How painful is Ulthera? Is it very painful?

I'm considering getting Ultherapy this time to refine my facial contours and improve my skin elasticity!

I've heard so many people around me say that while Ulthera is definitely effective, the pain is intense.

There are reviews saying that the bones tingle and it feels unpleasantly hot and painful from deep inside, and some people have said that they absolutely cannot undergo the procedure without general anesthesia.

On the other hand, some people say they could tolerate it with just anesthetic cream, so I can't set a standard.

Honestly, I am curious about the level of pain and whether it is necessary to undergo the procedure under general anesthesia.

I want to mentally prepare myself before going to the dermatologist, so I would be really grateful if those of you who have actually received Ultherapy could honestly share how the pain was!