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Is Pelleve or Ultherapy Better to Tighten Skin?

I have a thin face and am looking for tightening around the mouth and lower face.

Doctor Answers 14

Pelleve and Ultherapy work on different levels of collagen, so they are both good!

I describe these treatments, along with Botox and fillers, to my patients as a Peanut Butter and Jelly sandwich laying on a plate.  The Pelleve works on the top layer of the skin (the top bread), the Fillers and Botox work in the middle, like Peanut Butter and Jelly, and the Ultherapy works on the lower most level (below the fat) like the lower level of bread.  

There is no way to affect all these areas with just one treatment, so this is a huge benefit to doing all of these together.  

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Ultherapy vs Radiofrequency (Pelleve) for skin tightening

I think there is a place for both, and we offer both treatments.  I have more faith and confidence in Ultherapy for deep tissue tightening because of the focused depth of treatment.  Pelleve is working via a bulk heating strategy.  This is helpful in some areas that are to delicate and not as well treated by Ultherapy such as lower and upper eyelids. 



Arthur N. Falk, MD
Albany Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Pelleve` Versus, Ulthera Which Better Tightens the Skin

Hi Manny,

Ulthera is the only treatment that delivers precise energy at the levels necessary to both lift and tighten the muscles and skin of the face, neck, and eyebrows. Ultherapy uses micro focused ultrasound energy to create deep heat that results in immediate contraction as well as long term new collagen production. In a single treatment Ulthera can accomplish much more than multiple treatments of other radiofrequency technologies such as Pelleve`, Exilis, Accent XL, and Thermage. Good luck and be well. 

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Ultherapy or Pelleve

Both procedures act to induce new collagen formation.  We evaluated both devices and elected to add Ultherapy to our practice because it was more precise.  That said, we do not treat the lips because the tissue is too thin in this area.   A new hand piece will be available for the lips later this year.  You can wait or you may want to look at a laser resurfacing procedure as an alternative for skin tightening of the upper and lower lips.

Joseph Campanelli, MD
Minneapolis Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Pelleve or Ultherapy?

Ultherapy is generally performed as a single treatment wherein intense-focused ultrasound creates intense heat very quickly in the treated area of skin.  Pelleve treatment is given in several sessions, and within each session five passes of the treated area are performed, bringing the temperature of the skin beneath the surface to the same endpoint temperature as with Ultherapy.  The reason Pelleve hurts less is probably because the temperature is brought up slowly over a period of minutes rather than instantaneously with each pulse. At the target temperature of 65 to 70 degrees Celcius within the skin, immediate tightening ocurs, and fibroblasts are stimulated to produce increased amounts of structural proteins over the ensuing months.  

Both are effective, and each has advantages in terms of more or less pain, more or less time or money required. I have personally seen more reproducible results with Pelleve, ie every patient seems to get better, whereas the results with Ultherapy can be great but are a little unpredictable.

i hope this helps!

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 3 reviews

Ultherapy vs. Pelleve

While both treatments help with wrinkle reduction (and are effective), they are very different. 

Pelleve uses radio frequency to tighten the skin.
Ultherapy uses ultrasound technology to physically lift the skin - almost like a noninvasive face lift.

The Ultherapy goes down much deeper into the dermis - 4mm while the Pelleve barely hits 1.5mm.
Three sessions of Pelleve treatments are needed to see optimal results while only one session of Ultherapy is needed.

San Antonio TX

Sanjiv Kumar, MD
San Antonio Ophthalmologist
5.0 out of 5 stars 2 reviews

Ulthera for the lower face - Los Angeles

Ultherapy provides very effective improvement in the lower face and neckline. I use the procedure to address sagging skin and muscle fascia. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 57 reviews

Ultherapy vs. Pelleve

Studies have shown that Ultherapy treatments provide optimal results. Through our own experience with skin tightening, we choose to use the Ulthera skin tightening system.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Ultherapy and Pelleve

Both of these procedures work well.  Ulthera is the one time treatment and Pelleve works with a series of treatments.  Ulthera may be a bit more painful than Pelleve, but new protocols have made the ulthera treatments much more tolerable.  So both work – as do most of the RF therapies for skin tightening and ultrasound therapy like ulthera.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.5 out of 5 stars 10 reviews


In general, most non-surgical skin tightening treatments require multiple session. What makes Ultherapy unique is that it can achieve results in as little as one treatment. Of the non-surgical treatments available, we currently only recommend Ultherapy. None of the other technologies, and we have used and have access to them all, have compared to the results we are seeing with Ulthera. See a board certified facial plastic surgeon to see if Ultherapy is right for you.

James Chan, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.