Written by Dr. Viktoryia Kazlouskaya, MD/PhD, FAAD
As the owner of a small dermatology practice, I test every technology we offer. I try it on myself and our team before we share it with patients. We have owned and used the Sofwave device for nearly three years.
This article shares our real, professional experience. It shows what really works, who benefits the most, and what results look like—without any hype.
Why We Brought Sofwave Into a Dermatologist-Led Practice
Sofwave was one of the first energy-based devices I considered bringing into my practice. At that time, I wanted a technology to solve several issues. These included early skin laxity, soft jowls, neck aging, slight brow descent, and overall facial and body rejuvenation. I wanted a solution that did not require surgery or downtime.
Sofwave is marketed as addressing a wide range of concerns, which initially made us cautious and prompted hands-on evaluation rather than reliance on claims alone. As a dermatologist, I never rely on claims alone. We needed to see whether these promises translated into real, clinically meaningful results.
Before we made a decision, we asked an official company to bring the device to our office. I also tried the treatment myself. I noticed an almost immediate lifting effect—subtle but clearly visible—and even received compliments the same day.
That initial improvement was largely due to heat-induced tissue contraction and temporary skin response. Over the next few months, longer-lasting changes occurred. Collagen remodeling took place, leading to a more lifted and refreshed look.
I often compare the effect to the look from several syringes of dermal filler. It is more natural, gradual, and done without needles.
What We’ve Learned After Treating Patients for Nearly Three Years
Who Gets the Best Results
In our experience, we see the best results in patients aged 30 to 50. This is true for those with mild to moderate skin laxity.
We also see interest from younger patients seeking preventive collagen stimulation. In Korea, doctors usually use similar treatments that combine 2-5 treatments and perform them in one day. In many of these cases, treatment may not yet be necessary, and we actively discourage unnecessary interventions. However, when early laxity or subtle sagging is already visible, Sofwave can be an excellent option in younger patients.
Who May Not Be the Ideal Candidate
Patients with serious skin sagging and loose skin may not be happy with skin tightening procedures, like Sofwave. They are often better suited for surgery. Sofwave does deliver on its promises, but it is not a “one-and-done” solution. One should not expect it to fix advanced aging changes by itself.
The best results happen when Sofwave is part of a careful plan. This plan can include medical-grade skincare and other treatments like Botox, fillers, or biostimulatory injections.
The Importance of Expectations and Consultation
Expectations matter greatly. Many situations often require maintenance treatments and combination approaches.
For this reason, we strongly discourage scheduling Sofwave—or any aesthetic procedure—without a proper consultation. It is easy to get caught up in trends from friends or celebrities. However, the most popular treatment is not always the best choice for each patient. A consultation, though a small upfront cost, often saves patients time, money, and disappointment in the long run.
How We Address Discomfort During the Procedure
We strongly recommend that patients see a board-certified dermatologist for the Sofwave procedure. If there is pain, a provider who cannot prescribe medication, like an esthetician in a spa, may not help. This can lead to less energy used during the Sofwave procedure and unsatisfactory results.
Over time, we have developed a structured comfort strategy:
- We schedule sufficient time so the experience never feels rushed.
- A clinician applies a strong topical numbing cream 40–60 minutes before treatment.
- Oral medications (both prescription and over-the-counter) are available to address pain and anxiety when appropriate.
- We also offer nitrous oxide (laughing gas) to promote relaxation during the procedure.
Side Effects and Safety: What We’ve Observed
Over nearly three years of use, we have not observed any serious adverse effects associated with Sofwave.
In a small number of patients, we have observed mild, localized redness or small, swollen bumps after treatment. These typically last one to two days, are barely noticeable, and resolve completely without intervention.
Patient Satisfaction and Long-Term Engagement
The majority of our patients are satisfied with their results. Approximately 90% return for maintenance treatments. Most are busy professionals who value:
- No downtime and recovery time
- The ability to continue normal schedules without interruption
- Gradual, natural-looking improvement
- Great for all skin types, including melanin-rich skin
These factors are central to why Sofwave remains a popular choice in our practice.
Special Considerations: Weight Loss and Skin Laxity
In today’s world of wellness and medical weight loss, skin-tightening treatments like Sofwave are becoming more important. Patients who use weight loss medications like semaglutide or tirzepatide often lose fat quickly. This fast weight loss can cause skin to sag and become loose.
Sofwave uses ultrasound to tighten skin with heat and fibroblast stimulation. It works well in these cases, often together with dermal fillers or biostimulatory injections.
Ideally, patients should perform Sofwave after stabilizing their weight loss. Treatment during weight loss can still be suitable. However, keep in mind that weight changes may hide results. This may require more frequent maintenance sessions.
How Our Sofwave Protocol Changed Over Time
Using Sofwave for many years has taught us something important. The results we get depend more on how we use the technology. They are less about the device itself.
Early in our experience, we treated Sofwave as a standalone tightening procedure. Over time, patterns emerged that refined our protocol.
We learned that treatment density, energy selection, and pacing are crucial factors. Rushing sessions or under-treating due to discomfort often led to suboptimal outcomes. This showed how important it is to manage pain well and give enough treatment time. This lets us provide energy effectively instead of holding back.
Another key evolution was sequencing. We found that Sofwave produces more consistent results when placed strategically within a broader treatment plan.
In some patients, tightening first helps create a better base before adding volume. In others, fixing volume loss or muscle activity first improves the final tightening effect. There is no universal order — individualized planning became essential.
We also recognized that maintenance timing is as important as the initial treatment. Patients who return before their skin gets worse usually maintain better shape and skin quality.
Perhaps most importantly, experience reinforced restraint. Not every patient needs Sofwave immediately, and not every concern requires or should receive treatment with tightening alone.
Saying no — or recommending a different approach — ultimately leads to better outcomes and higher long-term satisfaction. We might not suggest Sofwave in certain situations. This includes cases of severe skin laxity.
It also applies if expectations are too high. Additionally, if another method would be more effective, we may not recommend it. Honest guidance is part of responsible care.
Why Sofwave Fits the Upper East Side Patient Profile
In our Upper East Side practice, many patients are professionals with demanding schedules, public-facing roles, and a preference for subtle, refined results rather than dramatic change. For this population, treatments must integrate seamlessly into daily life without visible recovery or disruption.
Sofwave aligns well with these priorities. Patients appreciate that tightening occurs gradually, preserving facial identity while improving contour and skin quality over time. The absence of downtime allows treatments to be scheduled around work, travel, and social commitments without planning recovery periods.
We also find that this patient group values thoughtful, conservative treatment planning. Sofwave often serves as a foundational procedure that supports long-term skin health rather than a one-time corrective intervention. When paired appropriately with injectables or skincare, it allows for natural-looking maintenance that evolves with the patient rather than chasing trends.
This emphasis on discretion, consistency, and longevity is a key reason Sofwave continues to resonate with our Upper East Side patients.
