clinics simply ride on consumer’s mentality that more is merrier. They use only 4 lasers, yet call their treatment Fotona6D. Do always read the fine print and proceed with treatment only if you are satisfied with the professionalism and consultation process.

Interested in this treatment? WhatsApp us today!

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