Can anyone recommend a permanent solution to ultherapy facial sag?

I tried voluma, but within 3 weeks it was gone! I cannot afford these fillers. I was told because the tissue is damaged , that fat grafts would not live. Would sculptra work with no facial fat? This has been such a waste of time and money. I feel completely deceived.

Doctor Answers 6

Ultherapy with fillers in Los Angeles

Ultherapy works very well in combination with a stimulatory filler such as Sculptra. Overall, the results are definitive and beneficial. 

Dr. Karamanoukian 
Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 93 reviews

Sagging after Ultherapy

Hi Saggingnow,

It sounds like you are saying that Ultherapy actually led to facial sag, which is not something I've seen with treatment.  Also, you are saying that your treatment has led to complete loss of facial fat, which is also not scientifically possible and never seen in my practice.  In fact, Ultherapy is the only technology on the market with an FDA indication for lifting and tightening the skin in the face, neck and chest.  This means that it has gone through extensive testing to prove that it is both safe and effective for this use.  When you make statements like those in your question, it contradicts a lot of scientific data and professional experience, leaving the audience wondering what is really going on.

It would be helpful for those trying to help if you could post before and after pictures, as well as your weight at the time of your photos. Most patients who experience fat loss in their face have either lost significant weight or gained significant age.  Ultherapy can injur fat cells when applied to the fat, but even if a whole facial treatment is applied directly to the fat in your face, the maximum fat loss would be about 1/4 teaspoon (1.25ml) spread throughout the face.  There are ultrasound technologies that were designed for targeting fat, but these fall under the spectrum of HIFU (high intensity focused ultrasound), which applies greater energy to a larger area leading to more fat loss.  

One of the things I like best about Ultherapy is that you can see the layers of tissue you are treating.  The energy is focused within the skin and underlying SMAS (tissue lifted during a formal face lift).  Your provider  is able to see these layers and able to focus the treatment where it is most effective.  The main reason to avoid fat, is not due to concern for fat loss, but rather to keep the treatment where it is most effective---skin and SMAS.  Energy applied to fat will not lead to lifting or tightening.

I would recommend you see a plastic surgeon who is familiar with Ultherapy, as well as filler and fat transfer.  Seems like you are confusing multiple different treatments and results.

Best of luck,

Dr. B

Can anyone recommend a permanent solution to ultherapy facial sag?

For severe skin laxity and wrinkling, a surgical neck lift will definitely give you a more noticeable result than Ulthera® laser. Please consult a board certified plastic surgeon for a consultation. 

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 8 reviews

ULtherapy tightens skin, but does not restore volume

Wish I could see your photos....
You are talking apples and pears... If you want more facial volume, use fat, fillers or Sculptra. Scultra can work with no facial fat.  That's what it was originally designed to do.  If you d id not get enough of a lift with Ultherapy, you may benefit from laser skin resurfacing or a surgical facelift. Speak with your trusted plastic surgeon for recommendations.  There can never be a guarantee of longevity of results of treatment, and you may have taken a "step" on the aging staircase.  Voluma works real well but you might have not had enough to make a difference, since although it lasts about 2 years, it comes in 1ml, or 1/5 teaspoon (small volume) syringes.
Hope this helps!

Steven Yarinsky, MD
Albany Plastic Surgeon
4.8 out of 5 stars 16 reviews

When ultherapy leaves you wanting more...

There are an increasing number of patients who try ulthera and/or fillers and are not satisfied.  This often happens when patients are given volume to treat laxity of the skin.  Volume should be used to treat volume loss, not to treat looseness. Laxity may be treated with ulthera, though the tightening results are modest in many patients and often by the time they see laxity, they are better treated with surgery.  At this point, you should see a facial plastic surgeon to review surgical options.

Very best of luck!

Benjamin C. Paul, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Ultherapy side effects ?

Thank you for your question.

You should consult with a facial plastic surgeon.

Dr Karamanoukian

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.