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.

I want to start by mentioning that this question was posed 6 years ago! the answer to this question has certainly changed over this time span. Allow me to explain. Thermage was introduced 10 years ago. I had one of the first units in Los Angeles. The origional Thermage was very painful and occasionally resulted in burns or slight indentations. Some patients got amazing results and others benefited marginally. A few years later Thermage NXT was introduced. It was less painful and more consistent. Finally Thermage CPT became even more reliable and 2-3 times more effective. I have used all 3 machines and still have patients who come for skin tightening on a yearly basis. Once you have a great result with a machine you want to continue using the same modality. Ultherapy was introduced 6 years ago. We nor have the 3rd generation machines with the deep-see hand piece. It is powerful and consistent. I find that patient do better with mild oral sedation. Yes- it is very uncomfortable. I personally perform both procedures and get great results. Both machines are tools and the results are very operator dependent. It all depends on how many pulses (line) and what settings and how the pulses are applied. generally speaking I prefer Ulthereapy a little more. I am able to physically see the tissue that is being treated on my screen. please look for an experienced physician and have realistic expectations.

Ultherapy procedure delivers consistent energy to the SMAS layers or deep layers of skin  by using ultrasound technology under direct visualization to lift the sagging skin.Where as Thermage is a  radiofrequency device which delivers the energy into the tissue layer with out direct vision. Both procedures can be effective, but have many limitations,  the results are usually seen after 6 months. The Ultherapy results depends upon multiple factors such as the degree of sagging, age of the patient, the knowledge of anatomy and the experience of the person who performs. In our office all Ultherapy procedures are performed by a Board Certified physician. I firmly believe Ultherapy is a better choice since I can see all the tissue layers before delivering the energy.
Best
Dr. Shanthala