You will notice a subtle reduction in pore size and pigment with Picosure as well as acne scars. It will not be a dramatic difference. The best step forward is to clear your acne. I do not think you need Ultherapy for your sagging skin, perhaps a face to face consultation with a specialist would...
PRP is great for sagging wrinkled skin only. Ultherapy® is great for sagging skin plus sagging underlying fat and muscle. Please consult a board certified aesthetic dermatologist for a consultation.
If done properly and with a FDA approved device you will not get fat melting. I do think you need more than just ultherapy though for tightening. I suggest you see an expert for treatment. Ultherapy is a great option though. Best, Dr. Emer.