Thank you for your question. I can certainly give you some guidance as I'm a Board-certified cosmetic surgeon, practicing in Manhattan and Long Island for over 20 years. I have witnessed a lot of technology come and go over these 20 years, and can shed some light on realistic results. To first answer your question, I would say that neither Ultherapy or Pelleve would be a good choice for you in this scenario.There are limitations to collagen stimulation through heat induction, and part of that limitation is your skin itself. Skin, especially thinner skin, can only accommodate so much heat before it begins to break down, therefore those horror storiesof Ultherapy causing fat depletion in the face is not uncommon. In fact, this is a reality for any radio frequency or laser device that generates a lot of heat. Heat can tighten skin up to a certain point, but when you have the intention of liftingthe face, you need to have a proper assessment to determine what the issues are—is it loss of volume? Sagging of the skin? Descent of the support of the skin or SMAS (superficial musculo aponeurotic system)? On the other hand, if you have a relatively thin face, a surgical face lifting may not be right for you, and you may be more of a candidate for a Y Lift®, which is based on the concept of structural volumizing wherein fillers are injected into the deeper levels of the face to create more significant and firmly supported volume, and a face lifting effect. When dealing with thin skin, adding volume at the deeper levels may be much better because we’re able to accentuate and restore volume in the structure of the face, without putting any additional weight on thin, saggy skin. With this method, you don’t need to feel limited to thermal devices only. In our practice, we rehabilitate skin using platelet-rich plasma in an effort to reverse damage caused by the aggressive use of thermal devices. This includes stimulating collagen production, and the quality of skin and soft tissue. With regard to cellulite, I would say there's no good solution for cellulite regardless of what manufacturers of thermal devices or various technologies will claim. When it comes to the crepiness of the skin in the extremities, again, there are limitations,and I would advise against any of the devices that are being overhyped. The thing about technology in the field or cosmetic medicine, dermatology and the like, is that there is so much hype—so much that even doctors become easily seduced by the claims. Some doctors will go as far as make statements about any device as long as they get paid for it. As a result, people and doctors alike will go from device to device in search of the Holy Grail. The whole thing is a cycle and clearly there's no one good solution, otherwise everybody would be doing something more consistent. I would advise you against both Ultherapy and similar treatments. Thermal energy devices do have a role and a purpose, but they are often overused and abused, which results in not the best outcomes for patients. I suggest for you to meet with doctors and discuss your options—you’ll find that you’ll get a lot of different opinions, so it’s just a matter of finding one that’s best for you. I hope that was helpful and I wish you the best of luck!