Which Laser is Best for Marionette Lines/Naso Labial ? Pelleve or Ulthera?

I am just beginning to get Marionette lines, they have not yet formed into deep wrinkles, just the beginning of that fat pocket and indentation starting. Which laser is best for the Naso Labial Fold/ Marionette area? I do not want to use Fillers, that never looks natural . Thanks for your suggestions !

Doctor Answers 8

Ultherapy is stronger than Pelleve for tightening

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Pelleve is okay but Ultherapy is better.  And I agree with the physicians who mentioned fillers, they can improve the marionette lines much better than Ultherapy alone. It's important to remember, when you see an unnatural or obvious filler treatment, it means the injector was bad or inexperienced, it's not the fillers fault.  In the hands of an experienced and artistic injector, you should get beautiful, natural looking results and no one should ever be able to tell you've been treated.

Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 217 reviews

Ultherapy is best! Combine with Voluma or Radiesse for amazing results without downtime.

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Ultherapy offers real fascia tightening to lift the sagging face and is the most impressive technology to tighten the skin that we have seen.  The newest generation of Thermage also offers good results.  

Ultherapy and volumizing facial fillers are really an amazing 1-2 punch to naturally and beautifully restore a more youthful facial architecture.  I agree that you need to see an expert for the best results, which does mean you see a board certified doctor (dermatologist or ENT, plastic surgeon) who does injections to have the best results.

I think the most impressive results on Jowls is seen when the full face and neck are treated together, because all of the fascia is connected and even some neck tightening will help the jowls.  

Michael H. Swann, MD
Springfield Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Ultherapy is probably best, but you may be surprised what fillers can do in the right hands!

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I agree - there are some bad fillers out there, but if you go to an expert (and this means a doctor who is doing their own injections and is board certified in cosmetic surgery), you have a better chance of having a good result.  As for which treatment, you probably will like Ultherapy, but the fact is that if you are having 'sagging' it is likely due to volume loss and that is best addressed by replenishment of volume via fillers.  Good luck!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.9 out of 5 stars 50 reviews

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Ultherapy and Facial Fillers

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Together Ultherapy and facial fillers will fulfill the desired effect, to tighten your skin and fill out the nasolabial folds and marionette lines respectively. Ultherapy is the best and only FDA approved device to treat skin laxity and nion surgical tightening of the face, neck. Read the Ultherapy book. 

Ultherapy is Best Non-Surgical Skin Tightening Device

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Ultherapy is hands down the current best non-invasive face and / or neck lifting, tightening device available at this time.

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

Ultherapy to lift face

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Dear Anna, thank you for your question. Ultherapy is the only FDA approvednoninvasive device for lifting the face and neck.It uses focused ultrasound to target the deep tissues above our muscles, as well as more superficial layers.Our San Diego clients have been very pleased to see significant results with no downtime.

Roy A. David, MD
San Diego Facial Plastic Surgeon

Best Non-Invasive Device for Lifting and Tightening the Skin

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Hi Anna,

Marionette lines, the vertical lines from the corners of the mouth down to the chin are difficult to treat.  Fillers are one of the best treatments for marionette lines. Fillers do look natural when the injecting physician has good artistic vision.   The best (and only FDA approved) non-invasive device for lifting facial and neck skin is Ulthera.  Most importantly, choose your treating physician most carefully.  Good luck and be well.

Dr. P 

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Pelleve vs Ulthera for facial skin tightening

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Pelleve uses radiofrequency currents (similar to Thermage) and Ulthera uses focused ultrasound, so neither one is a laser. An advantage of Ulthera is that the treatment can be focused with precision at 3 different layers under the skin, and it is the only nonsurgical device that is FDA-approved for facial skin lifting. It is done in a single treatment, has no down time for recovery, and is well-tolerated. I have to say that facial fillers done well and on the right patients can look very natural.

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