Ultherapy – Non Invasive skin tightening with no rivals

Dr. Weiner answers questions about Ulthera

Ulthera (or Ultherapy) was introduced in 2010 in the US.  It uses ultrasound (high frequency) to cause an extremely predictable controlled injury at a certain depth (1.5, 3, 4.5mm depending on the hand piece) and a certain tissue volume.  On the face, the level treated corresponds to the tissue called the SMAS, which is the area tightened during a facelift.  So in essence, the Ulthera is tightening the SMAS without any incisions.  The treated area is tightened and lifted gradually over the next 3-6 months as collagen is laid down in response to the treatment.  Clients will notice a firmer jawline, less turkey neck, elevated cheeks and eyebrows, and less fine lines around the eyes.  The newest hand piece, 1.5mm, is designed for the superficial fine lines around the mouth and eye area.

Almost all the other technology available (Thermage, Affirm, Exilis)  for non invasive skin tightening uses radio frequency (RF) to heat up the underlying tissue to cause a thermal injury.  Although Thermage was the gold standard for years, it’s problem was unpredictable results.  That is because RF needs to heat the tissue to about 41-45 degrees C.  Any more than that, too much damage is caused, and any less, no improvement is seen.  RF requires the treated tissue to conduct the energy through existing collagen fibers, and the conductivity of people’s skin is different, and not predictable.  (As previously stated, Ulthera will lay down it’s thermal injury at the exact skin depth and energy level in ALL PATIENTS similarly.)
The future of Ulthera is exciting.  As experience grows, treatments are becoming more aggressive.  More treatment line, more levels of treatment, seem to be able to create better corrections.  Off the face treatments are beginning on the chest, knees, and soon buttocks.
Keep in mind that Ulthera does nothing to improve the outermost skin (pigment, vessels, texture) and does not create much additional volume.  That is where lasers and fillers are needed to complete the total package of facial rejuvenation.
(We are very fortunate to have recognized the value of Ulthera and were very early adopters.  Sandy, our RN, is a major contributor in the Advance Providers Round Table discussions at the company headquarters.)
Dr. Steven Weiner is a Board Certified Facial Plastic Surgeon practicing in Santa Rosa Beach, Florida, between Destin and Panama City Beach, Florida. After laying down his scalpel in 2005 he has devoted his practice to Lasers and Injectables.Blog: https://stevenfweinermd.wordpress.com/YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Website: http://www.theclinique.net


  1. Donna Pirozzi

    I just had ultherapy done Saturday morning, I had an aggressive treatment done to my neck. I basically had 2 treatments during 1 visit. Today I woke up with my neck sagging worse then before and it actually jiggles. Is this normal?? If so, how long will this last? I look horrible.


    • Swelling can take 7-10 days to resolve.


      • Writer

        I have this same jiggle effect. Did this go away? I look way worse than before the treatment.


      • Hard to say, if swelling, it should get better.



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