Since Ultherapy has become so successful (and used by some celebrities) a number of copy-cat versions have appeared. None of these have been approved for use by the FDA and none have the ability to allow your practitioner to see before they treat (which is an important safety feature).
Because none of these other machines have been cleared by the FDA their ability to create the correct and precise targeted heat is unknown. If a treatment cannot create the correct level of heat to initiate the collagen and elastin production process it may feel virtually painless.