How Much of an Improvement in Measurement for Ulthera Compared To Facelift?

I was told at a clinic that there is only 1mm improvement compared to 8 mm with a facelift. 1 mm?? Tthat's nothing so why even offer a procedure with that little improvement. I don't get it 1mm is barely there!!

Doctor Answers 7

Ulthera and surgery both work, for different indications

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As an Ulthera provider and as a surgeon who also performs facelifts, what you have to understand is that each has their place for facial rejuvenation.  For those women who have early signs of skin laxity and loss of elasticity and support in the face, Ulthera is perfect.  Results do vary, but in my hands, everyone has had photographic evidence of tightening of skin and some lifting of the cheeks and neck.  The previous reply was very biased. SkinTyte is a valid therapy using the same philosophy as Ulthera.  The statement that there is no control with Ulthera is wrong: Ulthera provides an ultrasound picture of the layers of the skin and face during treatment showing precise delivery of energy.

If you want surgical results, you will need surgery.  There is no way around that fact, and if you wait too long and laxity is too far gone, both treatments will yield less than optimal results.  Both Ulthera and facelift depend on the quality of tissue offered to the surgeon.  The only way to know if Ulthera is appropriate, is to see a physician that can offer both and provide an honest opinion.  If you go to a provider who cannot operate, then you will get an answer that is "always Ulthera."  If you go to a physician who does not have Ulthera and only does facelifts, you will get an answer that is "always facelift."  The only way to know which is right for you is to have your face evaluated by someone who can offer both, and offer an honest opinion as to what can be achieved in your unique situation.  Every patient is different, and thus requires consultation.


I hope this helps!

New Haven Plastic Surgeon
4.8 out of 5 stars 33 reviews

Ulthera Is Noninvasive Alternative to Facelift for Slight Sagging

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While no nonsurgical procedure can give you results as dramatic as a full facelift, if you have early signs of aging such as minimal sagging and loose skin, Ultherapy is a more appropriate alternative to avoid having to undergo several face lifts in a lifetime, as surgery is also not permanent and we continue to age.  In the study using ultherapy to lift the neck, they measured an average of about 50mm cubed of a lift. Ultherapy not only lifts the skin, but it actually reverses some of the aging process by promoting the production of collagen and elastin. Collagen is a protein that forms the matrix in your skin that gives it support and form. Elastin is a highly elastic protein that allows the skin to snap back into place after being stretched. Therefore Ultherapy not only gives your face a “lift,” it gives it a “boost” by actually encouraging it to act like younger skin by producing the elements needed to keep it elastic and supported. Please consult with a board-certified dermatologist to find out how Ulthera can help rejuvenate your face.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 91 reviews

Ultherapy can work beautifully in some patients but it is not a facelift

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Why do Ultherapy if it doesn't do what a facelift does?

1. The lift can be a few, not 1 millimeter in many patients. It doesn't work well in terribly sun-damaged individuals and those who have lost a lot of elasticity with age.

2. The few mm.s in different areas add up to a global reujvenation that is usually aesthetically pleasing to the patient and is noticable by others who know them.

3. Many patients don't want surgery or are fearful of risks, or have medical conditions that preclude them from having surgery.

4. There basically is no downtime from Ultherapy unlike facelift and this is very important for many people.

5. Younger patients who are not ready for a facelift can benefit from an earlier facial restoration than waiting for them to be told they're a candidate for a facelift later in life.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Ulthera is not a nonsurgical facelift

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Ulthera uses highly focused ultrasound to stimulate collagen regeneration under the skin, but the results depend on each individual's response so measuring lift in millimeters isn't realistic. Factors that affect the response are age, how thick or thin the skin is, how much fat is in the layer under the skin, and so forth. A facelift is more than just lifting or tightening skin; a good facelift involves 3-D shaping of the face for a natural appearing result. Too much pulling does not look as good but would yield a bigger number if measured in millimeters of lift.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Is Effect from Ultherapy Measurable?

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Surgical face lifting will obviously trump non surgical procedures. Ultherapy and previous nonsurgical technologies were developed to provide an alternative for those who don't want surgery and the attendant downtime, but do want to "look better".

Nonsurgical tightening isn't appropriate for everyone and an upfront practice will tell you if you are not a good candidate.  As long as a patient understands the limitations and does not expect comparable results to surgery, Ultherapy offers enough improvement to satisfy many who simply aren't ready or willing to take more aggressive steps.

As far as measuring and comparing Ultherapy to surgery, each person will have different needs, desires and different response to nonsurgical alternatives.

The pluses for Ultherapy

  • No downtime aside from redness and possible mild swelling
  • No surgical or anesthesia risks
  • No post treatment wound care
  • No general anesthesia (but pain management is part of the process)
  • Deep level treatment SMAS level - same as surgical levels
  • No obvious "work done" result

The limitations of Ultherapy

  • Not a substitute for surgical lift
  • Not a "pain free" procedure
  • No instant results
  • Not appropriate for patients with excessive laxity
  • Not a substitute for treatment of volume loss which would normally be treated with collagen stimulators or fillers

Realistic expectations need to be in place for any procedure. Because Ultherapy contracts tissue and provides collagen stimulation, you do get a "lift" effect - but without excision of tissue.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Understanding Ultherapy.

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There are several things that must be understood about ulthera and other new technologies.  Firstly you must understand that all of the information out there is from a company that wants to sell you on this as the latest and greatest.  However if you read the company's statements, this is not intended or purported to replace a facelift.  What is the problem?  The problem is that no company makes money when someone perfomrs a beautiful facelift so no one is interested in promoting a facelift to the public.  Instead there is a nonstop flow of unscientific information pursuading patients to spend money on branded technology.


Ulthera is designed to give patients exactly what they want- a promise of rejuvenation with no downtime and no pain.  A promise that cannot be fulfilled.


Why I would NEVER use ulthera in the face-


Ulthera works like the multitude of other problematic tecnologies out there, by creating focused heat to contract tissue.  Heat beneath the skin causes destruction of the healthy fatty tissues of the face that are responsible for a youthful appearance.  It also creates a concentric contraction around each point of energy deosition - relatively uncontrolled for direction and magnitude.  Furthermore there is no feedback or monitoring of effect with Ulthera meaning that you could be heating below threshold for collagen degradation or heating so high it could be dangerous.  In this sense it is a blind technique where practitioners 'believe' the company knows what is happening and blindly apply this to patients.


What I do use-


I use infrared heating of the neck and forehead to get subtle changes in patients who are not ready for surgery after explaining the limitations of these modalities.  Infrared energy has much more superficial penetration then ulthera.  When combined with an ablative resurfacing Erbium fractional laser, really nice results can be achieved in the right patient.  The infrared modality that I choose to use(mostly on body and some on face) is called SkinTyte II by Sciton.  The Profractional erbium beam really delivers nice skin contraction for patients that can tolerate a few days of downtime.


What is more important than any of this:


CHOOSE A GOOD DOCTOR THAT CANA OFFER ALL OPTIONS AND CAN SELECT THE RIGHT ONE FOR YOU.   I always say that infinitely more important than the technology is the hand holding the technology whether it is a cold steel knife, a laser or other advanced technology.  You are better off with a good plastic surgeon with sound judgement and open ears then a different practitioner with the latest and greatesst new repackaging of modern technology.


I hope this helps!



All the best,


Rian A. Maercks M.D.

Ultherapy clinical outcomes are great

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Ultherapy measurements are not clinically relevant and not used in assessing outcome. 

Outcome measurements are based on patient satisfaction scores and objective analyses by blinded physician observers. 

No one measures and I am not aware how measurements can be made in terms of assessing such criteria.

Read the Ultherapy ebook provided on the link below. 

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.