Comparing Infini to Ulthera and Why Infini’s Technology is Superior for Laxity, Wrinkles, and Acne Scars

When it comes to skin tightening and wrinkles, there has been an increasing trend for the consumers to choose the less invasive approaches and opting out of surgery. Although results aren’t as dramatic, nonsurgical treatments offer less downtime, less risk, and less cost. These treatments are great for the people who are not quite surgical candidates because of very mild signs of aging as well as those that just want to delaying the sagging before it is even apparent. Then there are those who really are surgical candidates but can’t afford the downtime or are concerned about the looks of some of their peers who have had face/neck lifts.

The most recognized name for noninvasive skin tightening currently is Ulthera (Ultherapy). This technology uses highly focused ultrasound to cause a thermal coagulation zone beneath the skin without affecting the surface. This technology is akin to the one used to break up kidney stones or gall stones with ultrasonic energy (lithotripsy). The coagulation zones elicit an inflammatory response leading to collagen stimulation and contraction. This results in tissue tightening and wrinkle improvement. Ulthera was brought to market in 2009, with Dr. Weiner being one of the first 20 adopters in the US. Dr. Weiner has had significant experience with this device and with all the changes in protocols.

In 2013, the Infini was FDA approved and introduced in the US. This was a novel technology for the US, but it had been used in Asia for at least 1.5 years prior. Infini uses radiofrequency attached to microneedles to cause similar thermal coagulation zones as the Ulthera, below the surface of the skin. Dr. Weiner is the largest user on the Infini in the US and now lectures and precepts other physicians in it use.

The similarities of the 2 technologies:

  1. Both are fractional treatments (only treat a portion of tissue) which is safer and leads to faster healing.
  2. Both can treat at multiple different levels. While Ulthera is restricted to 3 levels, it is not uncommon for Dr. Weiner to treat at up to 5 levels with the Infini.
  3. Both have very little downtime – Ulthera has potential for bruising but otherwise no downtime. Infini has about 24-36 hours of redness and swelling. There are no activity or sun restrictions for either treatment.
  4. All skin types can be treated with both technologies.
  5. Both can be performed in the office with just topical – Patients who have had both technologies report that Ulthera had more discomfort in Dr. Weiner’s office.
  6. Both can improve skin laxity, particularly in the jawline. It is Dr. Weiner’s opinion that this is primarily due to fat destruction by both technologies. Both can reach into this layer (the Infini only if desired, Ulthera almost always by default with the deeper transducers).
  7. Both mechanisms of tightening are similar – create a controlled injury that leads to tissue contraction, tightening, collagen stimulation BUT the way the injury is produced is different.
  8. Both can be safely off the face – neck, chest, extremities, under arms (hyperhidrosis)
  9. Both are extremely safe technologies with very little side effects and don’t use lasers (so safer for the eyes).
  10. Both have better results with multiple treatments. Although Ulthera states one treatment is needed, the experience Dr. Weiner had with the technology was that better outcomes were seen with multiple treatments.

Comparing the differences of Infini versus Ulthera:

  1. Infini treatment of the face/upper neck lays down over 50,000 thermal coagulation zones VS Ulthera’s 16,000. It only makes sense that the more zones, the more results.
  2. Infini depths can be adjusted from 0.25 mm to 3.5 mm in increments of 0.25 mm. Ulthera has 3 depths: 1.5, 3.0, 4.5 mm. Using the ultrasound of the Ulthera, Dr. Weiner was able to measure skin depths over the face and neck. There were no areas of skin thickness greater than 2.5 mm in the entire face and neck (except in very thick skinned males in the upper cheeks). Therefore, MOST OF THE TREATMENT FOR ULTHERA IS BELOW THE LEVEL OF EVEN THE DEEP DERMIS. Only the 1.5mm transducer causes coagulation in the dermis. This is not included in most protocols, or if it is, is only a minor component. Studies have shown that the area of greatest collagen formation is in the deep dermis. Infini is able to lay the coagulation zones all throughout the dermis, including the deep dermis because of its ability to change it’s depths. The Infini can even treat different areas of the face at different depths, which is important because the face has significant variability of thicknesses between the forehead, eyes, cheeks, lips, jawline, submental, and chin area. Depths below the dermis injure the subcutaneous tissue, which is mostly fat. Fat is what we want to preserve, not destroy, except along the jawline and submental area.
  3. The treatment cost (consumable) of Ulthera for the physician is more than 10 times greater than for the Infini. The purchase price to the physician is also about 50% more for the Ulthera. The treatment time is also longer, sometimes up to 50% more for Ulthera. This all gets passed on to the patient resulting in Ulthera being about double the price of the Infini in most offices.
  4. Although Ulthera touts that deeper penetration causes contraction of the SMAS, to Dr. Weiner’s knowledge, this has yet to proven histologically. The deeper penetration does lead to more discomfort as well as potential for fat destruction. The Infini targets the dermis, particularly the deep dermis, the area for maximal collagen creation.
  5. Results seem to be more consistent with the Infini versus Ulthera. This seems to follow the science. More coagulation points in the correct zone of the dermis should lead to more collagen, more tightening.
  6. Superficial fine lines can be treated with the Infini but not Ulthera. In certain cases with skin type 1-3, shallow treatments of less than 1 mm can be used to treat these wrinkles and etched in lines. Ulthera doesn’t have this capability.
  7. Although there are some reports of Ulthera treating acne scars, Infini seems to be the best technology to treat these. It is probably the combination of the microneedles, RF energy, and adjustable depths that make it a superior technology to treat this difficult problem.

From about 2005 – 2009, Thermage was the most advanced noninvasive skin tighten device. This was replaced with Ulthera in 2009, which offered better, safer, and more predictable results because of precisely placed coagulation zones (albeit, maybe too deep). In 2013, Infini was introduce and it has been slow to catch on. However it is finally being adopted by the key thought leaders in the Aesthetic Industry. It will soon be recognized as the most efficacious noninvasive skin tightening technology on the market.

Blog: https://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Website: http://www.theclinique.net

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24 Comments

  1. My friend had Ultherapy almost 3 weeks ago and still suffering paralysis droop on the right side of her mouth. It has improved over the weeks but still noticeable when she talks, drinks or eats.
    The office initially gave her antibiotics to reduce the serious swelling. They said it would subside over the next week but she is still waiting for things to return to normal.

    • This is an error with technique. Antibiotics will do nothing to improve, steroids might. I haven’t heard of any permanent problems with this, so it should get better, but it can take months, not weeks.

  2. Sandra Meyers Snabl

    Has infini been used successfully for vertical chest wrinkles?. My doctor said the skin there is not a good candidate because it does not have hair follicles. She is planning to do infini for my neck and lower face and then switch to bbl for the chest. She lost me with that line of reasoning. What is your thought? Thank you!

    • It can be used in the chest with great results. She’s referring to sebaceous glands. It is fine to use there, better than BBL.

  3. Dr., thank you for the excellent post. I just had Ultherapy done a week ago so I wish I would have had this information prior to that. My questions is, can Infini be used after Ultherapy has already been done? Instead of going for multiple treatments of Ultherapy is it best to switch to Infini? Thank you.

    • I think Infini gives better results. It is no problem with switching.

  4. I had the Infini Thermirf micro needling procedure on Monday, Auugust 24. Five days later, I am still experiencing track marks and hundreds of obvious microneedle marks on my cheeks and neck. The area below my chin – my area of concern – is even more loose than it was pre-procedure. Thoughts?

    • These should improve. Results take several week or months. Swelling can make things look worse before they get tighter.

  5. Mei Huang

    Dear Dr, thank you for your posts, very helpful! I have done my ultherpy treatment 10 days ago. I wish I would have read your comments before that treament! Now I start to get worry about the fat loss. I hadn’t been told by my doctor about the ulterapy could cause fat loss. Is the fat loss going to happen to all the people who had ulterapy treatment? If not, How soon I would notice weather I have fat loss after the ultherpy treatment? Will my fat rebuild by time by itself if unfortunately it loss because my ultherpy treatment? I am looking forward to hear from you. Thank you very very much!

    • There hasn’t been much fat loss reported. I wouldn’t worry. If it does occur, it won’t grow back, but fillers can improve. Fat loss is needed for better jawline and submental contouring though.

  6. Maryam

    My doctor suggested infini sessions for my genital acne scars that left hypopigmentation scars and on my buttocks which have hyperpigmented acne scars. I was wondering if infini is safe for the genital area and the butt checks?

  7. Kim

    I had ultherapy done almost a year ago on my lower face and neck and I lost fat. My skin looks worse, more sagging, and my doctor agrees. They have offered a series of 3 Infini sessions to try to improve the sagging. I am wondering if I should tell them to not go as deep with the Infini so that I do not lose more fat. Your thoughts?

    • This all boils down to the science of these technologies. Ulthera goes deeper than the dermis in their 4.5 and 3.0 settings. This is the layer of fat. Infini is adjustable in its depths and shouldn’t go that deep during the treatments. There are no documented cases of fat loss besides the one person on Realself who has never shown before and after photos and has had other technologies to treat her face including Exilis (which has uncontrolled depths). Infini is safe regarding fat loss. Other RF devices which can’t control depths are not safe, such as Thermage, Exilis, Venus Freeze, Thermismooth.

      • Kim

        Thank you for your quick response. My doctor said she has never seen the negative results that I experienced based on my before and after photos. It’s bad enough that they are treating me with Infini for free. I am hoping for better results.

      • It is possible with Ulthera as previously explained. They use depths that in my opinion are too deep.

  8. Tiffany.K

    Dear Doctor, I had Ulthera just over 2 years ago, do I need another one? My skin appeared some sagging around the eye area. Can Ulthera be done after Thread lifting Therapy?

    • I don’t think Ulthera is the treatment of choice for the eye area. I would rec laser resurfacing or Infini for this. I would wait 3-4 months after PDO threads to do either Infini or Ulthera. Laser is fine to do.

  9. Hi Dr. Weiner,
    Would you recommend thermitight, ultherapy, thermage or infini for body skin laxity?

    I really really appreciate these reviews. I went to my local skin clinic almost stating your advice word for word in argument to have infini on my stomach, legs and arms as I lost 25kg and suffering from milk skin laxity as I’m still only 22.
    She turned me away saying the area was too big and I’d have better luck with thermage or ultherapy. I saw on your website you suggested to a woman to go for Themitight for her post pregnancy cheese grater stomach-I was curious as to why you didn’t mention infini? Mine is nowhere near in that severity, however, I would like to achieve a youthful look for my age.

    • Large areas are difficult to treat with Infini. The footplate is only 1x1cm. Larger areas are better treated with Thermi or the new Skintyte.

      • Not Skintyte, RFAL it is called.

      • Thankyou so much for getting back to me 🙂

Trackbacks

  1. Most Frequently Asked Questions about Infini, RF Skin Tightening from Lutronic | stevenfweinermd
  2. Infini vs. Ultherapy | Aler SM | Innovación en Tecnología Láser

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