I had Ulthera done approximately 11 months ago. The nurse used the deepest setting and it melted the fat in my face. I went back to my provider for filler to restore the loss volume but did not get a positive outcome. I went to another dermatologist for filler and again, it did nothing to restore enough volume to lift and smooth out the skin. My skin is like a balloon that’s been popped. All the skin has fallen and there is loose, bumpy indentations on my lower face. Do I need surgery?
Answer: Is Ultherapy damage reversible? Do I need surgery? Any skin tightening procedure that produces heat, has the potential to damage the fat if not done properly. Ultherapy is very safe it you use the ultrasound and identify the level of the collagen properly and the proper transducer accordingly. At this point, it appears that you have has volume loss. The best ways to restore volume is with a biostimulator (Sculptra) or a fat transfer. Those will give the longest lasting results.
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Answer: Is Ultherapy damage reversible? Do I need surgery? Any skin tightening procedure that produces heat, has the potential to damage the fat if not done properly. Ultherapy is very safe it you use the ultrasound and identify the level of the collagen properly and the proper transducer accordingly. At this point, it appears that you have has volume loss. The best ways to restore volume is with a biostimulator (Sculptra) or a fat transfer. Those will give the longest lasting results.
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Answer: Is Ultherapy damage reversible? Do I need surgery? (Photos) Hello Ann, I believe that there are two options to help you. If you are wish to undergo facelift with fat transfer then that is the way to go. If you are not ready for surgical intervention then I would treat you with Sculptra and/or hyperdilute Radiesse with or without Profound RF and prp. Most importantly choose an expert facial plastic physician to take care of you. Feel free to contact me with any further questions or concerns, or even a virtual consultation. Good luck and be well. Michael Persky, MD Encino, CA
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Answer: Is Ultherapy damage reversible? Do I need surgery? (Photos) Hello Ann, I believe that there are two options to help you. If you are wish to undergo facelift with fat transfer then that is the way to go. If you are not ready for surgical intervention then I would treat you with Sculptra and/or hyperdilute Radiesse with or without Profound RF and prp. Most importantly choose an expert facial plastic physician to take care of you. Feel free to contact me with any further questions or concerns, or even a virtual consultation. Good luck and be well. Michael Persky, MD Encino, CA
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May 26, 2025
Answer: Facial Volume Loss After Ultherapy: Are There Options Beyond Filler? Thank you for sharing your experience. What you’ve described reflects an issue we often see in aesthetic medicine: when treatments are approached from a single angle—without acknowledging that biology is holistic and all anatomical layers are interrelated—unexpected side effects can occur. This is particularly true with high-intensity focused ultrasound at deeper settings, especially on lean facial structures. You can think of the relationship between skin and the underlying fat like a pillow and its pillowcase. When volume is lost from the “pillow,” but the “pillowcase” remains the same size, the surface may begin to wrinkle, ripple, or sag in uneven ways. In cases like this, tightening the outer layer alone often isn’t enough—rebuilding structure or adjusting the skin itself becomes necessary. The most definitive way to correct both volume loss and skin laxity is often facelift surgery. If you prefer to stay non-surgical for now, treatment should focus on restoring volume strategically and stimulating skin repair without further harming remaining fat. This may include biostimulatory injectables, radiofrequency microneedling, or fractional treatments that avoid deep thermal injury. Small amounts of filler can still be helpful in selected areas, but need to be combined with technologies that support dermal remodeling. A full consultation would help determine whether surgical or advanced non-surgical options align better with your anatomy and goals. Warm regards,Op. Dr. Güray YeşiladalıBoard-Certified Plastic Surgeon
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May 26, 2025
Answer: Facial Volume Loss After Ultherapy: Are There Options Beyond Filler? Thank you for sharing your experience. What you’ve described reflects an issue we often see in aesthetic medicine: when treatments are approached from a single angle—without acknowledging that biology is holistic and all anatomical layers are interrelated—unexpected side effects can occur. This is particularly true with high-intensity focused ultrasound at deeper settings, especially on lean facial structures. You can think of the relationship between skin and the underlying fat like a pillow and its pillowcase. When volume is lost from the “pillow,” but the “pillowcase” remains the same size, the surface may begin to wrinkle, ripple, or sag in uneven ways. In cases like this, tightening the outer layer alone often isn’t enough—rebuilding structure or adjusting the skin itself becomes necessary. The most definitive way to correct both volume loss and skin laxity is often facelift surgery. If you prefer to stay non-surgical for now, treatment should focus on restoring volume strategically and stimulating skin repair without further harming remaining fat. This may include biostimulatory injectables, radiofrequency microneedling, or fractional treatments that avoid deep thermal injury. Small amounts of filler can still be helpful in selected areas, but need to be combined with technologies that support dermal remodeling. A full consultation would help determine whether surgical or advanced non-surgical options align better with your anatomy and goals. Warm regards,Op. Dr. Güray YeşiladalıBoard-Certified Plastic Surgeon
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March 5, 2025
Answer: Options for volume loss after Ultherapy Since the problem is volume loss, a collagen stimulator like Sculptra, powdered stem cells of fat like Renuva, or a facelift surgery incorporating fat transfer would all be options. I recommend an in person consult with a few board certified plastic surgeons to get opinions since the surgeon will be able to manipulate the tissue which gives more information than just photos.
Helpful
March 5, 2025
Answer: Options for volume loss after Ultherapy Since the problem is volume loss, a collagen stimulator like Sculptra, powdered stem cells of fat like Renuva, or a facelift surgery incorporating fat transfer would all be options. I recommend an in person consult with a few board certified plastic surgeons to get opinions since the surgeon will be able to manipulate the tissue which gives more information than just photos.
Helpful
November 7, 2024
Answer: Ultherapy damage One other option that can help to tighten tissue and stimulate collagen is Radiesse and Sculptra injections. If Ultherapy treatment truly reduces the fat layer, the only way to restore fat is to do a fat transfer. But Radiesse and Sculptra can help bring back the volume and help tighten the skin to reduce the visible loss of volume in the tissues.
Helpful
November 7, 2024
Answer: Ultherapy damage One other option that can help to tighten tissue and stimulate collagen is Radiesse and Sculptra injections. If Ultherapy treatment truly reduces the fat layer, the only way to restore fat is to do a fat transfer. But Radiesse and Sculptra can help bring back the volume and help tighten the skin to reduce the visible loss of volume in the tissues.
Helpful
October 15, 2024
Answer: Tough problem to solve Unfortunately, the only way to correct what you have is fat grafting and some fillers. The fact you had Ultherapy there makes the blood supply needed for the fat to take (Survive) lower that optimum. So, 2-4 sessions will be needed. An improvement is possible.
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October 15, 2024
Answer: Tough problem to solve Unfortunately, the only way to correct what you have is fat grafting and some fillers. The fact you had Ultherapy there makes the blood supply needed for the fat to take (Survive) lower that optimum. So, 2-4 sessions will be needed. An improvement is possible.
Helpful