Difference Between Ultra Sound Face Lift and Fraxel Repair Laser Treatment?

Dear Brookhaven: This is a common question in the mind of many patients who want to deploy their hard earned resources in getting the best result.  Comparing the Fraxel Repair (FR) versus other skin tightening treatments (like the Ulthera) is tough because they treat different things and have different downtimes. The FR works very well to rejuvenate the surface of the skin, but can have 3-6 downtime depending on the treatment levels.  The ultrasound technology attempts to tighten the deeper skin tissues and has NO downtime, but is somewhat painful.  Another more established non-invasive deep skin tightening technology with a similar goal includes the Thermage which is designed to tighten deep skin.  In theory, we would like to use both in synergy to rejuvenate the entire face.  Now, it is really a bit too much marketing to call the Ulthera, "an ultrasound facelift" device...subtle facial tightening- maybe, slight reduction in facial sagging volume - maybe, looking a bit better-yes, noticeable facial tightening - I have not seen it or heard of it, as of yet.  Again, the Ulthera is relatively new device, so I cannot definitively comment until I see more results.  In contrast, the changes with the FR are much more noticeable where almost all patients see a reduction in:


Fine lines around the eyes

Some of lines around the mouth

More even skin texture and color

Reduction in freckels, red spots, etc.

Improvement of skin acne scars and lines

Skin looseness / laxity


The main negatives with FR are the downtimes involved and the need to numb the face.  But for those who have funds for only one procedure to look better, I would steer most towards the FR and generally away from newest (think marketing) not yet fully proven technology platforms. 

Hope this of help, Dr. Vartanian

Fractional resurfacing is best suited to treat fine wrinkles and discoloration of the skin while focused ultrasound treatments are intended to tighten and contour the skin.  Ultrasound treatments do not address skin color changes.  There is no recovery period after ultrasound treatments whereas approximately 1 week of recovery is needed after ablative fractional resurfacing treatment.  These treatments tend to be complementary as opposed to competitive.  That is to say, many patients can benefit from both of these treatments.

Resurfacing for lines around the lips improves these lines but the lines will not usually go away completely. The best results are obtained with laser resurfacing but it does take a week or more to heal and there is a risk of scarring. Fraxel Repair, non-fractional carbon dioxide laser and Portrait plasma therapy can be done but all do require at least a week to heal. Tightening procedures with radiofrequency, such as Thermage, do nothing to help the surface lines. Often patients undergo both and can do the Thermage the same day and immediately preceding the Fraxel laser.  Fraxel Restore can be done in a series of multiple treatments with minimal downtime and no need to stay at home, unlike the Fraxel Repair, but the results are not expected to produce as good a dimunition of wrinkles of the lips.