I'm in my 40s and I post reviews about Ulthera about once a year. Please understand. I think I've done it 5-6 times so far. 600 shots as a genuine product, the price goes down every year which is good. The effect becomes less noticeable as you get older. In my late 30s, my skin became brighter after 2 weeks, and I felt the effect for 5 to 6 months. Now, my skin sagging has gotten so bad that I can't feel whether I did or didn't do the treatment. The doctor also said that thread lifting would now be more effective. ㅜㅜ (When it comes to thread lifting, I'm hesitant about whether Silhouette Soft is cost-effective, and I'm hesitant about using strong threads for fear that my cheekbones will explode and I'll end up with a joker's mouth.) Anyway, I think Ulthera is worth a try if your skin isn't very damaged. If we look at the pain and side effects, I only used sedative anesthesia so I don't know about the pain since I wasn't anesthetized. And the first time I did Ultherapy, the nerves near my mouth on the right side were paralyzed and it took several months for them to come back. It's not like I drool even when I'm still, but when I drink through a straw or gargle when brushing my teeth, I can't close my mouth completely, so water flows out. The doctor assured me that I would come back 100%. In fact, 90% came back within ~2 months, but 100% took about a year. Also, there were a few white marks from the Ulthera tip on my skin, which disappeared after a few months. Normally, I can cover it up with makeup. There were side effects like this only with the first Ulthera, and perhaps because the doctor has honed his skills, there have been no side effects since.