What is the Best Prescription Pain Med for a Ulthera Treatment for Full Face and Neck?

What is the best prescription med for an Ultera treatment for full face and neck? Is numbing cream and a dental block necessary? I have a low pain tolerance, so I have a lot of concern about this painful treatment. I have had 2 thermage treatments years ago. They were very painful and even after receiving a lot of meds. Thank you for your help.

Doctor Answers (13)

Pain Management for Ultherapy


Before we acquired our Ultherapy unit, both my partner and I underwent treatments.  I can tell you from personal experience that the procedure stings.  We both completed our brow treatments without any medication but it took twice as long because we had to stop multiple times.  After the treatment, the discomfort is gone immediately.  We have not had a single patient require pain medication after the procedure.

During the treatment, we generally offer our patients either injections or sedation.  We have had several patients that have requested that they try the procedure 'without anything' and all of them have requested local anesthetic to finish the procedure.  If you are hesitant to have injections, we have found that a combination of a sedative and oral narcotic to work very well as an alternative.  Hope this helps; good luck with your treatment.

Minneapolis Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Pain medication for Ulthera


I am in complete agreement with the other physicians.  My partner and I had the procedure without any medications, and found it  to be uncomfortable but completed the treatment.  Since then, I strongly recommend a combination of Valium and Percocet (sedative and narcotic) for patients to have a pleasant experience, complete the full treatment regimen, and decrease the time of the overall procedure in half.  These patients do quite well and are comfortable throughout the procedure.

If a patient strongly wishes to not have any medications (which requires a driver), then we do use nerve blocks (injections of numbing medication).  These injection may also uncomfortable to have performed . 

Although the discomfort is immediately gone after the treatment stops, I really dislike performing Ulthera in patients who do not wish to have blocks or medications.  If you can, get a friend to drive you and opt for the medications.

Luis Zapiach, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 7 reviews

Ultherapy does not need to be painful


Ultherapy is an excellent non-surgical treatment for lifting and tightening the facial tissues.  We have been treating patients for over a year and have treated over 100 patients thus far.  You are right, there are varying levels of pain tolerance and after I had my first Ultherapy treatment, I have offered all of my patients local anesthesia prior to treatment.  Although some patients are hesitant at first, the treatment session is completed with minimal discomfort for the patient and I can achieve the best possible results.  Over time we have found that many patients benefit from additional lines of energy, however, with local anesthetic we are able to provide this additional treatment level with minimal discomfort.  These treatments do not require any premedication or sedation, therefore, the patients are able to drive home immediately after Ultherapy.  I do have an occasional patient who does not want any local anesthetic and they seem to do well, though it would not be my recommended approach with the additional energy used in more advanced techniques.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 30 reviews

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Pain med options for Ulthera treatment


Of course everyone is different, I had the procedure done without any and it was OK. If you have a low pain tolerance then your doctor may prescribe either a sedative or a pain pill or both, but you will of course then have to have a ride home and it affects your schedule for the rest of the day. You don't want to hold back on getting a full treatment though.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 28 reviews

Recovery from Ultherapy

There are many options for pain control, including local anesthetic. Consult with an experienced ulthera user. Our patients report an overall pleasant experience. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Pain managment with Ultherapy


I have found that patients do better with lidocaine injections than oral sedatives and pain medications.  The patients feel better overall and do not need someone to drive them home.  With the injections, the patients feel very little of the treatment.  Also, since the protocol change, which allows us to have the same clinical outcome without the intensity of treatment, the patients need less local anesthetic, if at all!

Angela Sturm, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Ouch, What is the Best Rx Pain Medication for Ulthera Treatment?


Hi Phoenix,

I find that straight Morphine does the job...just kidding. 

Ulthera can be uncomfortable, but we can make it very tolerable in our patients.  Some patients just have the treatment with cold air blowing on them, we call them sado-masochists, or they are extreme fans of Fifty Shades of Gray!

It is best to take 2-3 Tylenol about one hour prior to the scheduled treatment.  When patients have a ride home, we give Xanax 1 mg.  Most patients then have strategically placed injections of lidocaine in the areas of treatment, and that is usually more than enough to bring the treatment down to the 1-3or4 level on a scale of 10.  Other prescripton meds that can be used are Toradol or Vicodan or Percocet.  Once in a while patients receive an injection of Demerol, but I find that usually unnecessary.

Good luck and be well.


Dr. P



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

Pain Medications Before Ulthera


I like to give patients a Toradol pill  and a Percocet pill 1 hour before the procedure.  I find that with this combination, patients rate the pain level as a 3 or 4 out of 10 which is very tolerable.  

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Ultherapy and managing discomfort


We have tried different protocols for pain management and have discussed it with many different practitioners to review what they have found to be successful. We have been very successful in providing reasonable comfort to our patients with the protocol that we have used for the last six months.

Each patient has a different pain threshold and our management differs depending on the history given to us by our patients. Most patients are given a combination of a narcotic pain killer, a strong non-steroidal antiinflammatory agent and a medication to relax them, all by mouth.  Rarely local infiltration, such as to the forehead, is helpful, but these anesthetic injections suddenly make a no down time procedure develop the possibility of swelling around the lower eyelids and bruising.  Even more rarely, a board certified anesthesiologist delivers sedation.  Discussion of this management is held during the consultation.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Ultherapy and Pain


I have performed several hundred Ultherapy treatments and have treated patients without meds, with nerve blocks, with valium/vicodin/and a nerve block, +/- NuCalm (a natural oral supplement that creates deep relaxation without controlled substances, causes no side effects, and requires no recuperative time or supervision).

Following are my personal observations:

Patients that state they have a "high pain tolerance", and are full-faced usually do well without any anesthesia and rate the discomfort between a 2-4.

Anxious patients who are thin do best with a block and valium/vicodin cocktail.

Non-anxious patients with average facial volume do well with a nerve block.

Men have overall tolerated this procedure better than women. 

I recommend a high dose of ibuprofen prior to the treatment per a current Ulthera Trial that has shown it to be as effective as a narcotic.

It is important to take the "pain medications" at leat 1 hour prior to the Ultherapy treatment. 

Patients should be reassured to know that if they are "uncomfortable", they can have more of a block, or they can do their treatment zones in stages.  Patients tolerate a 30 minute treatment, but anxious patients seem to fatigue after this point and if they break up the treatment into two sessions they do better (i.e midface, neck, and forehead treated on different days)

NuCalm helps to keep patients relaxed during treatment and is a great option for patients that don't have a driver but need something to "relax".

We avoid cooling the skin during the treatment because we want to maintain the heat in the skin for the best results.


Christina Steil, MD
Chicago Dermatologist
4.5 out of 5 stars 15 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.