Hello, I’m Dr. Dohoon Kim from ODE Clinic.
Today, I’d like to share my experience using CoolSoniq in real clinical practice—objectively and honestly—based on what I’ve observed firsthand while treating patients.
CoolSoniq (CoolSoniq) lifting is a high-intensity focused ultrasound (HIFU) lifting device released by Asterasys. What makes it different from conventional HIFU devices is its built-in cooling function. I’ll explain in a clear and easy-to-follow way what advantages this offers, what kind of results you can realistically expect, how much it hurts, possible side effects, and how it differs from Ultherapy.
What Is CoolSoniq Lifting and How Does It Work
1. High-Intensity Focused Ultrasound (HIFU)
HIFU delivers concentrated ultrasound energy to a single focal point to create thermal coagulation zones within the subcutaneous fat and SMAS (Superficial Musculo-Aponeurotic System) layers. This causes tissue contraction and lifting.
The key advantage of HIFU is that it targets deep layers of the skin without damaging the surface. The focal temperature exceeds 60 °C, which is optimal for fat-cell disruption and collagen denaturation, resulting in visible tightening and lifting of sagging areas.
However, the major drawback of classic HIFU systems like Ultherapy is pain. When thermal coagulation occurs, pain signals travel quickly through A-delta fibers, creating sharp, shooting discomfort—especially around the jawline where the skin is thinner and closer to bone. Most patients rate Ultherapy pain at 7–8 / 10.
To address this, CoolSoniq became the first HIFU device to integrate an active cooling system, reducing pain dramatically while maintaining full lifting power.
2. Advanced Cooling Mechanism
Each CoolSoniq handpiece contains its own fan and motor. When the system runs, it cools the internal water circuit so that the treatment tip—the part in contact with the skin—becomes cold. The device is typically powered on 3–5 minutes before treatment to allow adequate cooling.
This cold surface works through the Gate Control Theory: sensory pathways have limited bandwidth, so when the nerves first sense cold, the pain signal that follows cannot fully pass through. In addition, the cold temperature slows ion-channel activity within nerve membranes, reducing nerve-conduction speed and dampening the pain response.
Through these mechanisms, CoolSoniq reduces the characteristic discomfort of HIFU by about half.
While Ultherapy is usually rated 7–8 / 10 in pain, CoolSoniq averages 3–5 / 10.
Is CoolSoniq less powerful because it hurts less?
No. In my own acrylic-plate experiment comparing Ultherapy, Shurink, and CoolSoniq, the melted marks from thermal coagulation were largest and deepest with CoolSoniq—evidence that its energy output is fully comparable, if not stronger.
3. Pen-Type Cartridge
Unlike conventional HIFU cartridges that deliver a line of about 20 coagulation points per shot, CoolSoniq’s pen-type cartridge creates one focal point per shot. As a result, Ultherapy 300 shots ≈ CoolSoniq 6,000 shots in treatment volume.
This design allows for exceptional precision in narrow or curved areas. For example, near the nasolabial fold, Ultherapy’s larger handpiece often cannot reach close to the nose, but CoolSoniq can. It also allows safer targeting along the jawline by avoiding lateral-cheek areas, reducing the risk of unwanted hollowing.
Treatment Areas With the Best Results
1. Jawline and Double Chin
The jawline and submental region respond strongly to HIFU because the SMAS layer is distinct here and rich in subcutaneous fat. Thermal coagulation in this layer contracts collagen and induces fat-cell apoptosis, effectively tightening the jaw contour and reducing a double chin.
2. Nasolabial Folds (Sagging Component)
Nasolabial folds often include both hollowness and sagging of the malar fat pad. Although this area lacks a clear SMAS layer, HIFU can trigger fat-cell breakdown and contraction of fibrous septa between cells, providing noticeable lifting. CoolSoniq’s small cartridge makes it possible to treat right up to the nasal base—something Ultherapy often cannot do. For best results, combining CoolSoniq with radio-frequency tightening (such as XERF) enhances septal contraction and overall firmness.
3. Brow and Forehead Lifting
Using the 3.0 mm cartridge, CoolSoniq can target the fascia of the frontalis region to lift sagging eyelids and the brow area, improving a tired appearance without surgery.
Who Is an Ideal Candidate
CoolSoniq is suitable for individuals who:
Want lifting of the jawline, double chin, nasolabial folds, or brows
Prefer a low-pain procedure
Are concerned about cheek hollowing and need highly precise control
Want a visible yet natural lifting result with minimal downtime
Possible Side Effects
CoolSoniq shares the same general risk profile as other HIFU treatments.
1. Burns
If the tip loses full contact and heat accumulates too superficially, minor first- or second-degree burns may occur. Most heal without scarring when promptly treated. Maintaining firm contact during each shot minimizes this risk.
2. Cheek Hollowing
Because HIFU can destroy fat cells, firing over pre-existing hollow areas can worsen volume loss. To prevent this, thorough pre-treatment facial mapping and marking while the patient is upright is essential. In low-cost, high-volume clinics that skip this design step, unnecessary hollowing can result. A few minutes of proper marking drastically reduces the risk.
When Results Appear, How Long They Last, and Ideal Treatment Interval
Onset of Results
Collagen contraction begins immediately during treatment, but swelling and inflammatory response can obscure results for the first 1–2 weeks. After swelling subsides, visible tightening appears and continues to improve over the next several weeks as new collagen remodels.
Duration and Maintenance
Longevity varies depending on age, lifestyle, and collagen metabolism. On average, effects last 6 months to 1 year. Rather than calling it “duration,” I describe it as the treatment interval—ideally once every 6–12 months for maintenance.
Recommended Shot Count and Price Range
Because Ultherapy 300 shots ≈ CoolSoniq 6,000 shots, typical recommendations are:
5,000 shots → mild sagging, localized areas (20s–30s)
10,000 shots → moderate to severe sagging, full-face lift (40s–50s+)
At ODE Clinic (Gangnam, Seoul):
5,000 shots – ₩800,000
8,000 shots – ₩1,300,000
10,000 shots – ₩1,600,000
(Consultation and skin-analysis imaging included; VAT excluded.)
Frequently Asked Questions
Q. How many sessions do I need?
Because CoolSoniq’s mechanism and power are equivalent to Ultherapy, a single session every 6–12 months is generally sufficient. Instead of repeating the same device multiple times, combining CoolSoniq with different-mechanism treatments—such as ONDA, XERF, or Emface—provides more comprehensive lifting.
Q. What is the downtime?
Mild redness may last for several hours, with light swelling or tenderness for 1–2 weeks. Makeup is allowed the same day, but avoid saunas, vigorous exercise, smoking, and alcohol for about one week.
Q. Should I choose CoolSoniq over Ultherapy?
Patients who are pain-sensitive or who need high precision in areas like the nasolabial folds often prefer CoolSoniq. Both devices use 4.5 mm and 3.0 mm cartridges, and in practice the energy difference is minimal. In many cases, alternating or combining the two provides more even coverage across different depths.
The key is consistency—having the same physician perform both sessions and comparing before-and-after photos in the same clinic to find the most suitable approach for you.
Final Thoughts
Based on extensive hands-on experience using CoolSoniq on many patients, I can confirm that it offers powerful lifting results with significantly less pain than traditional HIFU systems. Still, because every face is unique, an in-person consultation is essential to determine suitability and the most effective treatment plan.
For best outcomes, seek care from an experienced dermatologist or aesthetic physician who can customize the procedure to your individual anatomy.
— Dr. Dohoon Kim, ODE Clinic
Author: Dr. Dohoon Kim, Chief Director of ODE Clinic
Specialty: Anti-aging (Lifting, Volumizing, etc.)