Ultherapy vs. Fraxel for Skin Tightening and Shrinking Pores?

Ultherapy treats underneath the skin so it will do nothing for hyper-pigmentation, and very litte for texture, fine lines, wrinkles or pore size but, it does tighten and lift skin. So, it’s a great treatment to combine with laser skin resurfacing because the laser treats the surface of the skin. The best treatment/technology for laser skin resurfacing is a CO2 fractional laser. This laser is considered the most effective treatment for combating wrinkles, aging, and many other skin imperfections on the surface level. It’s important to consult with a board certified facial plastic surgeon to see if you are a good candidate for either Ulthera or laser skin resurfacing and to discuss the possible risks and benefits of both.

Thank you for the detailed question. Ultherapy and Fraxel are two totally different procedures with its own benefits. Ulthera works by gently heating the tissue above the muscle and subcutaneous tissue which will then act like “saran wrap” that tightens the skin and tissue and remodels collagen beneath the surface of the skin. Fraxel on the other hand, works by resurfacing and retexturing the top layers of the skin. Fraxel treatments even skin tone and texture, refine pores, flatten scars, improves visual signs of sun damage and wrinkles. Both are great treatments. Also, large pores may indicate that a person has oily skin so topical retinoids may be needed as well.

Ultherapy will significantly tighten the skin around the jawline vs a Fraxel treatment. It does not however help with the size of your pores.  Ulthera utilizes ultrasound to deliver a small focused heat source to deeper tissues. It can be applied with great precision at the level of the SMAS(a collagen rich layer under the facial skin). It also has the advantage of imaging to confirm you are at the correct depth. It may however be combined with laser resurfacing for optimal results.

First of all, the Ulthera and Fraxel cannot truly be compared to
one another. The Fraxel is a procedure that works from the top of the epidermis
down. It works by breaking up the pigmentation and then having it slough off a
few days later. Due to the stimulation from the heat it does help promote
collagen growth and provide a bit of firming of the skin. Also because the skin
is being deeper exfoliated, fine lines are smoothed.The Ulthera is not a type of exfoliation, rather a collagen
stimulant, due to the heat that is placed in the lines/pulses of the Ultrasound
treatment. Also the treatment goes as deep as the muscle and helps the muscle
contract, thus lifting and firming – the results can be instant, but continued
results happen over the next 6 months post treatment.

Ulthera does improve the tightness of the skin of the face and neck. The pores in addition do shrink. I always tell my patients that Ulthera has multiple benefits, lifting the skin of the brow, face, and neck, smoothing the skin of the treated area, and decreasing pore size. Fraxel treatments  are aimed at skin resurfacing but not lifting. If you are interested in Fraxel you should look into 3 -6 Clear & Brilliant laser treatments in lieu . Great results with no down time and no adverse results.  

Thank you for an excellent question. As new technology develops, it is often difficult to determine the differences between them and which is used for whom. As for these two non-invasive treatments, they are quite different in how they work and what they treat.-Ultherapy uses a focused ultrasound energy to work beneath the skin and on the deep layers of the skin. This causes a lifting effect for areas like the brows, cheeks, and neck. It also causes collagen rearrangement, which improves the skin. It does not improve the superficial aspects of the skin, so it is not a treatment for fine lines and wrinkles.-Fraxel creates small holes in the skin which then produces tightening of the skin. It does not provide any lifting of the deeper structures, but does provide more superficial tightening of the skin.The proper choice really depends on what aspects of your face you are hoping to improve upon. If it is tissue decent that you are hoping to treat, then Ultherapy is a better choice. If you are hoping to treat the more superficial aspects of your skin, then Fraxel may be best. Consulting with your plastic surgeon about the options is always the best way to determine the best option for you.Best of luck with you face.Jeff Rockmore

I have both the  Fraxel Repair Laser (CO2 Laser) and Ultherapy and I have used both of them on some patients.  They do different things.  The Fraxel Repair is for skin surface irregularities such as wrinkles, scars and pigment irregularities from sun damage.  Ultherapy is for facial lifting and tightening.  Fraxel also tightens the skin, but it doesn't lift the deeper layers as Ultherapy can.  They are complementary procedures and I have seen excellent results with the procedures combined.  

Some patients do get improvement in their pore size with Fraxel, but some do not. I have not ever seen it get worse, though.  Ulthera is not going to affect the pore size as it only affects the deep dermis and connective tissue layers without changing the surface of the skin.  You mentioned that your pores are visible now after your cheeks have sagged but if they are lifted to some extent with Ulthera, the pores will not look better.  Sometimes volumization of deflated cheeks can help the surface look better in some patients. I have not found one device, nor chemical peel, whether a superficial or medium depth peel, to consistently shrink pore size, but I have seen a greater percent of Fraxel patients see improvement in pores than other treatments.

Hi,

Ulthera is better for the treatment of sagging of your jowls, cheeks, and neck.  Ulthera is a deeper treatment, targeting the muscle lining and deep undersurface of the skin with ultrasound heat energy.  It is the only device FDA approved for both tightening and lifting of the facial skin and muscles. 

Fraxel is a more superficial treatment that is better for wrinkles and pores (though there is some improvement of pores in the areas treated with Ulthera).  These two treatments can be used together, even at the same treatment setting (Ulthera before Fraxel).

The other synergistic treatment with Ulthera and Fraxel is Sculptra injections. Choose your treating physician most carefully, make sure that they share your artistic vision.  Good luck and be well.

Dr. P

Ultherapy uses sound energy – tried-and-true ultrasound – which has unique properties that allow it to bypass the surface of the skin to treat depths not matched by any other non- invasive cosmetic device. Ultherapy ultrasound stimulates collagen production in the skin’s foundation, resulting in a clinically significant lift of tissue over 2-3 months. Other lasers rely on light energy, which cannot reach deeper skin layers at an optimal temperature, so laser treatments typically only treat superficial skin and are not FDA-cleared to lift skin.