Does Ultherapy cause nasolabial folds? The jowls always look worse. Does it destroy vital fat to keep the folds from deepening?

Ultherapy will tighten and lift skin but when used with the current transducers has not been demonstrated to cause injury to facial fat.  Well nasolabial folds may or may not improve following Ultherapy treatment, they would not be expected to worsen.

Ultherapy is an FDA-approved noninvasive skin lifting technology which would improve nasolabial folds. I have not seen any pictures showing them worsening and have not seen it in my practice.

Ultherapy uses ultrasonic energy that by passes the outer layers of the skin and is micro-directed to the lower soft tissue layer of the face where it stimulates collagen and helps to tighten the skin. This ultrasound energy is focused so that the practioner can see exactly where the energy is being delivered.  We have been performing Ultherapy in our office since the device was introduced, and although results vary among patients, most of our patients are very satisfied with their results.  Increase in nasolabial folds or diminished  jawline have never been a concern for our numerous patients.  

I have not had patients complain of worsening NLF after Ulthera.  It will help to tighten the skin of the lower face, so that the jowls appear better.  There may be some fat shrinkage as well in the jowl and under the chin.  But it will not deepen the NLF.    

I don't know which before and after pictures you have been looking at, but in all my experience I have never seen an Ultherapy treatment worsen the jowls and the nasolabial folds. Ultherapy will soften the appearance of nasolabial folds, but will not replace the lost volume in the area. Fillers are good for that. With Ultherapy we are treating the various layers of the skin, up to 4.5 mm deep. It does not go deep enough to have an effect on the fat. Hope this helps clear things up for you.

You are absolutely wrong in your assessment of the effects of Ultherapy on the nasolabial folds and jowls. I have been doing this procedure since 2011 and I have never seen that on follow up pictures, on my physical examinations at follow up or from the standpoint of patients who have had Ultherapy who complained of this as a side effect of treatment. 

I have never seen jowls or Nasolabial folds get worse with Ulthera.  The main effect of Ulthera is from stimulation of collagen and not from destruction of volume.  On a few of the patients undergoing Ultherapy in San Antonio, we are able to reduce some fat under the chin using special techniques.  You might want to seek out a specialist for a consult or look at the Ulthera Facebook page, they have a simulator to give you an idea of what you may look like after a treatment.