Ultherapy has amazing results. However, unlike some other non-invasive procedures, this one involves skill and experience. I believe this is why there are not as many positive reviews for Ultherapy on this site. During treatment, the tissue is visualized with ultrasound. The treatment lines are placed precisely. Experience and expertise in ultrasound are very important to both safety and results. I am an Ob-Gyn. I went to a physician's office to have Ultherapy personally. During that treatment, I realized that I had more ultrasound experience than the person performing the procedure. She did a wonderful job, and I got great results. However, I realized this procedure was a natural fit for an office that does so much ultrasound! This is how an Ob-Gyn started doing Ultherapy. It is extraordinarily popular in our office. Our patients trust us to ultrasound their babies during pregnancy, and they trust us to also ultrasound and treat them aesthetically. In short, an experienced RN at a medi-spa can do a great job if she is experienced. An MD can do a terrible job if they are not experienced. Seek reputation and results. Good Luck!