Am I a Candidate for Ulthera in my Lower Face?

When I look at photos from a year and a half ago, I did not have those tiny little jowls, but I have them now. I would like to know if I look like a candidate for Ulthera for the Jawline. I do have some laxity on my neck, too. Are passes made directly on the throat? (Mine is sensitive.) I do not want to use numbing agents, as I can't stand that strange feeling. Have high tolerance for pain, just don't want to gag. Thanks.

Doctor Answers 19

Ulthera helps the Jowls

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Ulthera utilizes ultra focused ultrasound energy waves to tighten the smas layer of the skin at both the 3mm and4mm depth. We have performed many in our practice and to date the results have been very encouraging. Approximately 80% of patients see a significant clinical difference- much better than what we were achieving with previous technologies. One big advantage of the Ulthera technology is that there is no downtime- as people go back to work the next day with only minimal to no swelling. We utilize multiple pain reduction techniques including 1) cold air 2) ice 3) topical anesthetic 4) oral analgesics - like Tylenol or stronger medications 5) stronger techniques ,if required or desired by the patient after a thorough consultation. If the patient can have some down time we have found the Pixel laser or fractionated Co2 laser to be of added benefit to the Ulthera treatment. While this technique can help the neck, better define the jaw line, and help the jowls - we do not treat over the thyroid gland -over the central neck. You really need a consultation to give you peace of mind and to answer your questions completely.

Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Ulthera is useful for the jowls and sagging skin of the neck

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Based on your description, you seem like you would be a candidate for Ulthera. Patients who do well with Ultherapy are those with mild to moderate tissue laxity. It works well to tighten the tissues along the jowls and neckline. Generally, younger patients tend to have more robust results. No passes are made over the thyroid cartilage, which is the major cartilage in the throat. There is not much pressure exerted on your neck or throat from the device.

There are various methods to make you comfortable during the treatment. In addition to a mild sedative, some physicians will give you a local anesthetic while others may offer you an oral pain medication and others may offer both. If you don’t want to use a numbing agent, you can have the treatment with an oral pain medication and a sedative. Hope this helps! Good luck!


Sarmela Sunder, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Effectiveness of Ulthera in the Lower Face

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Your photo suggests that you may be an appropriate candidate and that you would get good results.  The final determination would rest on an exam in person.

Ulthera is best for patients with early signs of aging.  Jowling, submental fat and mild skin laxity respond well to Ulthera treatment.  Should you choose to proceed, I would recommend that you discuss oral sedation if you want to avoid local anesthetic.  We have had several patients that wanted to try the procedure without any pain control measures and in all cases we had to stop the procedure and inject local anesthetic.

The firm central neck structures (hyoid bone and thyroid cartilage) should be avoided.  Ulthera treatment is best for soft tissue.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon

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Patient selection for Ulthera

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As you know, Ultherapy uses micro-focused ultrasound to precisely stimulate collagen remoldeling in the collagen layers under the skin. While I can't predict your results without seeing you, here are some general guidelines: Since the body's response to the treatment is what determines the results, people who are younger tend to do better. That is because with age and skin thinning there is less collagen to begin with, so patients in their 40's to early 50's are often the best candidates although we have had results from older patients too.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Ulthera for Jowling

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From the picture you show, you look to be a good candidate for Ulthera to help in tightening up your lower face and neck. Best would be an examination i person. The central portion f the neck should not be touched in an Ulthera treatment and the pressure is mild. As for pain control, I recommend topical anesthesia and possibly oral agent if necessary. Hope this helps. Good luck  

Mary Jo Wright, MD
El Paso Plastic Surgeon
5.0 out of 5 stars 9 reviews


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Thank you for your question. Based on the pictures it does appear that you would be a good candidate. The passes are made on the neck but not directly over the middle of the throat. Most doctors do not use topical numbing agents for this treatment but some may use prescription drugs to help with pain and anxiety. Good luck!

Janet Allenby, DO
Delray Beach Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Ulthera Can Lift Jowls and Lower Face

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If you have slight sagging of the jowls and lower face, Ultherapy could be an excellent option for you. It uses ultrasound energy to rejuvenate the SMAS layer and tighten the skin along the jowls and jawline. Results are subtle but profound. It may take up to 4 months to see the full results.    The device passes very lightly on the neck and does not touch the thyroid cartilage, so it is generally very tolerable. We can use a combination of cold air, ice, and over-the-counter painkillers to control any discomfort you may feel. Consult with a board-certified dermatologist to find out how you can benefit and maintain your comfort during the procedure.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 91 reviews

Ultherapy for the Lower Face and Neck

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To make a definitive recommendation, I’d have to examine you. However, from what I can see in your photo, you look like an excellent candidate for Ultherapy. You’re concerned about the skin laxity that is causing jowls to emerge along with sagging under the chin and around the neck. Ultherapy will stimulate a lifting and tightening of the skin in those areas to deliver a very natural-looking improvement. I would add that Ultherapy should work especially well for you because you are young and still have plenty of collagen and elastin in your skin to maximize skin retraction.
With regard to a topical anesthetic, we use it with patients who are very sensitive. It sounds like you would be among those who find the treatment highly tolerable, so no topical anesthetic would be required. Additionally, to allay your fears, no passes are made over the throat and thyroid gland.

Hal Michael Bass, MD
Miami Plastic Surgeon

Ultherapy for Tightening of Jowls

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Hello and thank you for your question!

Ultherapy is great for laxity around the jawline and lower face, as well as the neck. It is done in the upper neck area from the jawline to the adam’s apple area, and we take it down to the collarbone (around the sides of the trachea). It is not done in the lower center of the neck, over the thyroid. You actually don’t have to put numbing cream on, we recommend our patients take oral analgesics (Percocet) and something to relax, such as valium. We only suggest the topical to help with the 1.5 mm transducer, and not everyone needs this. We offer it as an option, if they are feeling discomfort with this part of the treatment. Everyone is different with pain tolerance. We have some people that feel very little and others that are more sensitive. In our practice, we are using the triple depth approach for our patients. We find this to provide the most efficient treatment and superior results by targeting all three layers of tissue. Our extensively trained NP & PA’s customize each treatment for each individual patient. We offer complementary consultations, as well.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Good candidate for Ultherapy - Williamsville NY

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You are a good candidate as you seem to have mild to moderate skin laxity based on a single image. An in person exam obviously would be best to determine candidacy.

Ultherapy is focused high intensity ultrasound using B mode diagnostic imaging to ensure delivery of the ultrasound energy into the predetermined depths of tissue - skin (1.5 mm and 3 mm) and SMAS layer (4.5 mm).

Read the Ultherapy book on the link below.

We have performed Ultherapy since 2011 in hundreds of patients with high satisfaction rates.

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.