Can Pelleve cause fat loss in the face? If it can cause, what can I do for recovery?

Thank you for your question. You are wondering whether or not Pelleve can cause fat loss in your face. You state that after undergoing Pelleve, your face looked older starting the next day, but you were pretty satisfied with Ultherapy approximately one month prior. You are now noting that the appearance is regressing to the pre-treatment state.
I can share with you my thoughts with this technology, what effect it may have had in your face, as well as some options that might be worth considering with what you are trying to do with these non-surgical treatments. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. We have the full range of skin enhancement services in our practice, starting with skincare products we’ve designed, radiofrequency devices and lasers, injectables, and a wide range of surgical procedures I perform from eyelid surgery to face lifting surgery to help our patients look their best. I could tell you from a more global perspective the common issues I come across when people like yourself come to my practice with similar questions and comparable experiences.
It is important to first recognize some of the science behind radiofrequency devices. Pelleve is one of the original radiofrequency devices used for skin remodeling. It is based on a particular science where the skin is heated to a certain target level of temperature. At a certain temperature, you get skin and collagen remodeling, wrinkle improvement, and some degree of tightening. Beyond that and sustained, you can get fat reduction.
We have a device in our practice for non-surgical fat reduction in addition to Pelleve we’ve had for many years since Pelleve was initially introduced in the market. We also have a long pulse laser device where we use a scanner for non-surgical fat reduction and skin tightening. These principles are applied, and it’s just a question of what kind of technology is used.
It seems unlikely that Pelleve would cause fat loss. To get fat loss as I described, you need to have a certain target temperature maintained for an extended period of time. I can say from experience that the Pelleve approach of using a handpiece to roll over the skin, it’s difficult to get the skin to that high temperature for a sustained period to cause fat reduction. It’s not impossible, but it seems unlikely.
Given that particular technology and others were also being aggressively used to try to tighten skin, a lot of people share your type of story with other modalities. Understand that when fat is disrupted and reduced, a lot of it is diminished relatively permanently. However, we have helped a lot of our patients with similar situations improve their skin quality using platelet-rich plasma (PRP). Platelet-rich plasma (PRP) has been shown in scientific studies to stimulate fat cells. In helping people get skin rehabilitation, I have used platelet-rich plasma (PRP) injections done, let’s say every 3 months, to help improve fat cells, improve skin quality, and to help recover from very aggressive heating devices. Heating devices were not designed specifically to reduce fat, but intended to tighten the skin, but crossed the line where skin wasn’t  tightened, and actually further aged the skin. Beyond that, they didn't have much fat under the skin to begin with.
It’s very important to understand that a youthful appearance is not just about smooth looking skin. What I try to explain to my patients is a young person doesn't look tight, but has as we often describe as baby fat. When you are using a device intended to tighten the skin, you aren't that far away from potentially reducing some fat, whatever the device may be, but understand it still requires a certain amount of time to get that kind of effect.
Often, I find patients don't really appreciate that the skin is only 2 millimeters in thickness. Further, the fat layer under the skin gets thinner as we age. The one area that is overlooked almost universally is bone loss. People don't understand that as we get older, we actually lose a lot of bone structure, and that bone structure volume loss is really the foundational issue that results in the facial aging issues we all complain about, whether it’s deepening of lines, loss of definition, and what is perceived as excess skin or loose skin.
Something to consider, which may not apply to you since you didn't submit a photo, but I suspect is likely of value is the idea called Structural Volumizing. Instead of finding more thermal energy devices to tighten the skin, you may want to consider the foundation, and restore volume using this principle. This principle uses a long lasting hyaluronic acid filler such as Juvederm Ultra Plus and Juvederm Voluma. I’m placing it at the bone level to restore structure and get this beautiful, harmonious balance in the face, whether it’s in the cheekbone, jawline, jaw angle, or the chin. What often is perceived as sagging and loosening becomes restored. It’s like restoring the real basis of what everyone keeps trying to tighten, whether it’s with non-surgical treatment such as radiofrequency and lasers, or with surgery such as facelift. These are all valid modalities, but if you are able to treat the true foundation first, then everything else becomes icing. Anything from a laser point of view, whether it’s discolorations or wrinkles, are more about the shine and the enhancement apart from the foundational issue.
Think about skin rehabilitation and skin quality improvement with platelet-rich plasma (PRP), and think about Structural Volumizing using this technique to get volume at the bone level. It’s in contrast to putting filler at the skin level, just below the skin, or even within the skin because you aren't going to be able to get enough correction and stability that looks natural. Often, people don't like the way a lot of celebrities look because they often look pillowy and strange because the filler is placed below the skin as opposed to the bone level. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Pelleve cannot cause fat loss in the face. Fat tissue actually reflects the RF rays. Pelleve only results in modest collagen tightening and reformation, and in the formation of additional elastin tissue in the lower layers of the skin, resulting in modest "tightening" of the skin, smoother skin, and less minor wrinkles. RealSelf's Web reference below gives additional information.Best,Michael P Goodman, MDDavis, CA, USA