Ultherapy Vs Thermage for Skin Tightening

Keep in mind these are only tools and by themselves are neither good nor bad.  A scalpel is neither good nor bad but can be used to perform beautiful surgery or make a terrible mess.  That being said, these devices are commonly used by practitioners with no formal training in plastic and reconstructive surgery and thus no understanding of what interventions, forces structures and vectors make a beautifully rejuvenated face.  Now that Thermage has a long history, people are begining to understand that the patients are nearly universally displeased to enraged with their results.  I have seen several difficult reconstructve cases resulting from them paying for aesthetic enhancement with Thermage. 

 

Now comes Ulthera the new better thermage and can you guess what is happening. . . the same thing.  I personally do not like deep heating of the face.  it causes the absorbtion and atrophy of fat which over time makes patients look aged and there is no control of vectors.  When a plastic surgeon restores a face with a facelift, there are multiple different vectors created with different forces to create a natural concavity and convexity.  The contraction forces created by these technologies are concentric and pull equally in all directions, flattenening the faces- a very undesirable form.

 

I use infrared energy(Sciton SkinTyte) mostly when skin and tissue tightening is the goal,  I like it because it is gentler and not as deeply penetrating.  I really dont think there is anything wrong with a well trained plastic and reconstructive surgeon using any of these devices in a responsible manner after explaining the risks and benefits to their patients.  I think these technologies are applicable for moderate correction of neck laxity but should really be of limited application in the face because of the inability to control form.  Aesthetic form with wrinkles and laxity is much preferable to unaesthetic form with smooth skin.  There is no question that significant tightening can be achieved, but at what cost?  Remember whether a scalpel, thermage or ultherapy, the hands holding the device are much more important than the device.  Make sure the hands are connected to an experienced and well trained plastic and reconstructive surgeon so that you can benefit from their experience, knowledge and insight.

 

 

All the best,

 

Rian A. Maercks M.D.

Ulthera™ has only recently been approved by the FDA for use in the US. It has, however, been available in Asia and in Europe for several years, and preliminary results have been impressive. Ulthera™ is currently only being offered to select physicians within the US who have significant facial aesthetic practices, many of whom are involved in research and clinical studies as well.
To refer to Ulthera™ as a "gizmo" is to discredit the technology behind the device. Unlike Thermage ™ , which many doctors and patients have found to be disappointing, Ulthera is the first device that uses ultrasound technology to stimulate the body's own collagen response for lifting and tightening the skin and underlying soft-tissue of the face. This system also uses acoustic imaging to enable the physician to see the layers of soft tissue beneath the skin prior to treatment to ensure a uniform and accurate application of the ultrasound waves. This differs significantly from any other device that is currently on the market which typically use radio frequency or lasers to stimulate the skin.
While Ulthera is not going to yield the dramatic results of a surgical face-lift, many patients in my practice prefer the subtle, yet significant tightening and lifting of the skin that Ulthera provides. It is less expensive than a traditional facelift or MACS lift, has no downtime, and no bruising or swelling. I see Ulthera™ as one tool in a full spectrum of options we have available to help patients achieve their desired outcome for facial rejuvenation. Physician credentials and experience, communication, education and expectation of the patient are all key to having an optimum outcome, regardless of whether the procedure is surgical or non-surgical.

Ultherapy is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity.

Best,
Dr. Karamanoukian
Realself100 Surgeon