I am considering a procedure to tighten the skin on my face and neck and also looking to improve the lines around my eyes and lips. I heard fraxel repair was expensive, very painful and there was a lot of recovery time needed. I have recently heard of an ultra sound face lift, could you please tell me the differece between the two and which would give the best results with the least amount of down time and money???
Difference Between Ultra Sound Face Lift and Fraxel Repair Laser Treatment?
Doctor Answers 7
I always caution people on the use of these new technologies
The one thing that I always caution people about is the use of these new technologies which are just not proven over the long term. There is ultra sound that has been used in medical applications. But, as far as using ultra sound instead of a surgical facelift, I wouldn’t recommend it. Fraxel is a different story. It shouldn’t be painful and usually is not that expensive and is appropriate for skin wrinkling and skin tightening, superficially. But, it’s not a lifting procedure. Face lifting and Fraxel are really two different procedures that achieve two different things and work in different layers of the face. Fraxel works superficially for finer lines and skin tightening. A facelift works deeper to lift the deeper tissues of the skin. In general, a lot of these technologies that sound too good to be true, are too good to be true. They may not be expensive, but you’re usually just wasting your money as they usually don’t deliver the results promised. I like to see several year’s worth of real results before I recommend a technology.
Fraxel Repair versus Ulthera
Dear Brookhaven: This is a common question in the mind of many patients who want to deploy their hard earned resources in getting the best result. Comparing the Fraxel Repair (FR) versus other skin tightening treatments (like the Ulthera) is tough because they treat different things and have different downtimes. The FR works very well to rejuvenate the surface of the skin, but can have 3-6 downtime depending on the treatment levels. The ultrasound technology attempts to tighten the deeper skin tissues and has NO downtime, but is somewhat painful. Another more established non-invasive deep skin tightening technology with a similar goal includes the Thermage which is designed to tighten deep skin. In theory, we would like to use both in synergy to rejuvenate the entire face. Now, it is really a bit too much marketing to call the Ulthera, "an ultrasound facelift" device...subtle facial tightening- maybe, slight reduction in facial sagging volume - maybe, looking a bit better-yes, noticeable facial tightening - I have not seen it or heard of it, as of yet. Again, the Ulthera is relatively new device, so I cannot definitively comment until I see more results. In contrast, the changes with the FR are much more noticeable where almost all patients see a reduction in:
- Fine lines around the eyes
- Some of lines around the mouth
- More even skin texture and color
- Reduction in freckels, red spots, etc.
- Improvement of skin acne scars and lines
- Skin looseness / laxity
The main negatives with FR are the downtimes involved and the need to numb the face. But for those who have funds for only one procedure to look better, I would steer most towards the FR and generally away from newest (think marketing) not yet fully proven technology platforms.
Hope this of help, Dr. Vartanian
Focused ultrasound vs. fractional resurfacing
Fractional resurfacing is best suited to treat fine wrinkles and discoloration of the skin while focused ultrasound treatments are intended to tighten and contour the skin. Ultrasound treatments do not address skin color changes. There is no recovery period after ultrasound treatments whereas approximately 1 week of recovery is needed after ablative fractional resurfacing treatment. These treatments tend to be complementary as opposed to competitive. That is to say, many patients can benefit from both of these treatments.
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Neither Fraxel (despite Dr. Oz's recent show) nor Ulthera will give you anything close to a "best" result. At best they might slightly tighten you up but in no way will they do much very impressive. Keep your expectations in line with what a treatment can realistically do and you will be happy.
Best Non-Surgical Face Lift Ultrasound (Ulthera) vs. Fractionated CO2 (Fraxel repair)
Fraxel repair will give you skin rejuvenation by improving the tone, texture, and color of your skin as well as tightening select areas of crepe skin such as around the eyes, cheeks, and somewhat in necks. Fraxel repair is the best technology for wrinkles around the eyes and lips. The treatment should not be painful when performed by a physician who knows how to use local anesthesia. Thankfully, the post-treatment recovery is pain free (in 4 years I have not prescribed a pain med for a patient after Fraxel repair). The acute recovery period is 7-10 days, but it takes 4-8 weeks for the skin color to return to normal.
The current ultrasound technology used for tightening the face and neck is Ulthera. Ulthera can be quite painful during the treatment, and there can be some discomfort afterwards. Ulthera will "lift" the eyebrows, face, and somewhat the neck more so than Fraxel repair, but will not treat the crepe skin of the eyes and lines of the lips as well. I have been treating patients with Ulthera for the past 2 1/2 years with excellent patient satisfaction. The new "Amplify" protocol cuts the discomfort of Ulthera greatly by decreasing the amount of energy per pulse by 25% and increasing the total number of pulses by 33%.
As with many of the procedures in facial aesthetics, the old saying, "No Pain, No Gain" applies. Good luck and be well.
CO2 will improve the texture and color too
Fraxel Repair and other fractional CO2 systems give some tightening, but mainly help general photoaging symptoms like lines, wrinkles and especially blotchy discoloration. Ultrasound and radiofrequency tightening just gives some improved contours and lift. Many patients actually do need both.
Thermage and Fraxel or Portrait
Resurfacing for lines around the lips improves these lines but the lines will not usually go away completely. The best results are obtained with laser resurfacing but it does take a week or more to heal and there is a risk of scarring. Fraxel Repair, non-fractional carbon dioxide laser and Portrait plasma therapy can be done but all do require at least a week to heal. Tightening procedures with radiofrequency, such as Thermage, do nothing to help the surface lines. Often patients undergo both and can do the Thermage the same day and immediately preceding the Fraxel laser. Fraxel Restore can be done in a series of multiple treatments with minimal downtime and no need to stay at home, unlike the Fraxel Repair, but the results are not expected to produce as good a dimunition of wrinkles of the lips.