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 17

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

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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.  

Ultherapy vs Radiofrequency (Pelleve) for skin tightening

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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

Pelleve` Versus, Ulthera Which Better Tightens the Skin

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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

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#Pellevé or #Ultherapy?

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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

Ultherapy vs. Pelleve

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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

Ulthera for the lower face - Los Angeles

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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

Pelleve vs. Ultherapy for facial tightening

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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.  

Ulthera and Pelleve : Two technologies that drive me nuts!!!

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  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!

What is better – Pelleve or Ultherapy ?

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In Dr. Ebrahim’s opinion Ultherapy is the technology that is currently approved by FDA to lift and tighten skin on the jowls, neck, and upper eyes.

Ultherapy goes deeper, it is a more intense energy for the building and formation of new collagen compared to Pelleve.

Ultherapy vs Pelleve for skin tightening

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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 15 reviews

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