Ulthera Created More Lines and Hollowing of Eye Area?

I had an Ultherapy treatment done only to my orbital area a month and a half ago. I know results take between 3-6 months, HOWEVER I am actually noticing more hollowing, darkening and lines at this point!! YIKES! What is this? Is the first stage of Ulthera supposed to look worse? Is the collagen being damaged in that area!? I am terrified by what is happening. It is noticeable in before & after pics at this point and friends can see the negative progression as well! :( Advice , input please

Doctor Answers 5

Ultherapy around the eyes

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I have been working with Ultherapy since 2009 and participated in some of the earliest studies performed with this technology around the eyes.  None of the patients we treated either in the study or in my practice have experienced worsening of their skin or the other structures around the eyes after this treatment.  I would suggest seeing your doctor to determine what else might be responsible for the changes you are noticing.

Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

Ultherapy does not cause volume loss

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I believe that although temporally relate, i.e. noticing volume loss along the same time period as getting Ultherapy, I have never seen this happen and other Ultherapy providers have not reported this to occur. 

Ultherapy should not worsen lines around the eyes, nor cause hollowness

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Ultherapy should not in the lease worsen the skin's appearance in the periorbital area. It actually does not treat the skin right up to the eyelashes as there is a physical restriction of the transducer preventing doctors from reaching that skin of the eyelid. 

Sometimes wrinkles are temporarily produced by a dryness of the skin such as with eczema or contact dermatitits, not that you have either of these conditions but your skin needs to be evaluated in person, either by the physician who performed your Ultherapy treatment or a second opinion dermatologist or plastic surgeon. Sometimes Botox injections around the crows feet make the smile muscles work harder to try to squint and then the cheek pads push on the lower eyelid skin making more lines during smiling.

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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Lines after ulthera

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6 weeks post op is too soon to really tell the full effect of Ulthera. It sounds like what you are experiencing is mainly loss of volume. Hollowing and lines around the face and eye area can be due to several different factors including: weight loss, diet, and dehydration. Although it is hard to say without a before and after picture, I would recommend volume enhancers or fillers for immediate results. This hollowing and darkening are not side effects of Ulthera.

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

"More Hollowness and Lines" After Ulthera?

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Hi Lidia,

Ulthera does not destroy existing collagen, rather the heat lesions that are created during Ultherapy stimulate collagen production during the healing phase.  There are many factors that can influence lines and hollowing around the eye area including weight loss, not enough hydration, coincidental loss of volume.  I would advise waiting the full 6 m months for the treatment to take effect.  You should made sure that you are staying well hydrated and should be using excellent hydrating eye cream.  If you feel that you want to do something earlier, then you may benefit from fractional CO2 laser tightening of your eyelid skin and injectable Restylane volume augmentation.  Good luck and be well.

Dr. P

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