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 16

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 9 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 39 reviews

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 33 reviews

Pain control protocol with Utherapy

We have performed Ultherapy since 2011 in hundreds of patients with high satisfaction rates.

I have had the procedure myself and asked my physician assistant to stop twice because of discomfort around the jaw. I pretreat my patients with ibuprofen an hour before and another does of 800 mg immediately before in liquid form and have never had a problem with my patients. 

There is no need to write for prescription pain meds after the procedure. 


Read the Ultherapy book on the link below.

Ultherapy and controlling pain with the Amplify software

We specializes in Ultherapy procedures and have had success with pain control using the newer Amplify Ulthera upgrade. In addition, an analgesic and anxiolytic are sometimes needed. The type of meds really depends on your medical health.

Dr. Karamanoukian

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 63 reviews

Pain tolerance and length of procedure matter.

If someone is having a full face and neck, I encourage some prescription anti-anxiety meds such as Xanax or Valium and at least a strong NSAID such as ibuprofen 800 mg.  We may add in in some Vicodin too if the pain tolerance is low and there are no other contraindications.  

If, however, we are doing a more limited area, such as neck and lower face only, and if the patient has some degree of pain tolerance, plus a motivation not to take meds, i.e., "I'm busy at my job and need to go straight back to work," then we will certainly attempt the procedure with ibuprofen alone and some topical anesthetic creams with possibly some distraction techniques like peaceful music and vibration.  

I have found that some people who have tolerated some pain in the past with other procedures or through life events, may be able to tolerate Ulthera without prescription pain medications, but this may represent 30-40% of all patients.  

Allison Readinger, MD
Fort Worth Dermatologist
5.0 out of 5 stars 2 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 21 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 7 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
Encino Facial Plastic Surgeon
5.0 out of 5 stars 28 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.