Thermage or Ultherapy? I'm 48 and would like to tightening the areas around my lower eye and sides.

Question

I’d like to tightening the areas around my lower eye and sides. Thermage was recommend. I’m 48, I don’t have large bags or deep wrinkles. I want to be preventive. However, I’ve heard Ultherapy is a newer technology and might be a better option. What is the best option?

Jason Emer, MD · Answer

theramge and ultherapy should be done every 6 months to prevent sagging. morpheus every 2 months for tightening and lasers every 2-4 months for wrinkle prevention. at home peels like emeragecosmetics aerify, cosmelan, enlighten should be started now (see link).
 
As we age the skin sags there is  nothing  you can do that but try preventative  energy-based or thread-based  treatments or get a neck/facelift earlier in the aging process.  There are numerous options and some can be used in combination to get best outcomes but you need a consultation with an expert.
 
Options include for skin tightening :
1. thermage radiofrequency to heat skin and tighten it over time and prevent the aging process
2. ultherapy highintensity ultrasound to contract muscle and tighten the face and neck and prevent the aging process
3. PDO nova threads or instalift threads for immediate lifting without surgery and long term collagen production
4. sculptra injections for collagen production to areas of the face and neck with crepe skin or early sagging
5. btl exilis ultra, venus legacy, thermi250 , or inmode forma/contoura  for constant collagen stimulation monthly with facials
6. facelift/necklift with fat grafting/fillers if you need a big improvement
7. ThermiRF or J plasma /Renuvion or Inmode FaceTite   internal heating and tightening to long term internal heating and tighting with or without surgery
8. Platysmaplasty to tighten the muscles of the neck long term and create contour
9. Facial implants or fillers to contour the jawline and chin to improve the apperance of the nec k
10. Fractora/Morphenus8 or Intensif microneedling RF for improve superficial tightening, neck and chest wrinkling and crepe skin 
You need to see an expert in facial sculpting and age prevention.  Best, Dr. Emer.

Leyla Arvas, MD · Answer

Hi, if your skin is thick ulthera would be better, if your skin is thin thermage is better. But if you want only some part of your face ulthera can be divided, but thermage all face is recomended because when you open one tip it would be finished in 1 hour.

Kimberly Butterwick, MD · Answer

Thank you for your question. Both Thermage and Ultherapy are effective modalities for tightening skin without surgery. Ultherapy uses ultrasound energy, delivered deep into the connective tissue, to heat the tissue, and stimulate the body to produce more collagen. As collagen levels rise, the skin becomes firmer and smoother. Thermage works in a similar fashion, but with radiofrequency energy instead of ultrasound energy. Thermage is typically my choice for the delicate area around the eyes, as it has a specialized eye tip that can even be used on the upper lid area and produces excellent results. It is somewhat more comfortable than Ulthera but pain with either can be managed with Pronox. This is a nitrous inhaler that relaxes you slightly and afterward you are alert to drive home. Always work with an experienced, board-certified dermatologist who has the expertise necessary to produce the best possible result for you.

Nuket Eroglu, MD · Answer

Firstly, due to your age, I highly recommend Thermage FLX, as it is an excellent non-surgical treatment for facial tightening, pore refinement, and skin rejuvenation. Thermage FLX is globally recognized and particularly effective for patients around the age of 50, irrespective of gender. It provides a natural youthfulness with long-lasting effects, FDA-approved for enhancing jawline contours. The monopolar radiofrequency system penetrates deep tissues, impacting all layers from skin to bones, resulting in noticeable rejuvenation. On the other hand, Ulthera uses ultrasound waves to target the SMAS layer, primarily addressing sagging skin in the mid-face. It is more focused and suitable for reshaping but lacks the widespread skin rejuvenation seen with Thermage FLX. Considering you are 48 and in need of substantial collagen stimulation, Thermage FLX would be the more appropriate choice for maximum fibroblast simulation.

Anshul Gambhir, MD · Answer

Thank you for your question. Ultherapy and Thermage are both great procedures and technology. They both encourage the same outcome which is stimulating collagen growth but with different modalities. Ultherapy uses ultrasound energy to heat the skin while Thermage uses radiofrequency heat. I have personally been treated with both and have found that Thermage is much less painful than Ultherapy. I do not think one is better than the other so I would research practitioners in your surrounding area that perform either and go with the most experienced practitioner. We personally carry Thermage in our office as we have had it for many years and trust the technology. I hope this helps you in making your decision!

Thermage or Ultherapy? I'm 48 and would like to tightening the areas around my lower eye and sides.

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