Ulthera and Deep Plane Facelift

Great question — this is something that comes up often in consultations.
Previous Ulthera (Ultherapy) treatments generally do not affect the SMAS layer directly, as the energy doesn’t penetrate deeply enough to reach below it. However, they can cause changes in the subdermal plane, such as tissue tightening and fibrosis, which may affect surgical dissection.
While it doesn’t necessarily make the surgery riskier, it can make the procedure more technically demanding. The surgeon may need to spend more time performing careful, precise dissection to avoid damage to adjacent tissues.
In experienced hands, a deep plane facelift can still be performed successfully after Ultherapy — but it’s important to let your surgeon know about your treatment history, as it may influence the surgical approach and planning.
I hope this helps clarify things!

Ulthera is a procedure that aims to tighten deeper structures through the use of ultrasound to heat and slightly shrink deeper tissues in the face including the SMAS. It also claims to stimulate collagen production.

A Deep Plane facelift on the other hand elevates the SMAS directly and reshapes fat and muscle. There is no comparison in the results or to the length of time they last. Surgery is by far more effective.

A Deep Plane lift can be done just as easily on those that have had Ulthera as those that have not.

Dr. J

Yes, ultherapy severely damages the structures of the neck. This makes a significant scar tissue burden, damages the lymphatics and obliterates normal tissue planes. This makes the surgery far more challenging and that sometimes may provide some risk.