Denise L. Sweeney, MD

Your results look good! The firm area is most likely a knot in the suture, to keep it in place. Your body wants to get rid of the stitch (a foreign object) and creates swelling and some discomfort. This should resolve soon.

You should be fine to return to work in that period of time. Swelling is gravity dependent, so you may notice more when you are on your feet more. If you were home, you would still likely be sitting, so a desk job is ideal. I totally agree with Dr. Stanton's recommendations as far as activity: "No exercise for two weeks, no baths/jacuzzi or swimming for 3 weeks, and no sexual activity for typically 4 weeks." Honestly, most people find the restrictions harder than the surgery, as they feel ready to progress their activity before this time. A soft silicone or donut seat can help during recovery.

I am always amazed at the Ultherapy ratings too. In our office, it is one of the most popular procedures! The POSITIVES: 1) Stops the aging clock. Seriously! If you're not doing this, you are missing the boat.   2) No down-time or incisions    3) No repetitive maintenance. It is designed as a one time procedure, though we do it repetitively to add to the effects.   4) Totally customizable

The NEGATIVES: 1) Painful for many people. If done at a physician's office, pre-medication helps!   2) As already said, anyone can buy the machine. Skill in ultrasound is paramount to achieve great results.  3) Cost- It is expensive, but again.... you are stopping the aging clock!

Great question! My office has both. We prefer Ultherapy for facial support and structure. And yes, it does hurt, but is TOTALLY worth it. If you did not see a result, I unfortunately think it was not done right. Unlike many aesthetic procedures, Ulthera really requires a high level of ultrasound skill. It also really should be repeated yearly, as aging continues.

We prefer ICON for age spots and vessels (Max G) and the 1540 laser attachments for fine lines (XF) and deeper lines/scars (XD).  The ICON is a brilliant laser for skin surface, with minimal to no down-time, but no amount of perfect skin surface will help sagging structure. 

Thank you for asking this question! Ultherapy and toxins/fillers are totally complimentary to each other. Think of Ultherapy as the structure of your face. Properly done, it stimulates collagen production down to the SMAS/deep layer. This results in a lift that is totally natural and individual to you. Toxins and fillers work on a more superficial layer. 

It is best to have Ultherapy first, then injections. However, if you have already had the injections, we ask that you wait 2 weeks after Botox/toxins and 4 weeks after filler before doing Ultherapy. When you see reports of people claiming that Ulthera caused "hollowness" or their "face to melt" it is because it was done improperly or it was done too soon after filler, and melted the filler!

Ultherapy takes 3-6 months to show benefit, so many people choose to have it done, then toxin/fillers for immediate benefit. As time progresses, you will find that your botox and filler last longer, which is a huge time and financial savings!