Considering Ultherapy but am quite scared off by the "loss of fat" and "face melting" reviews?

I have some fine lines, crows feet. The place I went to suggested Ultherapy. I'm really worried about the reviews saying their face loss fat and face is melting. Is this likely due to an inexperienced operator? I keep reading that it is supposedly very safe but heating up the skin like that could make fat melt away? Before and after pictures don't show much improvement in fine lines. Is Ultherapy more for tightening and not for wrinkles or does that happen over time as collagen builds?

Doctor Answers 6

Ultherapy Information

Hi there,

Ultrasound energy has been used safely in the medical field for more than 50 years. Ultherapy is safe and effective in tightening, lifting and reducing fine lines on the face, neck and brows. 

Ultherapy targets its ultrasound energy a few layers beneath the skin’s outer surface. It generates a stimulating energy that directs your skin to start producing collagen. This helps your skin look tighter, lifted, and much fuller. Some patients see results directly after receiving an Ultherapy treatment, but it continues to stimulate collagen for 2 to 3 months, so it will take that long to see the full extent of the benefits. When administered correctly, Ultherapy should not cause fat atrophy in the face. 

When you are exploring the options of a facial procedure, make sure that you also explore the right type of cosmetic physician to perform your procedure. A facial plastic surgeon is a cosmetic doctor that is an expert strictly in the head and neck, which is where Ultherapy is indicated to treat. 

Toronto Facial Plastic Surgeon
4.8 out of 5 stars 148 reviews


Ultherapy is very safe in the hand of an experienced provider. I would recommendf following up with an experienced provider for an evaluation and treatment.

Kristin J. Tarbet MD, FACS
Bellevue Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Ultherapy safety

Any medical procedure, cosmetic or not, is as effective and as safe as the qualifications of the treating provider. If you want the best result with Ultherapy insist on having your treatment performed )not supervised ) by a board certified dermatologist, facial plastic or general plastic surgeon.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

Ultherapy Safety

Ultherapy is very safe when performed by experienced physicians. It is a good treatment for lifting and tightening the skin in appropriate candidates. However, it's not the best option for fine lines and wrinkles or crow's feet lines. Consider laser resurfacing in combination with Botox and fillers to treat those. Please see an experienced provider. Best wishes. 

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

Ultherapy Safety and Results

Ultherapy is a customized treatment and is operator & patient selection dependent.  The ultrasound imaging is designed to help the Ultherapist pick the depth of treatment depending on whether tightening or fine line improvement is desired. The goal is to avoid treating the subcutaneous fat layer in thinner/select patients (& avoid treating the levels where dermal filler has been placed) and imaging assists with the procedure's safety. The "number of lines" done in a treatment also affects results. Get Ultherapy done in a board certified dermatology or plastic surgery office. Best to you.

Anita Saluja, MD
Melbourne Dermatologist
5.0 out of 5 stars 18 reviews

Ultherapy Effect on Fat

Thanks for your question. The effect of Ultherapy on facial fat has been studied and is not significant.  It is at most a fraction of a teaspoon (less than 1/4 teaspoon- basically half the volume of a small marble- if a full face treatment is done) - and that's if ALL of the energy were to be delivered to the layer that contains some fat, which is not the case in the protocols we use. So essentially, that estimate is based on "even if it was done "all wrong". We have had great results with it and I myself have had it done twice with no issues. Hundreds of thousands of Ultherapy procedures have been performed since 2007 and I know that the FDA has looked at the issue of effect on fat and they have issued no warning or caution.There is a video on realself which may be helpful to you- the link is provided below. It was made by a plastic surgeon out of California:David Boudreault, M.D. of Illuminate Plastic Surgery, Inc.

Titled: “Ultherapy and Fat Loss: The Doctor Explains This Common Misconception” by David Boudreault, MD Summary: A common misconception of Ultherapy is that it causes fat loss. Dr. Boudreault explains why some patients appear to have a thinner, more hollow facial structure after receiving Ultherapy and addresses how to achieve optimal results from treatment.

There is the lifting protocol, using the 3.0 and 4.5 mm transducers, but there are also smoothing protocols using the 1.5 mm transducer. It sounds like you are looking for the smoothing protocol. There is no fat at 1.5 mm- that's your dermis. 


Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 11 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.