Background: High intensity microfocused ultrasound Ulthera@ is expanding to be used for consistent significant lifting of upper and lower face tissue in a broad range of patients. Extensive research pipeline support expanded indications i.e. face, upper eyelid & neck lift, lower eyelid tightening& the improvement of dark circle, breast lift, and body tightening etc. Objectives: Advantage of ulterapy is no need to incision, therefore, no bleeding, no downtime, safe to expose to sun immediately after procedure. Main target of ultherapy was deep dermis and fascia especially retaining ligaments which make the skin firm and lifted effectively. Methods: To compare noninvasive ultherapy and facial lift surgery Results: Ultherapy revealed the upward elevation of fat sagging, and producing the mandibular V line(Nefertiti line). High intensity microfocused ultrasound can make fat atrophic, which makes mild lower bulged eyelid fat reduced. Vector of direction of lines can also affect the results. Conclusion: In respect to skin anti-aging, ultherapy works as like main H beam of the building construction, and other anti-aging procedures like radiofrequency, botox and filler will work synergistical for fine refinements. It can also contribute to prevent the future aging process by stabilizations of aging skin structures. I will explain strategies like ‘Double U, W Theory,’(Whang’s suggestions) for better understanding and performance of ultherapy in this presentation.