Is Pelleve or Ultherapy Better to Tighten Skin?

 



  Ulthera is hyped as a face-lifting and neck tightening technology that is revolutionary because of its use of focused ultrasound that creates ridiculously high amounts of heat in tiny little spots underneath your skin. The thought is that a line of these spots will create a vector of pull or lift. Well, the results are difficult to appreciate (if you do not take a post procedure picture with an elevated chin which makes the neck appear tighter) and the long term results are just sad. The heat deep in the face must dissipate and no matter how focal energy delivery is, healthy facial fat suffers. It has been around long enough to have many patients see the horrible eyelid retraction and fat atrophy that it can cause. I see young patients in my practice, who otherwise would not need a surgical intervention, present with discontent after these treatments that need blepharoplasty and canthal suspension as well as fat grafting to restore them to reasonable aesthetics.

Pelleve is a radiofrequency device, actually a powerful electrosurgical generator for cutting cauterizing and fulgarating tissue that for marketing reasons developed a special handpiece with lower power settings branded as a cosmetic intervention to increase market share. The results of Pelleve are sometimes even more devastating. This is because Ulthera charges doctors every time they push the button for a pulse which results in generally limited energy delivery.

With most of these technologies one should consider themselves lucky if no result is seen because changes caused are usually negative. I encourage patients to avoid the latest name branded repackaging of last years' disastrous technology and to find a plastic surgeon who has resisted the urge to join corporations to shake money out of patients. Many of us including myself use ultrasound, radiofrequency and other technologies under true surgical judgement and let experience and knowledge guide us to offer reasonable treatments that do not harm patients instead of following directions from sales representatives with business degrees on how to alter someones face.

Also if you are going to let someone deliver energy near your eye, make sure they are a surgeon that understands the surgical anatomy, do's and don't's, risks and potential complications. Otherwise there is no way you will avoid them!

If you are impressed with before and after pictures of a neck or face, look at the position of ear landmarks to eye landmarks, hold a straight edge to the picture and you will likely see a relatively elevated angle in the post picture that will explain any improvement. If the ears are not in the picture, well now you know why. Also be careful with lighting flash and exposure settings as well as frank manipulation.

Be careful it is not pretty out there!

Ultherapy is rebuilding of the foundation using ultrasound for deep tissue tightening and is recommended to be the first step when wanting to tighten/lift the skin. Ultherapy works on the deeper layers and is usually more aggressive and long lasting with only one treatment. Especially in areas of jowling, submentum and neck. For jawline lifting and tightening results with Ultherapy are better. Pelleve uses radio-refruency not going as deep as Ultherapy but is taking care of the top layers of the skin to help reduce fine lines and wrinkles at the surface and promote collagen rebuilding. More treatment sessions are required with Pelleve but there is less downtime. It is suggested 1 treatment per decade of age every four weeks. Pelleve works wonders on under the eyes as well! Hope this was helpful. Best, Dr Rosy Sandhu. 
 

I think that Ultherapy and Pelleve have similar results but I went with the Pelleve because it doesn't hurt.  It feels like a hot-stone massage.  Very relaxing.  I just made and uploaded a new video about Pelleve. XOSheila Nazarian

Beverly Hills

Ultherapy provides very effective improvement in the lower face and neckline. I use the procedure to address sagging skin and muscle fascia. Raffy Karamanoukian Los Angeles

Studies have shown that Ultherapy treatments provide optimal results. Through our own experience with skin tightening, we choose to use the Ulthera skin tightening system.

In general, most non-surgical skin tightening treatments require multiple session. What makes Ultherapy unique is that it can achieve results in as little as one treatment. Of the non-surgical treatments available, we currently only recommend Ultherapy. None of the other technologies, and we have used and have access to them all, have compared to the results we are seeing with Ulthera. See a board certified facial plastic surgeon to see if Ultherapy is right for you.

Ultherapy and Pelleve are two completely different modalities. Ultherapy uses ultrasound waves to cause micro-wounding and stimulate new collagen to lift and tighten your skin. Pelleve uses radio frequency to plump your existing collagen making your skin appear tighter and is usually done in a series for best results. My recommendation would be to have a lower face and peri-oral Ultherapy treatment and then six months later try the Pelleve. My reasoning is that you will generate new collagen and elastin with Ultherapy and the Pelleve treatments will amplify the results of the Ultherapy.  

I describe these treatments, along with Botox and fillers, to my patients as a Peanut Butter and Jelly sandwich laying on a plate.  The Pelleve works on the top layer of the skin (the top bread), the Fillers and Botox work in the middle, like Peanut Butter and Jelly, and the Ultherapy works on the lower most level (below the fat) like the lower level of bread.  

There is no way to affect all these areas with just one treatment, so this is a huge benefit to doing all of these together.  

There is no doubt that Ultherapy delivers deeper energy and heat to the dermis and connective tissue layers than Pelleve. Usually Pelleve is done as a series of 3 treatments and can provide improvement, but not to the same extent as Ultherapy.  Pelleve is a more gentle treatment and is often done on patients who have less to lift up than the Ultherapy patient.  The Pelleve is excellent for the upper lip and eyelid areas but deep vertical lines will not improve much with either treatment.

Hi Manny,

Ulthera is the only treatment that delivers precise energy at the levels necessary to both lift and tighten the muscles and skin of the face, neck, and eyebrows. Ultherapy uses micro focused ultrasound energy to create deep heat that results in immediate contraction as well as long term new collagen production. In a single treatment Ulthera can accomplish much more than multiple treatments of other radiofrequency technologies such as Pelleve`, Exilis, Accent XL, and Thermage. Good luck and be well. 

Dr. P