Asymmetry with Ulthera?

I recently had my 2nd treatment of Ulthera because the fabulous results I experienced the 1st time, diminished due to loosing 16 pounds in 6 months. My Ulthera experience the 2nd time has resulted in noticeable asymmetry of my cheeks which, in my opinion, was caused by much more aggressive treatment on one side of my face; which I felt it during treatment. One month later, I also feel much tighter on one side. What are the chances that the asymmetry will resolve &/or what can be done now?

Doctor Answers 6

Ultherapy and Asymmetry

Dear lormich, thank you for your question. Ultherapy is the only FDA approved noninvasive device for lifting the face and neck. It uses focused ultrasound to target the deep tissues above our muscles, as well as more superficial layers. Our San Diego clients have been very pleased to see significant results with no downtime. Side effects are extremely rare but you should follow up with your provider to express your specific concern. 


San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Facial asymmetry and Ultherapy

Facial asymmetry is a common trait. It is not likely to be related to Ultherapy. Speak to your provider and return for an examination and assessment. 

Ulthera Asymmetry

You can always ask to see your treatment map, to determine if one side was treated more aggressively than another.  We are all asymmetric to begin with, and sometimes with treatment we notice our asymmetries even more. I always encourage my patients to return for photos, to compare there after photos with their before photos and visualize the difference from treatment and which asymmetries already existed. Good luck.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 66 reviews

Complications with ultherapy such as asymmetry

Everyone's face is different on one side than the other. This might be manifested by shape, amount of fat, sagging, amount of pain felt during filler injections, laser therapy for facial redness or fraxel laser for wrinkles, or ultherapy or thermage tightening procedures. Possibly with weight loss, the inherent difference between one side vs. the other is more apparent with the pain and not that Ultherapy was done more aggressively on one side. In my NYC practice, Ultherapy is done with the latest technology that allows the physician to see on the monitor the amount of lines of treatment and the different energies used in each location of the different cheeks so it is very easy to maintain equal treatment. Sometimes patients who have marked asymmetry before Ultherapy agree to having more lines of treatment on the side that needs more lifting. More aggressive treatment may mean more lines or more energy per line or both. One may ask their doctor if the energy was equal on each side.

If after six months, one side is notably more raised, then the other side could be treated again without treating the side that is higher. A good result is usually obtained.

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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Asymmetry of Face After More Aggressive Ulthera Treatment on One Side of Face

Hi Lormich,   We have not seen asymmetry with our Ulthera treatments.  It is possible if one side was treated more intensely than the other.  I would speak with your treating physician about the treatment.  If one side is more lax than the other then it can be retreated with more energy after a few months.  Good luck and be well.  Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Ultherapy can be very helpful after weight loss

Congratulations on your recent weight loss!  Kudos to you for making the most important step to improving your overall health.  Ultherapy can be helpful to tighten skin after weight loss, and we have seen this on many patients.  

The most common cause of asymmetry after a cosmetic procedure, is an unrecognized pre-existing asymmetry.  Better stated, you may have had that asymmetry before the treatment and did not notice it.  To see if this is the case, follow up with your doctor and look at the before and after photos.  

It is also common during an ultherapy treatment to have more discomfort on one side, and it's usually the second side treated.  This is likely because the inflammatory cascade and collagen building machines get revved up and cause to to be more sensitive on the second side of treatment.  

W. Matthew White, MD
Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.