Key summary. Lifting procedures fall into three broad groups: energy-based non-surgical procedures (focused ultrasound and radiofrequency), non-incisional procedures that use threads, and area-specific surgery (facelift, mini facelift, neck lift, and brow lift). Based on what this site has reviewed, the choice should rest on where the sagging is and how severe it is, and on the level of evidence behind the procedure (whether controlled studies exist and, if they do, how many people were followed and for how many days). It should not rest on a procedure's name or price. This article does not conclude that any one procedure is the best.
What this article covers
- Comparison criteria: main procedure categories and treatment areas, level of evidence (whether controlled studies exist and how large they are), downtime and recovery period by category, and common misconceptions about non-surgical and surgical options
- Cautions: "new technology or high-priced procedure" does not mean "proven," and it is also not true that "non-surgical is always safe and surgery is always risky"
- Evidence status: this article brings together content already checked against the original sources in the 9 individual procedure articles and 1 comparison article listed below. This article does not cite any new primary literature itself.
Key points
- Definition: lifting falls into three broad groups: energy-based non-surgical procedures, non-incisional thread procedures, and area-specific surgery.
- Who it is for: the usual approach is that different categories are considered depending on the degree and location of sagging, but whether a procedure suits an individual is decided in consultation.
- Order of checks: identify the location and degree of sagging → check which procedure categories address that area → compare the level of evidence within that category (see the individual articles in this series) → confirm in consultation.
01 How are lifting procedures broadly categorized?
| Main category | Method | Main areas | Individual article |
|---|---|---|---|
| Energy-based (ultrasound) | Heats the layers beneath the skin with focused ultrasound | Face and neck | Ulthera, Shurink |
| Energy-based (radiofrequency) | Heats the layers beneath the skin with radiofrequency energy | Face and neck | Thermage, InMode |
| Non-incisional thread | Pulls tissue using the barbed projections of absorbable threads | Face | Thread lift |
| Surgery (full face) | Directly incises, lifts, and secures the SMAS fascial layer | Full face | Facelift, Mini facelift |
| Surgery (neck) | Open (direct treatment of the fascia) or closed (lateral fixation) | Neck | Neck lift |
| Surgery (brow and forehead) | Open or endoscopic | Brow and forehead | Brow lift |
Even within the same main category, the domestic permit number differs by device or product (for example, Ulthera Import permit 09-1024, while Shurink Original Manufacturing permit 14-1422 and Shurink Universe Manufacturing permit 21-831 are products from different generations). In some cases, the brand name alone was not enough to tell whether a product actually held a permit (the InMode/Morpheus8 case).
02 Which categories are usually considered for each degree of sagging?
| Degree of sagging | Categories usually considered | Summary of evidence level |
|---|---|---|
| Mild, with minimal incision burden | Non-surgical (energy-based) or thread lift | For Ulthera vs. Thermage, a head-to-head RCT exists (20 participants, 180 days). For thread lifts, there is only 1 RCT, and the effect had already declined by day 60 |
| Mild to moderate, with incisions kept to a minimum | Mini facelift, closed neck lift | Mostly observational studies. Only 4 study (286 participants) compares MACS with deep SMAS |
| Moderate to severe | Facelift (deep plane, etc.), open neck lift | Complication rates vary widely across studies, from 2.0% to 21.1%. Most of the evidence comes from retrospective studies without control groups |
| Sagging brows and forehead | Brow lift (endoscopic for mild to moderate, open for severe) | A literature review of 15 studies (4 RCTs) was checked. Complication profiles differ by technique |
This table summarizes "the directions generally considered." It is not a tool for deciding whether a procedure suits an individual. Where one degree of sagging ends and the next begins may be judged differently by different practitioners.
03 Why does the level of evidence vary so much between procedures?
Based on what this track checked directly, the level of evidence differed widely even among procedures grouped under the same "non-surgical lifting" label.
- When head-to-head RCTs exist: For Ulthera vs. Thermage, two RCTs with 20 participants reported no difference in effectiveness or side effects (only pain was greater with Ulthera).
- When RCTs exist but the results differed from expectations: For thread lifting, a 22-participant RCT found no difference in effect even when the number of threads was doubled, and the effect seen on day 20 already tended to decline by day 60.
- When most studies are observational or single-arm: For Shurink, brand-specific studies are few, and even those mostly measure the immediate effect right after the procedure. For facelift, most complication statistics come from retrospective case series without a control group.
- When the independence of the evidence itself is in question: For InMode, two brand-specific papers appeared in the same special issue and are also posted on the manufacturer's website, which has raised questions about whether they are independent evidence. In some comparison studies of newer devices related to Thermage, the manufacturer of the newer device supplied the study equipment.
Knowing this difference helps you tell apart the statement "there is research" from the statement "that research is an independent, adequately sized controlled study."
04 Items to check before any procedure
Detailed ways to check these items are laid out step by step in How to find a clinic for a lifting procedure consultation. Here, we summarize only what to look at first when choosing a procedure category.
| Item to check | Why it matters |
|---|---|
| Area and degree of sagging | The category itself changes (face/neck/brow; mild/moderate/severe) |
| Level of evidence within that category | Whether controlled studies exist, their size, and their independence differ by procedure (see §3) |
| Whether the device or brand is approved in Korea | In some cases, approval status could not be determined from the brand name alone |
| Differences in complications and pain by category | Non-surgical procedures are by no means harmless (e.g., swelling in 34% of thread lifts), and surgical risk can be lowered with preventive measures (such as hemostatic nets) |
05 How do downtime and recovery periods differ by category?
How well the claim "recovery is short" is supported by evidence also differs by category. Regrouping the figures already confirmed in the individual articles from a downtime perspective gives the following.
| Main category | Common early reactions | Time to recovery and return to normal | Evidence |
|---|---|---|---|
| Non-incisional thread (thread lift) | Swelling 34%, bruising 26% (pooled from 26 studies) | Most individual studies have short follow-up; the effect itself already tends to decline by day 60 | Thread lift article |
| Surgery (brow lift, endoscopic) | Mild, such as tenderness | Generally short. Even when reduced sensation occurs, it mostly returns to normal after 6–18 months | Brow lift article |
| Surgery (brow lift, open, especially coronal incision) | Numbness, hair loss, etc. | Open approaches are classified as having longer recovery than endoscopic ones | Brow lift article |
| Surgery (facelift) | Swelling, bruising | Complication rates vary widely across studies, from 2.0 to 21.1%, so a "standard recovery period" is hard to state definitively | Facelift article |
| Surgery (neck lift) | Varies by technique | Recovery and reduced-sensation profiles differ between open and non-open techniques (see the article for individual figures) | Neck lift article |
The clearest fact in this table is that "no incision does not always mean no downtime or short downtime." Even the non-incisional thread lift was reported to cause swelling and bruising in close to half of cases, whereas the surgical endoscopic brow lift was reported to cause only relatively mild early reactions such as tenderness. Rather than predicting downtime from whether there is an incision alone, looking at the figures confirmed in the individual article for that category and technique is closer to the evidence.
06 Common misconceptions
"This one procedure will take care of the whole face" — The procedures reviewed in this track are divided by area: brow lift addresses forehead and brow sagging, neck lift addresses the neck, and facelift-type procedures address overall facial sagging, each separately. No evidence was found in this track that one procedure can replace all areas.
"The newer or more expensive the technology, the stronger the evidence" — This is not the case. Thread lifting has only one controlled study, and for InMode, the independence of the brand-specific studies itself was questioned. In this track, new technology or high cost and the quantity and quality of evidence were found to be separate matters.
"Non-surgical is always safe and surgery is always risky": the complication rate of a facelift can vary considerably with preventive measures such as a hemostatic net, and even non-surgical thread lifting has complications such as swelling (34%) and bruising (26%) that are by no means rare. Safety cannot be judged by "whether there is an incision" alone.
07 In summary
When choosing a lifting procedure, the first thing to look at is not the procedure name but the location and degree of sagging, and the next is the level of evidence for each procedure within that category. Even among procedures that are all "non-surgical," this track found cases with head-to-head RCTs, cases with only observational studies, and even cases where the independence of the evidence itself is questionable. Even so, this overview does not make the decision for you. The approach this whole series supports is to check the level of evidence in each individual article and then narrow down your options in consultation, based on your own condition.
08 Frequently Asked Questions
How are lifting procedures categorized?
There are three broad groups: energy-based non-surgical procedures (ultrasound and radiofrequency), non-incisional thread lifts, and area-specific surgery (facelift, mini facelift, neck lift, and brow lift). However, even within the same group, regulatory approval and the level of evidence differ by brand and device, so you need to check those details separately in each individual article.
If my sagging is severe, do I have to have surgery?
That cannot be stated as a rule. This series found that surgical options tend to be considered more often as sagging becomes more severe, but whether a given option suits an individual is ultimately a question to settle in consultation. Rather than assuming "severe means surgery, no exceptions," weighing the area, the degree of sagging, and the recovery period you can tolerate together is closer to what the evidence supports.
Can I have several lifting procedures at the same time?
This track alone cannot answer that, because no controlled studies were found that directly tested the safety and effectiveness of specific combinations (for example, Ulthera plus Thermage). Whether to combine procedures is ultimately something to confirm in consultation, based on your individual condition and the practitioner's judgment.
Which lifting procedure is the most effective?
No such procedure exists. At least within this track, no combination of procedures had its superiority confirmed by a head-to-head controlled study. Ulthera and Thermage showed no difference in a direct comparison, and for other combinations, head-to-head studies were lacking in the first place.
If there is no incision, is downtime always short?
No. Sometimes the opposite happens. Even non-incisional thread lifting has reported common early reactions such as swelling (34%) and bruising (26%), while endoscopic brow lift, a surgical procedure, has been reported to cause only relatively mild reactions such as tenderness. "Whether there is an incision" and "how long the downtime is" do not always move in the same direction, so it is better to look directly at the figures confirmed in the individual article for that category.
09 Pre-consultation checklist
- □ I first checked the location and degree of my sagging and narrowed down the relevant procedure categories
- □ Within that category, I compared the level of evidence for the candidate procedures (whether controlled studies exist, and their size)
- □ I checked whether the device or brand used has domestic regulatory approval in Korea
- □ I treated explanations such as "this one procedure does it all" or "it's new technology, so it's better" as warning signs
- □ I checked the complication and pain information for both non-surgical and surgical options in the individual articles
- □ I checked the downtime and recovery period for the categories I'm interested in, in the relevant individual articles
10 Glossary
- RCT (randomized controlled trial): A study design that randomly divides participants into groups for comparison; considered relatively reliable.
- Controlled study: A study that includes a separate comparison group (control group) alongside the group that received the procedure. Without a control group, it is hard to tell whether an "improvement" was caused by the procedure or by something else.
- Observational study: A study that only observes outcomes without intervening. It is rated as a lower level of evidence than a controlled study.
- Retrospective study: A study that looks back at past medical records and analyzes them after the fact. Its evidence tends to be weaker than a study designed in advance to follow what happens going forward.
- SMAS: The fascial layer that surrounds the facial muscles. In facelift surgery, this is the tissue that is directly accessed through an incision, lifted, and secured.
- Hemostatic net: A mesh-like supportive device applied after surgery to reduce bleeding and hematoma.
11 Sources and verification date
- This article synthesizes evidence whose original text or abstract was already checked in each of the articles below. The primary sources and study designs behind individual figures can be found in the relevant article: Ulthera, Ulthera vs. Thermage comparison, Thermage, Shurink, InMode, Thread lift, Facelift, Mini facelift, Neck lift, Brow lift. Synthesized as of 2026-09-19.
- The articles above are meant to help readers understand how each procedure works and the state of its evidence. They do not guarantee any specific clinic, surgeon, or outcome.
12 Editorial responsibility and interests
- Written by: Korea Beauty Report Editorial Team · Editorial responsibility: Korea Beauty Report Editorial Team
- Review scope: The editorial team prepared this content from published research and public data. It was not separately reviewed by a medical professional and does not replace individual diagnosis or treatment.
- Conflicts of interest: No clinic mentioned in this article has a contractual or advertising relationship with us.
- First published: 2026-09-26, last materials check: 2026-09-26