What Does the Pain During Ulthera Feel Like?

Ultherapy overall is a well tolerated procedure.  It can be done in the office and can be done with no means of chemical pain control (e.g. nerve blocks, anxiolytics, narcotics)  That doesn't mean it is a walk in the park.  I have personally tried Ultherapy and did one half with no pain control and used nerve blocks on the other half.  I would rate my overall discomfort level as 5/10.  However, there were times when it was a 2-3/10 and other times when it was 7-9/10.  After the procedure, I had minimal discomfort and started seeing patients.  The numbing definitely made the treatment more comfortable, but I had several hours of feeling like I've been to the dentist on half my face.

For my patients, I offer talk/music/distraction therapy (i.e. no chemical intervention), nerve blocks, or if they have someone to drive them home, they can take an anxiolytic (e.g. Ativan) and/or a narcotic. 

Each individual experiences pain differently, making it difficult to generalize. Most of our patients say it feels like a very deep vibration that can be uncomfortable especially around the jaw and orbital bone. However, with Ulthera’s new technology upgrade patients are much more comfortable throughout the procedure and with proper medication patients are tolerating Ultherapy very well.

Many patients find it tolerable with  the assistance of medication that relieves some anxiety and pain. Certain areas are more intense, such as near the bony areas.Once the energy is delivered to the "line" and the transducer is moved on, the pain starts to fade. Interestingly, despite Botox being the most common cosmetic procedure, this website, RealSelf.com, shows patients rating Botox at a 65% satisfaction rate whereas they have rated Ulthera at an 85% satisfaction rate!

Immediately after the procedure, the skin feels like a sunburn and that goes away quickly although there may be some tenderness for a week or two, rarely more.

By the nature of it's deeper penetration and spot heat production, ulthera treatments that hit some of the nerves in the face or bone across the forehead, cheek and jaw can produce twinges of sharp plain that can make patients jump or pull away. While one can reduce the energy delivery, and likely the effectiveness of the treatment, we prefer to give injections of local anesthesia (novocaine like) across regions of the face. Our patients are very comfortable with this approach and cruise through the treatment with ease! Tyelenol or advil is also used routinely and some people opt to take a pain pill or Xanax but will require a ride home.

This is a very commonly asked question, because Ultherapy is typically an office based procedure, performed without IV sedation.  The simple answer is that it is somewhat uncomfortable, but much more tolerable in certain areas than others.  I would equate the discomfort as that of a small electric shock with every pulse.  For that reason, we typically have our patients take a combination of Valium and a narcotic pain reliever about 30 minutes prior to starting.  Ultherapy cause the internal tissues to heat briefly to a about 60 degree Centigrade, so it is normal to feel some discomfort during the process.  Most patients feel the result made the process worthwhile.