Risks of Having Ulthera over Fillers?

I understand many doctors believe Ulthera can dissolve fillers. Besides Dissolving fillers, what other possible side effects are there of doing Ultherapy over fillers? Can the filler move? I've had Restylane injections around the eye/cheekbone 2 months ago and now want Ulthera around the orbital area as well.

Doctor Answers 12

Ulthera with Radiesse fillers - Los Angeles

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New clinical research has shown that Ulthera can work synergistically with stimulatory fillers such as Radiesse and Sculptra to stimulate collagen formation. We advise patients to undergo Radiesse with Ulthera. Raffy Karamanoukian, Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Ultherapy and Sculptra and Radiesse

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There is clinical data that shows that Ultherapy can be combined with certain fillers and the effect is compounded with the combined treatment.

Read the Ultherapy ebook provided on the link below. 

Ultherapy and Fillers

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It has been a question that physicians have had, and one that has not been scientifically proven, if fillers dissolve faster because Ultherapy energy was passed through the filler. If it can be scheduled such that Ultherapy is done before the fillers then there is no concern. I am not aware of any cases of Utlherapy making a filler change in its chemical properties or make it migrate.

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

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Ulthera and fillers

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As you mentioned, the main risk of preforming Ulthera over fillers is that is can dissolve the fillers faster. In the future, I recommend having your Ulthera treatment prior to filler injections to ensure. This time, just make sure you communicate to your physician that you have had filler injections on the cheek and eye area.

Carlo P. Honrado, MD, FACS
Los Angeles Facial Plastic Surgeon

Ulthera and fillers

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The risk of performing Ulthera after fillers is that the filler will dissolve faster.  I prefer to perform Ultherapy before fillers.  After the lift from Ulthera, the patient may need less filler.  However, you can have fillers first.  I would wait 2 weeks betweeen treatments.  It is useful to go to the same physician for both, since they will know exactly where the fillers are and easily avoid them. 

Angela Sturm, MD
Houston Facial Plastic Surgeon

Ulthera after fillers

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The major issue with performing Ulthera over fillers is exactly what you mention- the risk of dissolving the product.  Other than that, there is not data to suggest any other risks associated with this sequence of procedures.  Having said that, it is important to be aware of the risks of Ulthera, in general, such as bruising, swelling, temporary numbness, and welts (especially with the more superficial transducers.  THere are many circumstances in which we have performed Ulthera over areas where fillers have been injected, however, we tend to wait about a month or so at least before doing so. 

Ritu Saini, MD - Account Suspended
New York Dermatologic Surgeon

Ulthera and fillers

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Ulthera at the upper cheek or undereye region targets a more superficial depth than where filler is typically injected in that area. If you had Restylane injected at the undereye region or "tear trough" area, typically the filler is injected deep, along the bone. Most practioners are concerned that Ulthera directly over fillers may dissolve the filler more quickly (not that the Ulthera will cause the filler to move), so we recommend doing Ulthera first, then injecting filler after. There are other possible side effects with Ulthera in general, regardless of fillers, such as bruising or swelling or even blistering. Whoever is performing the Ulthera (plastic surgeon, dermatologist, or supervised nurse or physician assistant) should take a thorough history and advise you to stop any blood thinning medications and herbs in advance of your treatment. It's an excellent technology that I'm excited about, and have had great results with. Technique and safety are key.

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Ultherapy & Fillers Safe

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The issue of whether Ultherapy & Fillers are safe together is really not that complicated. Ultherapy causes collagen tightening by heating the layers of tissues of the face in a targeted way. Fillers restore volume in those tissues.  Ultherapy before fillers is very safe.  We often combine ultherapy with fillers by first doing the ultherapy then placing the fillers so that the heat does not affect them.  Heat is more likely to affect botox than fillers.  Ultherapy after fillers immediately after fillers and botox probably is not a good idea, but in a delayed fashion is safe. Ultherapy is usually a one time treatment where filler are not.  Even if you have some absorption of fillers which will happen anyway...you can get more.  The combination together is very effective!

Ulthera Treatment after Fillers

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You are correct ultherapy can potentially lessen the effects of fillers so I prefer to do ultherapy first than fillers.  However if this is not possible, I will still move forward with ultherapy but make patients aware of possible side effects.  These include but are not limited to: welts, numbness, paralysis, bruising, burns, soreness, poor cosmetic outcome, no cosmetic outcome, or reduced effects of filler.  Although these risks are unlikely with an experienced practitioner, patients should be fully aware of all possible side effects prior to any procedure. 

I hope this information is useful.

Paul L. Leong, MD, FACS
Pittsburgh Facial Plastic Surgeon
4.8 out of 5 stars 50 reviews

Ulthera Over Fillers

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Regardless, I generally wait 2 weeks after a hyaluronic acid placement to perform the procedure on my patients and I keep in mind where I have placed the filler.  Studies have been done to evaluate the effect of other energy devices that heat the skin as deep as 3 mm, immediately over 4 different fillers, and they have shown through biopsies that it doesn't break the filler down any quicker.  I would recommend seeing someone that does many Ulthera treatments for evaluation and treatment. Good luck.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 91 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.