Hi Bullet, One of the advantages of Ulthera is that the ultrasound visualization allows the physician to visualize what is being treated. We do not treat over the boney areas of the cheeks, but rather treat the soft tissue between the lower portion of the cheek bone and the superior edge of the mandible (jaw bone). I agree with Dr. Weiner that Ulthera should not be performed over Titanium, but I believe that it can be avoided and that I can treat a patient such as this safely. I only speak for the treatment in my hands. Good luck and be well. Best, Dr. P
I believe that you need to proceed with caution. The area overlying the titanium plate can be skipped or treated with the very superficial hand piece and lower settings. The Ultrasound energy can heat up the plate and cause deep burns.