Will Ulthera Cause Damage to Facial Nerves?

The basis of Ultherapy is use of focused ultrasound waves to cause deeper tissue neocollagenesis and subsequent soft tissue tightening. Ultherapy is also a very safe treatment and permanent injury to sensory or motor nerves is hard to imagine. The only possible way this could occur is via pulse stacking, which should not happen in the hands of an experienced Ultherapist.

There have been no permanent problems with nerves reported by the company to-date.  There have been temporary areas of sensitivity along sensory nerves such as the forehead nerves that transmit sensation from the scalp and some scalp paresthesias were noted to occur but spontaneoulsy improved.  The marginal mandibular nerve along the front of the jaw near the chin can cause a temporary weakness in pulling down the corner of the mouth when trying to open fully. This neuropraxia has been reported rarely to occur and has been self limiting, but caution is now taken not to treat that area of the jaw and lower cheek right near the chin.

Overall, Ultherapy has proven its safety via the numbers of procedures done.

I have done Ultherapy since 2011 in hundreds of patients.Key point to remember is that if the patient is experiencing undue pain or tingling while the procedure is being done, the energy setting should be reduced to prevent the likelihood of these problems in 2 areas:1) over the brows especially if the patient feels tingling and pain shooting over the scalp and forehead2) near the jawline for the marginal mandibular branch of the facial nerve. Surgical anatomic pearl : The relation of the marginal mandibular branch of the facial nerve with the inferior border of the mandible is extremely important. The marginal mandibular branch of the facial nerve is always above the inferior border of the mandible while anterior to the facial artery. Read the Ultherapy book provided on the link below. 

Thank you for taking the time to ask your question.  The nice thing about Ultherapy is that the depth of the treatment is controlled by which transducer is used.  When treating the deeper layers of the skin, injury to the facial nerve should not occur since the energy of the delivered treatment is on the surrounding fascia of the muscle.  In the face, the nerve is usually much deeper and innervates the muscle from its underside and therefore should not be affected.  Granted proper technique should be used.