What is the best non surgical treatment alternative to a Facelift? Would it be radio frequency? If so which one is best? (photo)

I had ultherapy about 2 years ago but not great results for the money. I am 40 years old and have some sagging of the face and under the chin and just look tired all of a sudden. Also hollows/wrinkles have appeared under my eyes. I'd prefer to try a non surgical option before my last resort of a facelift as still so young. Not sure what treatment is best to try, if it's radiofrequency and if so what machine is the best?

Doctor Answers 12

Volume & Tightening | Best Look!

Thank you for the question, and thank you for posting your photo. First of all, you look great! To turn back the clock a bit, you may find better results by volumizing the cheek area (Apple and zygomatic) to provide a natural youthful look with dermal fillers. Thr Ulthera is operator dependent, and results will vary from experience to experience. I tailor my treatment plan for each individual to get the kind of results each patient is excited about. But I wonder if all along it was some volume that was needed in the mid face that left you dissatisfied with the Ulthera? Best luck, Dr. P.


Great Neck Dermatologic Surgeon
5.0 out of 5 stars 24 reviews

Antiaging treatment at 40

In general I try to vary my treatments based upon where people are aging. In your case I would recommend volumization to the cheeks and around the eyes with fat or filler followed by a CO2 laser to tighten the skin. The downside to this treatment is that you are red and swollen for 2 weeks after with the redness lasting for up to 1 month afterwards. Even though there are no stitches in your skin, the recovery is significant but so too are the possible benefits.

Aric K. Park, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Best non-surgical alternative to facelift

There are several non-surgical alternatives to a facelift, but it is difficult to say which one is the best.  Some procedures may work better in some than others and the physician performing the treatment can also influence the results.  Aside from Ultherapy, which you stated you already had, I would look into radio frequency treatments as an option.  There are many different devices but the one I am most familiar with is called Fractora.  It is possible you could get some improvement with any of these radio frequency devices.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

FAMI using SVF from fat to reshape the face, good alternative to face lifting

Around 40 women have some features changing in their face. The culprit is the receding of BONE surfaces and edges starting the ageing chain reaction.This is responsible  of baggy eyelid and tear trough, lost of malar eminence with naso-labial folds and chin deformity.

The face lifting lift the skin of older structures as bone and muscles of facial expression. (FAMI)  will rejuvenate the old structure for life time! It is not a joke!

The adipose Stromal Vascular Fraction (SVF) will give back its support to the skin and will do and Endo-lift by restructuring  the facial scaffold, bones, muscles and deep fat pads.

Roger Amar, MD
London Plastic Surgeon
4.0 out of 5 stars 2 reviews

Soft Lift

Dear smithskin:

Looking at your photos, I would recommend starting off with a Soft Lift procedure which incorporates use of both Botox for line softening and fillers for volume restoration in the appropriate places.  Please see an expert injector.  Remember less is more.  Best wishes.

ThermiTight and Suture Lifting are in between non invasive facial tightening and a surgical facelift

We still don't have a magical non invasive procedure that can lift as much as surgery. Some patients with heavier thicker and more sagging skin won't respond as well to Ultherapy and minimally invasive non cutting procedures such as injectable radiofrequency energy done with ThermiTight and possibly using a new suture lifting technique from InstaLift, may provide some patients with better results than ulthera but there can be downtime with swelling and bruising that could last as much as a week and a half or more. The results as good as they may be for some patients still don't match a surgical face lift for the face but some necks do get as good a result, especially if their double chin is only a consequence of excess fat .

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

Best Non Surgical Treatments For A Facelift

One of the most common requests for patients in the office is to seek improvement in facial and neck sagging without a scalpel.  The answers from a few years ago was not as exciting as many treatments which were above the skin were found to be not as effective.  While none of these options is as dramatic as a surgical facelift here are a list of nonsurgical options:

-"Under the Skin Radiofrequency"-  This is the hottest area of facial rejuvenation and an area that is expected to rapidly grow over the coming years.  There are several devices here including Facetite, ThermiRF and others who place a probe under the skin which causes contracture of the skin and tightening. This bottom up approach will often demonstrate visible tightening and contracture of the office and can take up to 6 months to see a final result.  I personally like the Facetite since it involves a contained thermal field rather than uncontrolled heat and in this regard think of it as safer and allows surgeons to heat with higher temperatures.  These procedures do involve some downtime and are done comfortably in the office.

-Filling out the Face-  Fillers around the face can add volume where volume has been lost.  There are a variety of facial fillers available including hyaluronic acid, calcium hydroxyapatite, and poly-L-lactic acid which can be used to fill out cheeks, lips, temples, nasal labial folds and other areas of the face.

-Smoothing out the Skin-  Here a variety of techniques can be used including fractionated C02 resurfacing of the face, radiofrequency ablation of skin (a top down approach), erbium resurfacing, chemical peels and other treatments to treat fine lines and wrinkles.  

Options not mentioned as ideal include the following:

-Botox Neck Lift or Nefertiti Lift-  This involves placing a large amount of botulinum toxin in the neck to selectively tighten the neck muscles.  While patients may see some improvement, it needs to be repeated every 4 months and since it requires a large amount of Botox other treatments include the Bottom Up Radiofrequency techniques are probably more cost effective and offer more longevity to the result.

-Radiofrequency (Top Down) or Ultrasound treatments- Treatments such as Thermage, Ultherapy are probably better at maintaining facial contour than lifting face and necks.  Unfortunately, the pricing on these options makes many of these treatments not as ideal.  


Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Non Surgical Facelift-- Reverse Signs of Age with Lasers like Fraxel/Clear + Brilliant, RF like VIVA, Peels, Fillers, Skin Care

I find that a combination of lasers or RF, sculptra for collagen building, microneedling/prp and skin care help the skin rejuvenation and prevent aging.  Please see a cosmetic dermatologist for a long term treatment plan.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Nonsurgical facelift

Hello and thank you for the question.

You are in luck. There are a lot of modalities that will provide you with a facial rejuvenation without having to undergo surgery. I would recommend a blend of treatments for optimal effect. This would include radio frequency, micro needling, injectable fillers for volume replacement, laser resurfacing, and lastly, there are some great suture lifting products out now, which, although they do not last a long as a surgical result, do produce dramatic results lasting from 12-18 months.

Best of luck, Dr. Vallecillos 

Glenn Vallecillos, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 29 reviews

Non surgical options for Facelift

There are newer devices on the market which are minimally invasive but can be performed under local anesthesia in an office based setting.  These are not surgery like traditional facelift but they are radiofrequency options such as Thermitight and Profound.  Both use a technology called radiofrequency which has been around for decades but they use it under the skin as opposed to earlier devices where you would place on the skin and hop enough heat dissipated down to the deeper tissues.  Ultherapy used ultrasound but results are not consistent and a significant percentage of clients who had this treatment saw little to no improvement for the money they spent.  

These newer modalities approach satisfaction ratings in the 80 to 90 percent. 

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 22 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.