Ultherapy or Silhouette soft face lift (threads)?

Question

I have lower face starting to sag. I don't want a surgical facelift just yet, nor do I think I need one (as agreed by surgeons I have visited). I've been offered two alternatives - either a silhouette soft face lift (with threads) or ultherapy. They are both by different clinicians and apparently both procedures provide the similar results. Is this true or is one better than the other? I really do not know which to opt for and could do with some external advice.

Leah Totton, MBBS · Answer

Thank you for your question. Both are good treatments in their own right, both safe in the right hands and both provide a good but modest lifting result. I am the UK trainer for Silhouette soft lift. In the right hands Silhouette soft thread lifts can give great results but for patients with moderate facial laxity I rarely perform silhouette soft without combination with other treatment - most commonly dermal filler but we now offer both ultherapy and thread lift in combination where more of a lift is required - called "The Dr Leah Lift".We have conducted trials on the combination method of Ultherapy followed by silhouette soft threads (we are publishing our case study findings at present) but generally the results tend to be much more dramatic when both treatments are combined (albeit 3 months apart - we perform Ultherapy and then insert threads 3 months later). Our findings were that the Best results are 6 months after Ultherapy and 3 months after silhouette soft threadlift and they tend to last a full 18-24 months (this longevity of result is something we were struggling to achieve with either of the treatments in isolation).We have offered Thermage in the past but found Ultherapy to give better results. For neck we are now trialling ultherapy followed by a treatment called profhilo and early outcomes for that combination treatment are very good, will update further on this when our mid and long term data is available. Both ultherapy and silhouette soft thread lift's are safe and effective if performed by a skilled practitioner. For more dramatic results a combination method may be worth discussing with your physician. Good luck and I hope this helps, 
Dr Leah Totton

Ron Shelton, MD · Answer

I have been performing non-surgical facial tightening procedures in my NYC practice for two decades and have seen an increasing number of procedures developed in the last few years. I have used radiofrequency tightening including Thermage, Pelleve, ThermiSmooth and the ultrasound energy device, Ultherapy. None of these procedures will cause the same amount of lifting in someone who needs a facelift but many patients aren't yet willing to undergo surgery. An in-between technology, called ThermiTight,  involving local anesthetic injected before delivering radiofrequency with a small rod underneath the skin, does provide more tightening than these external non-invasive procedures but does cause more swelling and often bruising for a week or so. Even with ThermiTight, we have found that in order to help raise the jowl, suture lifting with Silhouette sutures, called InstaLift, is often needed to be done along with the ThermiTight. Those patients who have heavy large jowls will not see much of a difference and I tell them that a facelift is their best option for a good aesthetic result.In general, one can learn from the above, that for some patients it may not be an appropriate decision to have either Ultherapy or Silhouette Instalift, rather, which non invasive tightening procedure should be done along with InstaLift. Certainly, some patients only need Ultherapy or ThermiSmooth but those with jowls that are hanging over the jawline might consider InstaLift as well.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Richard Baxter, MD · Answer

Ultherapy is the only noninvasive facial skin lifting technology that is FDA approved. Variations of the threadlift have been around for some time but it is a surgical procedure and I have not been impressed with the results. Better to improve the collagen under your skin with microfocused ultrasound using Ultherapy.

Victoria Manning, MD · Answer

Both are FDA approved methods of lifting the face
non surgically and it is true that both treatments stimulate collagen but do
this in completely different ways. Ultherapy uses ultrasonic waves and
Silhouette Soft is a thread lift.  However,
as passionate Silhouette Soft advocates we believe that the latter is a far
more effective treatment because it both lifts the skin immediately giving you
results straight away, then it stimulates collagen so that the results get even
better in the ensuing weeks – in this way it can deal with skin laxity and
drooping of the lower face the area which you are looking to treat.  Some people find the Ultherapy treatment
quite uncomfortable whereas the Silhouette Soft treatment is rendered painless
after local aneasthetic is applied to the treatment areas.

Hratch Karamanoukian, MD, FACS · Answer

Thank you for your question.Ultherapy is FDA cleared and is time tested with great outcomes and high satisfaction rates. The technology was the first to utilize non invasive techniques using safe high intensity focused ultrasound with B mode ultrasound imaging (DEEPSee technology) to  image the area being treated - either skin level (1.5 mm to 3 mm) or deeper in the supporting layer of the skin (SMAS @ 4.5 mm). It provides lifting of the mid and lower face as well as neck. In addition, they have done studies to treat eyebrow (non surgical lift) and treat fine wrinkles under the eyes, around the eyes, upper lip and around the corners of the mouth with new transducers that are uique for these areas. There is also FDA clearance to use it for the decolletage. I recommend that you read the book providedo on the link below before you make your decision.I have been doing this procedure since 2011 and the patients love it. I have had the procedure myself and endorse it as a physician and patient.

Davin Lim, MBBS, FACD - Account Suspended · Answer

I perform all 4 procedure, and they all have a role in lifting and tightening. Nothing lifts or tightens better than a conservative face lift. Predictable, with safety in the correct hands. Ultherapy better than Thermage in general, if you have good quality collagen (i.e. little elastosis and sun damage). Asians and ethics do better due to thicker dermis and in general better collagen quality age for age. Not a racist comment, but a scientific one. Darker skin patients scar and keloid easier, meaning the tissue response for these methods are different. Thread lifts- if mild to moderate laxity is present, esp. in the jowls in someone who is not overtly heavy or too thin in facial fat, - this is the ideal candidate. Expect a 2 cm lift in key area. Last for 18 mths to 24 months. Uncomfortable for 10 days or so after the procedure, but little downtime. Bruising common. Dr Davin Lim, Laser and surgical dermatologist. Brisbane. Australia.

Ultherapy or Silhouette soft face lift (threads)?

Answers (6)

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