ONDA Lifting — When Do Results Show, and How Many Joules Is Right?

What a "joule" is, how long it lasts, whether it works on the arms — in the order people ask

People searching for ONDA type almost the same things: when do results show, how long does it last, 60,000 joules, upper arms, pain. Here are the answers I give in the consultation room, in that order.

ONDA is neither radiofrequency nor ultrasound

ONDA uses Coolwaves™ technology from DEKA of Italy — microwave energy. Where radiofrequency (RF) targets dermal collagen and ultrasound (HIFU) targets the SMAS, ONDA passes through the skin surface and acts on the subcutaneous fat layer and the dermis at the same time. Reducing fat and restoring firmness in one treatment is ONDA's place.

There are two handpieces. The 3 mm treats dermal firmness; the 7 mm breaks down the fat layer. They are chosen or combined by area.

When do results show?

Right after treatment there is an immediate tightening sensation, and the contour begins to look different after 2 to 3 weeks, because fat cells take time to shrink. Results last around 4 to 5 months, and we recommend repeating every 2 to 3 months to maintain and build on them.

The fat cells ONDA reduces do not come back on their own, but weight change and ageing can add new fat or let the skin sag again. That is why we never say "permanent."

ONDA is measured in joules — face 100,000–120,000 J, body 150,000 J or more

ONDA is measured not in shots but in energy — joules (J). Treatment can be divided by joules, and whether the target energy goes in strongly at once or gently over a longer time is the practitioner's decision, made by looking at the patient's face or body area. Because the full target energy is delivered in the end, it is somewhat different from devices that count shots.

ReYeonK's standard is 100,000 to 120,000 J for the face and 150,000 J or more for the body. With too few joules, not enough heat accumulates and the change is weak — so we do not recommend going below this. When combined with Ultherapy, ONDA is sometimes reduced to around 60,000 J and added on.

Upper arms and abdomen too

Beyond the face (double chin, cheeks, deep cheek fat), ONDA is used on the abdomen, thighs and upper arms. Body areas have thicker fat, so the 7 mm handpiece takes a larger share. It is especially useful for fat in places where Ultherapy is awkward to apply, such as a double chin or marionette lines.

Upper-arm ONDA is usually done at monthly intervals, 150,000 J each time.

Does it hurt?

Smart cooling chills the skin surface as treatment proceeds, so most patients have it without anaesthesia. It feels like warmth building to a wave of heat inside the skin. Higher energy can be less comfortable, and the doctor adjusts it in real time. For very pain-sensitive patients, anaesthetic cream is applied first.

It can be combined with Ultherapy and Thermage. For patients who find Ul-Thermage too much, we tend to recommend Ultherapy + ONDA.