Ultrasharp is great for anything not photo realism, in other words images without sharp edges. If you want photo realism use NMKD Superscale or NMKD Face.
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Unzip in this folder: Stable-Diffusion\stable-diffusion-webui\models\ESRGAN
Don't use extra tab, instead use hiresfix in text2img, or use SD Upscale alt Ultimate SD Upscale ( I have not tried Ultimate) in img2img tab. You can find it in script menu. SD Upscale is very similar to hiresfix in that it generates new pixels that increase the quality of the image while upscale in extra tab only makes the image larger without any improvement in actual quality.
You could even get a decrease in quality if you use the wrong upscaler. The pro of SD Upscale over hiresfix is that it uses tiling.
The resolution you set in img2img tab sets the tile size and the multiplier how large the image will be in the end. This means that you can get a better result faster with less vram. The con is that you can't control how many steps it will use, like you can with hiresfix. It's a big pain that it takes so long to use hiresfix and it also is limited by your vram. I think that you preserve the image better with hiresfix and get potentially a better result. I'm not so sure about this anymore though as I used to be. Good testing has to be done. I don't know the difference between SD Upscale and Ultimate SD Upscale since I have only used SD Upscale so far. If you do widescreen images like I do with latent couple SD Upscale is a must. I have tried hiresfix, it does work but it's problematic and takes even more time than usual for some reason.
I don't see the benefit in doing upscaling 2 times. I would need to see convincing evidence first to believe this.
You could at least get to 4k easily with SD Upscale in one go without it taking ages. Just set the tile size small enough.
Example: You could generate 480 x 720 and then use SD Upscale with multiplier set to 3 and get 1440 x 2160. Technically this is a portrait format image in 4k. If you use the very common 512x768 and multiply by 4 you will get 2048x3072 wich is technically almost 6k in portrait format. It's the height that matters in the name "k" in a portrait image since it's ap a 3rd of the width of the widescreen image of the same height. Ok sorry for the long rambling post I hope I made my point clear enough.