Can Nerve Damage from Ulthera Be Permanent?

There have been no cases, to-date, of which I am aware of permanent nerve weakness induced by Ultherapy.

Nerve weakness could occur from heating a nerve if the energy delivered is in the area of the nerve.  The nerve may then hibernate and take a few weeks to recover. Meanwhile, muscle weakness could cause a failure of the corner of the mouth to lower when the whole mouth opens, making it look like the other side is drooping. This is from temporary irritation of the marginal mandibular nerve and so the area in which the nerve becomes less deep near the corner of the mouth is not treated with the deep-reaching transducers, but doctors have been able to use, off-label, the new 1.5mm superficial transducer with a greater treatment area while they avoid the 4.5mm. deep transducer in the avoidance zones.

 

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. If you are experiencing a medical emergency proceed to your nearest emergency room.

 

One of our providers just returned from the
Advanced Training Seminar by Ulthera. The most updated information from
the company reports that in 500,000 treatments, globally, there have been no reports of permanent nerve damage. The are reports of rare, inflammation
of the nerve, which has always been transient. This inflammation can result in a variety of symptoms such as numbness and tingling or weakness around the mouth. We have found this to be a very
safe procedure with very minimal side effects.

I have done Ultherapy since 2011 and have never seen this complication, although it is described with aggressive use. Typically, the physician is alerted to the problem because the patient will complain of excessive pain or sharp pain in the area. When this occurs, either energy settings are reduced or the transducer is switched to 1.5 mm to avoid this problem. In any case, if it does occur, it will be temporary and resolve spontaneously.Read the Ultherapy ebook provided on the link below. 

Ultherapy treatment is delivery of ultrasonic energy through the skin.  I have personally never seen a motor nerve injury with Ultherapy.  Cutaneous nerves are more likely to be affected with a feeling of "pins and needles" or temporary soreness in the distribution of the nerve. Again, these effects have been temporary. I personally had an Ultherapy treatment at had a slight tingling sensation in one side of my lateral brow area that lasted approximately one week.  I also routinely perform Vaser liposuction which is a higher energy ultrasound treatment delivered below the skin with a probe directly into the tissues followed by liposuction.  In this treatment, any nerve effects have always been temporary, whether they have been motor or sensory.  I believe that the Ultrasound technology is very safe in both of these circumstances.

Ultherapy uses focused beams of Ultrasound to cause microscopic trauma to soft tissue underlying the skin in order to stimulate scarring, otherwise known as collagen formation. As the scar or collagen contracts, the face is lifted and skin is tightened. Any chance of temporary injury to a facial berve is extremely rare, and permenant deficit has never been reported.

 

The nerve injury caused by Ulthera has been temporary.  It is usually a weakness rather than a true injury and generally resolves within a few weeks. There are new 1.5 mm transducers available that allow close treatment  around the mouth without the risk of the energy penetrating too deeply to affect the nerve which causes the corner of the mouth to droop.