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.

Ultherapy is well tolerated and feels like tiny electrical pricks. I have had it myself for the full face and neck and have been very happy with the results at 4.5 years follow-up. Read the Ultherapy book on the link below under 'ebooks'

The pain generally feels like a moving warm sensation or small electrical shocks that can build up to a crescendo. Each pulse starts out with some prickly sensations that can then get more intense and feel almost like a burn. The discomfort is usually mild but can built up to short spikes of brief pain. The pain felt during the treatment is highly variable from patient to patient and also can vary greatly depending on the experience of your doctor. There are many techniques which can be used to lessen the discomfort such as manipulating the tissue, adjusting the settings, performing more passes at lower fluences for those who are really sensitive. It helps to apply a topical numbing cream, and take a painkiller like Percocet prior to the procedure. It's also important for the doctor to understand the physics of this device and how it interacts with the tissue and understand the anatomy. There are critical areas on the face that the doctor needs to avoid and know how to adjust settings accordingly (ie: when over the bone or nerves). It's normal to have some numbness that lasts for a few weeks after the procedure.

I personally have had Ulthera.  It was tolerable to me but many patients find it pretty painful.  I describe the pain as a crescendo-decrescendo heat, similar to that of a very hot heating pad or the sensation you get when you hold your skin too close to a fire for too long.  the pain was a 2-3 on a scale from 1-10 most of the time but there were several hot spots that were a 10.  I did not premedicate with any medication.  In general, most people find the treatment a little painful, but a few do find it very painful.  The good news is that the pain is over immediately and there is no lingering pain.  We do premedicate everyone before the treatment unless they refuse it. 

Most of the many patients we treat with Ulthera find it quite tolerable. Most describe the Most severe aspects Of the pain as a 3-4 on a scale of 1-10. To lessen the pain We utilize multiple modalities including Valium, percoset, or other pain medication; ice, cool air ,and other techniques. All of our patients have been able to get through the procedure without any problems. The patients in general have been quite pleased with the results and the fact that there was no downtime. To further improve the results for Ulthera we may combine it with another procedure.