What is the Best Prescription Pain Med for a Ulthera Treatment for Full Face and Neck?

Question

What is the best prescription med for an Ultera treatment for full face and neck? Is numbing cream and a dental block necessary? I have a low pain tolerance, so I have a lot of concern about this painful treatment. I have had 2 thermage treatments years ago. They were very painful and even after receiving a lot of meds. Thank you for your help.

Steven L. Ringler, MD, FACS · Answer

Ultherapy is an excellent non-surgical treatment for lifting and tightening the facial tissues. We have been treating patients for over a year and have treated over 100 patients thus far. You are right, there are varying levels of pain tolerance and after I had my first Ultherapy treatment, I have offered all of my patients local anesthesia prior to treatment. Although some patients are hesitant at first, the treatment session is completed with minimal discomfort for the patient and I can achieve the best possible results. Over time we have found that many patients benefit from additional lines of energy, however, with local anesthetic we are able to provide this additional treatment level with minimal discomfort. These treatments do not require any premedication or sedation, therefore, the patients are able to drive home immediately after Ultherapy. I do have an occasional patient who does not want any local anesthetic and they seem to do well, though it would not be my recommended approach with the additional energy used in more advanced techniques.

Robert Heck, MD, FACS · Answer

That's a great question. There is always preparation before the treatment and we offer Xanax and a pain pill (s) if needed. We also now offer PRO NOX which is a gas much like "laughing" gas that you get at the dentist offer and that allows patients to tolerate the procedure without medications at all. We also still topically numb our clients bc sometimes on the surface transducer it still helps take the edge off. If you go to a great place the provide also knows how to decrease the energy level if needed. Best of Luck.

Sam Naficy, MD, FACS · Answer

We do a lot Ultherapy treatments each year and during consultations our providers discuss the different options to keep our patients as comfortable as possible. Every one has different pain tolerance so what might work for one person may not be appropriate for another.  
Most of our patients find a pain medication in combination with anti-anxiety to works well. Having a ride arranged after your treatment is necessary but worth the extra effort it to keep you comfortable so your provider can offer a through comfortable treatment.

Raffy Karamanoukian, MD, FACS · Answer

We specializes in Ultherapy procedures and have had success with pain control using the newer Amplify Ulthera upgrade. In addition, an analgesic and anxiolytic are sometimes needed. The type of meds really depends on your medical health. Dr. Karamanoukian

Melissa Chiang, MD, FAAD · Answer

We have found that pretreating with lyrica for several days increases comfort immensely.  Lyrica decreases the nerve signaling of pain.  I especially like lyrica because the patient is alert during the procedure and able to drive herself home.

Michael A. Persky, MD · Answer

Hi Phoenix,

	I find that straight Morphine does the job...just kidding. 

	Ulthera can be uncomfortable, but we can make it very tolerable in our patients.  Some patients just have the treatment with cold air blowing on them, we call them sado-masochists, or they are extreme fans of Fifty Shades of Gray!

	It is best to take 2-3 Tylenol about one hour prior to the scheduled treatment.  When patients have a ride home, we give Xanax 1 mg.  Most patients then have strategically placed injections of lidocaine in the areas of treatment, and that is usually more than enough to bring the treatment down to the 1-3or4 level on a scale of 10.  Other prescripton meds that can be used are Toradol or Vicodan or Percocet.  Once in a while patients receive an injection of Demerol, but I find that usually unnecessary.

	Good luck and be well.

	 

	Dr. P

Jonathan Pontell, MD, FACS · Answer

I like to give patients a Toradol pill  and a Percocet pill 1 hour before the procedure.  I find that with this combination, patients rate the pain level as a 3 or 4 out of 10 which is very tolerable.

Ron Shelton, MD · Answer

We have tried different protocols for pain management and have discussed it with many different practitioners to review what they have found to be successful. We have been very successful in providing reasonable comfort to our patients with the protocol that we have used for the last six months.

	Each patient has a different pain threshold and our management differs depending on the history given to us by our patients. Most patients are given a combination of a narcotic pain killer, a strong non-steroidal antiinflammatory agent and a medication to relax them, all by mouth.  Rarely local infiltration, such as to the forehead, is helpful, but these anesthetic injections suddenly make a no down time procedure develop the possibility of swelling around the lower eyelids and bruising.  Even more rarely, a board certified anesthesiologist delivers sedation.  Discussion of this management is held during the consultation.

Sarmela Sunder, MD · Answer

Hi,

	We offer patients an oral narcotic and an oral sedative prior to their full face & neck Ultherapy treatment. With this combination, none of our patients have needed to stop treatment part-way due to discomfort. Options for the oral narcotic include Vicodin or Percocet. 

	In addition, there are techniques that your physician can employ to make it a more pleasant experience for you, such as adjusting the energy level. The energy level can be modified to a certain extent such that it is more comfortable, but without compromising the results.  The key is to finding a physician who really understands and is well-versed in the technology in order to make it as comfortable for you as possible. Hope this helps!

	Sarmela Sunder, MD

Richard Baxter, MD · Answer

Of course everyone is different, I had the procedure done without any and it was OK. If you have a low pain tolerance then your doctor may prescribe either a sedative or a pain pill or both, but you will of course then have to have a ride home and it affects your schedule for the rest of the day. You don't want to hold back on getting a full treatment though.

What is the Best Prescription Pain Med for a Ulthera Treatment for Full Face and Neck?

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