Sofwave usage fees rose 60% in one quarter. What does Sofwave tell investors about practice margins?

Who this is for

This is for the physician or medical professional who owns a plastic surgery or aesthetic medicine practice in the US, UK, UAE, and beyond, with self-pay cosmetic patients. Dermatology practices and med spas that offer skin tightening, or are weighing an energy device, are included. Operations leads count too, since they price treatments, manage device contracts, and set the marketing budget.

What we found

Sofwave says US patients paid $2,500 to $3,000 in 2026 for a lower face and neck treatment, and that a practice keeps 70% to 80% of the price as gross margin before overhead. It made both claims in a 2026 presentation at an investor summit held by Jefferies, an investment bank.¹

Sofwave Medical's revenue combines console sales with recurring usage fees, which practices pay Sofwave for the pulses they use in treatment.¹ Inside MedSpa, a trade publication for med spa owners, reported these fees rose 60% to $13.3 million in the third quarter of 2026. That was 47% of Sofwave's revenue for the quarter.²

A Sofwave treatment of the lower face and neck uses 150 to 200 pulses, the company said in the same presentation.¹

The US Food and Drug Administration (FDA) cleared Sofwave's ultrasound device for skin tightening on the face and neck in 2021. In 2023, the FDA added cellulite, acne scars, and upper-arm laxity.^3,4

How much of Sofwave's revenue comes from usage fees?

Usage fees now make up 47% of Sofwave's revenue, the same trade publication reported. Sofwave's third-quarter 2026 revenue was $28.5 million, up 35% from a year earlier, and usage fees rose 60%.² Quartr, a platform that publishes companies' investor materials, reports that Sofwave had sold approximately 3,400 systems.⁵

The first nine months of 2026 show the same pattern. Revenue was $82.9 million, up 41%. Usage fees over the first nine months of 2026 were $38.2 million, up 56%, or 46% of revenue.²

In our view, Sofwave's growth leans more on what practices pay per treatment than on console sales, since fees outgrew total revenue in both periods, which leaves console sales growing more slowly. The fee total rises with more treatments on systems already sold and with any rise in what Sofwave charges per pulse, and the reported total combines the two.^2,1

Sofwave's earnings release, carried by Yahoo Finance, put its third-quarter gross margin at 76.6%. Gross margin is the share of revenue left after the direct cost of what was sold.⁶

For more about what another energy device costs a practice, see fractional laser costs.

Which skin treatments is the Sofwave system cleared by the FDA to perform?

The FDA cleared the Sofwave system in 2021 for the lower face and neck (clearance number K211483). The route was premarket notification. That is the FDA's review of a device shown to be substantially equivalent to one already on the market.³

The 2021 clearance covers treatment "to improve facial lines and wrinkles, lift the eyebrow and lift lax submental (beneath the chin) and neck tissue." It applies to patients 22 and older.³

The FDA's 2021 letter names the device the SofWave System and lists it as a focused ultrasound stimulator system for aesthetic use.³ Sofwave calls the technology inside it SUPERB, short for Synchronous Ultrasound Parallel Beam.⁷

A second clearance, K233104, issued in December 2023, added three uses, and one is "short-term improvement in the appearance of cellulite." The others are "skin laxity on the upper arms" and the treatment of acne scars.⁴

Sofwave announced the acne scar clearance in August 2023, with results from its own study. It treated 67 subjects, and after three sessions, 97% showed improvement in acne scar appearance as judged by masked (blinded) evaluators. The average improvement was 46% relative to baseline acne scar severity. Of the subjects, 88% reported that their acne scars looked better.⁷

What does Sofwave say a practice keeps from each treatment?

Sofwave says a practice keeps most of what a patient pays for a treatment. Its 2026 presentation at the Jefferies investor summit cited practice gross margins of 70% to 80%. Here, a practice's gross margin is the share of the treatment price left after direct costs, so it leaves out overhead such as rent and salaries.¹

In 2026 the same presentation states a US patient price of $2,500 to $3,000 for a treatment of the lower face and neck.¹ The margin and the price both come from Sofwave, describing its own typical customer.

What do patients report paying for Ultherapy, a rival device?

On RealSelf, a site for reviews of cosmetic procedures, patients reported paying $2,609 on average for Ultherapy, a rival technology to Sofwave, across 848 reviews, as of 2023. Costs in those reviews, as of 2023, ran from $1,000 to $5,000. These prices are patient-reported, so they may differ somewhat from what was paid, since a review gives the price as the patient recalls it.⁸

The site's 2023 guide to cosmetic procedure costs lists a different Ultherapy average, $2,650, with a range of $500 to $4,500.⁹

While the prices above are for Ultherapy, in our view what patients pay for this rival device affects what a practice can charge for Sofwave. Because the usage fee follows the pulse count, it does not move with the patient's price. A lower price then leaves the practice less of each treatment after the fee, as it would with any device maker that charges by use.¹

What we would do

1. Before signing, we would have the practice's lawyer check the Sofwave contract for minimum pulse purchases and any terms that allow fee increases. That review decides whether usage fees can climb after the console is paid for.

2. For the first months, we would log the pulses fired in each treatment, by area. Each pulse adds to the practice's usage fee, so a treatment that runs above Sofwave's stated range costs more than one inside it. If the counts run high, we would look at technique first, and raise the price for that area only if the extra pulses are part of the result patients come for.

About this review

We read nine sources in November 2026: one trade press report, Sofwave's third-quarter earnings release, two investor platform pages on Sofwave, two FDA clearance letters, two RealSelf cost pages, and one Sofwave press release. No number in this piece mixes two publishers' data, and each is credited where it appears.

The Sofwave revenue and fee data cover the third quarter and the year to September 2026, as the company reported them in November 2026. The investor presentation dates from 2026. The FDA letters date from 2021 and 2023. RealSelf pages report patient-reported Ultherapy costs as of 2023, while Sofwave's acne scar study covers 67 treated subjects.

Fractional Aesthetics is a growth strategy practice for aesthetic medical businesses.