Can Ultherapy be used directly under eyes? For crepey skin/fine lines/wrinkles directly under eyes. (photos)

For my patients, Ultherapy can be used under the eye if the skin is pulled down over the orbital bony rim and pointed away from the eyes. It is microfocused ultrasound heat. However, we have decided instead to focus on ThermiEyes for the periorbital (i.e., all the way around the eyes) area. This is radiofrequency and it feels like a warm stone massage. So it is less uncomfortable during the treatment.  We also have ThermiEyes Plus, where we can put in a protective eye contact lens and then lower the settings to treat directly on the eyelids. It is usually a series of three or four. For pts that want even more improvement to the crepe like skin, we can also add in a Madonna lift which is laser on a very low setting directly onto the eyelid for a series of three. This also has a protective contact. When our pts subscribe to the layering effects of different treatments, they are very happy with minimal downtime.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello and thank you for your question and photo.
Fine lines of the eyelids can be treated with Ultherapy.  Ultherapy is typically used in conjunction with other treatments, including laser, microneedling with PRP and also fillers.  I would recommend a consultation with a board certified provider who can discuss your desired outcome and plan of care.  I hope this information helps and best of luck to you!

In my practice we combine  ultherapy with PRP injections/microneedling, lasers and/or fillers to get the best results.  Please see an expert for combination treatment. Dr. Emer.

Thank you for your question. Ultherapy is most commonly meant to treat tissue that is not directly under the eyes; it is meant to treat tissue at the orbital bone and below. The skin above the orbital bone is, as you mentioned, very thin. It is possible to get some of a treatment in the area but you need to see a physician that is highly experienced. Either way, you can only pull the skin so far down and get the treatment so high. This is probably not the best choice for treatment under the eyes. There are better and safer treatments out there for this delicate area such as radiofrequency treatments. In people that have severe lines and wrinkles under the eyes, botox, fillers, and/or surgery are typically recommended. I hope this helps. Best of luck to you!

When it comes to treating eye wrinkles, Ultherapy is considered to be a top contenders. If your concern is leaning more towards issues with skin sagging underneath the eye, Ultherapy would be a more suitable treatment and can be applied to the area you have shown in your photos.  

Yes, it can be used with caution under the eye area or above the orbital rim. As you correctly said, skin is displaced and the transducer is aimed away from the orbit. Ultherapy is best combined with dermal fillers, and lasers to address skin texture, tone (Ultherapy) and volume. Dr Isobel Walker, Brisbane. Australia.