Is Pelleve or Ultherapy Better to Tighten Skin?

I have a thin face and am looking for tightening around the mouth and lower face.

Doctor Answers 16

Pelleve and Ultherapy work on different levels of collagen, so they are both good!

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.  

Omaha Dermatologic Surgeon
4.8 out of 5 stars 39 reviews

Ultherapy vs Radiofrequency (Pelleve) for skin tightening

I think there is a place for both, and we offer both treatments.  I have more faith and confidence in Ultherapy for deep tissue tightening because of the focused depth of treatment.  Pelleve is working via a bulk heating strategy.  This is helpful in some areas that are to delicate and not as well treated by Ultherapy such as lower and upper eyelids. 



Arthur N. Falk, MD
Albany Facial Plastic Surgeon
4.6 out of 5 stars 10 reviews

Pelleve` Versus, Ulthera Which Better Tightens the Skin

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

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

#Pellevé or #Ultherapy?

Dear Manhattan:

Ultherapy is generally performed as a single treatment wherein intense-focused ultrasound creates intense heat very quickly in many hundreds of focal points (called TCPs) in the treated area of skin.  Pellevé treatment is given in several sessions, and within each session five passes of the treated area are performed, bringing the temperature of the skin beneath the surface to the same endpoint temperature as with Ultherapy.  Ultherapy can target tissues deeper in the skin than Pellevé, which mean it can truly lift the skin as it tightens the fascia, the same tissue that is tightened during a surgical facelift. The reason Pellevé doesn't hurt is probably because the temperature is brought up slowly over a period of minutes rather than instantaneously with each pulse. With both treatments, at the target temperature of 65 to 70 degrees Celcius within the skin, immediate tightening ocurs, and fibroblasts are stimulated to produce increased amounts of structural proteins over the ensuing months. 

Both are effective, and each has advantages in terms of more or less very transient discomfort, more or less time or money required. Pellevé can be used on the upper eyelids themselves and closer to the margin of the lower eyelid. Ultherapy seems to give more of a lift to the brows. I have personally seen wonderful results with both modalities, and actually there are creative ways to use the treatments in combination to optimize results..

i hope this helps!

All the best,
Dr. Clark

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 8 reviews

Ultherapy vs. Pelleve

While both treatments help with wrinkle reduction (and are effective), they are very different. 

Pelleve uses radio frequency to tighten the skin.
Ultherapy uses ultrasound technology to physically lift the skin - almost like a noninvasive face lift.

The Ultherapy goes down much deeper into the dermis - 4mm while the Pelleve barely hits 1.5mm.
Three sessions of Pelleve treatments are needed to see optimal results while only one session of Ultherapy is needed.

San Antonio TX

Sanjiv Kumar, MD
San Antonio Ophthalmologist
5.0 out of 5 stars 2 reviews

Ulthera for the lower face - Los Angeles

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

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Pelleve vs. Ultherapy for facial tightening

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.  

Pamela Gallagher, MD
Long Island Plastic Surgeon
4.2 out of 5 stars 12 reviews

Ultherapy vs Pelleve for skin tightening

Both procedures work to stimulate new collagen production. Ultherapy is the only FDA approved nonsurgical option to tighten and lift the neck, decollatage and eyes utilizing ultrasound technology. This technology has the ability to emit ultrasound energy to a precise location, safely heating only the target. Pelleve utilizes Radio Frequency which is a bulk heating technique in where efficacy can be effected. Best of Luck.

Steven Gabel, MD, FACS
Portland Hair Restoration Surgeon
5.0 out of 5 stars 12 reviews

Ultherapy and Pelleve

Both of these procedures work well.  Ulthera is the one time treatment and Pelleve works with a series of treatments.  Ulthera may be a bit more painful than Pelleve, but new protocols have made the ulthera treatments much more tolerable.  So both work – as do most of the RF therapies for skin tightening and ultrasound therapy like ulthera.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews


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.

James Chan, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.