Neck tightening - ulthera or fractora. (photos)

I'm 40 and I've noticed that my necklace lines have become more prominent with some laxity right under the chin. What procedure would work best, ulthera or fractora? I do not want surgery. Thx

Doctor Answers 8

Ultherapy for Neck Laxity

Often a treatment combination approach is the way to go.  Ultherapy is great for skin tightening and fractora works well for skin texture.  In our office, we will often use Ultherapy for tightening followed by the non-ablative 1540 fraxel laser.  The two treatments together show great results. Based on your photos, I recommend Ultherapy followed by a procedure to treat the skin texture. You could also consider filler in the "necklace lines". 


Chicago Plastic Surgeon
4.9 out of 5 stars 88 reviews

Best Non-Surgical Neck Tightening Treatment

You would really need an in-person consultation and evaluation to determine which treatment would be appropriate for you. Looking at your pictures I think you would do best with a combination of treatments. If you are looking for a lift and tightening, then Ultherapy or ThermiTight would be appropriate. For texture improvement and fine lines/wrinkles the treatments can be combined with microneedling, chemical peels, thermismooth, or laser. Fillers can help soften the deep horizontal neck creases. Please make sure you find an experienced provider. Hope this helps!

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 9 reviews

Ultherapy for neck tightening

Ultherapy is a no downtime procedure that is FDA approved for noninvasive skin lifting. With your age and condition you are a good candidate. Be aware that every nonsurgical treatment has a range of responses.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 48 reviews

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I wouldn't do either for necklace lines

While I do like ultherapy for skin tightening of the face and neck, one major drawback of the technology is that it does nothing for fine lines and wrinkles (texture issues).  Texture issues such of those are best addressed with resurfacing devices  i.e. laser, peels, microneedling.   I do not have much experience with fractora personally, but the device makes me nervous as it has uninsulated needles an is very technician dependant.  I Personally prefer Lutronic's Infini, In my opinion this device is the gold standard in regards to RF Microneedling devices.   It has insulated needles which makes it more controllable with less downtime.  I find it works great on necklace line and the perioral region.   As opposed to fraxel and other lasers it has less downtime and also gives a degree of skin tightening.  



Reps B. Sundin, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 26 reviews

Getting the right treatments for neck tightening: Thermage, Ultherapy, Liposuction, fillers

A combination approach is needed. My recommendation for neck tightening for all my patients that are candidates for RF treatments is Thermage combined with exilis or Ultherapy. Liposuction with energy on the neck such as ThermiRF also does very well to tighten. Fillers can go directly into the lines for improvement. I suggest seeing an expert for an in person consultation.  Best, Dr. Emer. 

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Tighten up!

I highly recommend the Ultherapy. It is the only FDA device to tighten up and lift those tissues. One of my favorite things about Ultherapy, other than the results, is that there is no down time. With Fractora you could have social downtime for up to a week! In my opinion, you don't need something that aggressive. Ultherapy will give you an amazing result. Good luck!

Ellen A. Janetzke, MD
Birmingham Plastic Surgeon
5.0 out of 5 stars 15 reviews

Ultrasound vs radiofrequency

Ulthera is good for tightening the neck and jowls.  You have some mild laxity in the neck so should do well with this.  The radiofrequency is better for helping with the skin texture.  So if you have a lot of fine lines and wrinkles in the neck RF is better choice. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Ulthera for neck tightening...

Thank you for your question.  I think you are a fantastic candidate for Ultherapy.  Ultherapy is the only FDA cleared non-invasive procedure that lifts and tightens the neck.  Ulthera uses micro focused ultrasound to generate heat deep in the skin to lift and tighten.  Fractora uses fractionated radiofrequency to create heat in the skin.  Over time, ultrasound has consistently outperformed radiofrequency for lifting and tightening.  Radiofrequecy is good for acne scarring and skin rejuvenation.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 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.