Ultherapy almost 4 months out now!!

We have done hundreds of Ultherapy treatments and the overwhelming majority of patients are pleasde with their result by 3 months.  It will be good for you to look at your before pictures to see what you think, it is easy to forget what you started with and you could be pleasantly surprised.  In the event that there is no improvement above the brow then a second treatment does make sense. When we have done that the results do improve.  Whether your doctor charges for  touch up treatments will vary of course.  I suggest an honest discussion about your expectations and results.  Most doctors want you to be happy and stand behind their procedures.

There are times that Ultherapy will be more effective in some areas of the face or neck than others. Ultherapy has a high patient satisfaction rating in my NYC practice but that does not  mean that every patient receives the amount of lifting they were hoping to achieve. There can be no guarantees when a physician treats a patient with a non-invasive or minimally invasive energy-delivering system to effect a lift because the patient's body must respond with an optimal dermal improvement and this is idiosyncratic to the individual. There may be some element of improvement that patients don't realize until they look at their before photographs and see the difference that was achieved because when we live with ourselves every day since the procedure, we don't see the change as dramatically. On the other hand, whether it's with Ultherapy, Pelleve, Thermage and ThermiRF, there may be more improvement obtained when a second procedure is done. The physician has to be concerned about which areas of the forehead are treated and is limited by needing to avoid certain anatomical structures during treatment with Ultherapy. Different physicians may perform the treatment differently and some may deliver more energy/more lines of treatment, and use different applicators to treat different depths of the skin and subcutaneous tissue.If a second procedure is done, many physicians will charge a second fee, although it might not be as high as the first, to offset the very high consumable cost to the physician..This varies from practice to practice and possibly from case to case. The information provided in Dr. Shelton's
answer is for educational purposes only and is not intended
to constitute medical advice. The information provided should
not be relied upon as a substitute for consultations with a qualified
health professional who may be familiar with your individual medical
needs.

Like all  noninvasive treatments, Ulthera uses energy to stimulate a healing response which in turn produces the desired effect. Because of this, there is inherent variation in the response, and as you have noted it can vary from one area of the face to another in addition to different responses by different patients. Older patients tend to respond less well to these treatments because the collagen-building capability is less. We sometimes give a "booster" treatment at about 6 weeks.