Ulthera... Dermatologist or Plastic Surgeon?

Question

assuming of course both are excellent within their specialty and have experience with Ulthera.. My thought is that the plastic surgeon would be the better choice given the nature of the treatment. Meaning they're working at a depth that is most familiar to the surgeon in terms of musculature etc. Thoughts? thanks!

Rebecca Fitzgerald, MD · Answer

The Ulthera system uses ultrasound, so the advantage to any treatment provider is that we can "see" where the treatment energy is being focused.

	The technology was developed with specific guidelines - which all providers follow, though with some customization to get best results - so it's really a matter of personal preference as to whom you choose to take your treatment with.

	More frequently than not, physician extenders (usually Physician Assistants or Registered Nurses) are the ones providing Ultherapy and they will have had the same training as the physician.

	As with any cosmetic procedure, it's the patient's choice. Many people are very comfortable with a nurse or PA because they will often actually have more experience using nonsurgical technology. Others are only comfortable with a physician operating the device.

	When booking your treatment, you should be told who will be actually administering the Ultherapy treatment and if you specifically desire the physician, make that clear.

Ron Shelton, MD · Answer

Dermatologists, plastic surgeons, their nurses, physician assistants, etc. can do Ultherapy. Is the person who is doing your Ultherapy experienced at it? Do they have the latest technology with all levels of transducers, or have they not invested in keeping their system updated to have the latest software and the new 1.5 mm transducer as well?  What treatment do they deliver? There is no set number of lines that a doctor must deliver, and some will treat with far fewer lines and others, with many more.  There is also a need to know the anatomy and customize treatment for each patient as faces are very different and focusing Ultherapy in one area can be quite different for different patients.

	In the last year, our treatments have increased numbers of  lines of energy that are significantly greater than the first protocol the company suggested when the device came to market. With that we are seeing even better results.

	So it is not the type of specialty, but the doctor or the doctor's assistant that is delivering the utlherapy treatment that is important.

	 

	The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. If you are experiencing a medical emergency proceed to your nearest emergency room.

Young R. Cho, MD, PhD · Answer

This is a challenging question. Both specialties have a great deal of experience with facial aging. I practice with with my wife who is a board certified dermatologist and I am a board certified plastic surgeon. We both do consultations and perform Ultherapy and we also share aesthetician who performs Ultherapy. I do see a greater percentage of the patients and my wife will often refer patients to discuss the benefits of Ultherapy versus surgical face/neck lift. I have found that a greater number of our older patients enjoy the discussion of invasive vs non-invasive options before they make their decision on how the invest their time and resources to achieve their desired results. Our younger patients are looking for more preventative options or non-invasive ways to mitigate the aging process so either way would work. I would also say that I tend to be more aggressive with my treatment options and the overall energy I provide. I hope this helps.

Richard Baxter, MD · Answer

Ulthera uses microfocused ultrasound for nonivasive skin lifting, but it is not a nonsurgical facelift. The ultrasound is focused at different depths, one of which is the SMAS layer under the skin which plastic surgeons use in a facelift. So my personal bias is for plastic surgeons, who understand the anatomy of that layer, but as a practical matter there are plenty of dermatologists who get good results with Ulthera.

Hratch Karamanoukian, MD, FACS · Answer

Ultherapy is a great procedure and in my opinion is very dependent on the provider. Whoever you choose to perform the procedure should be someone who has done many and understands the way the technology works and uses various vectors of treatment - the lines that are routinely used and custom lines of treatment that are not necessarily 'up and down the face and neck'. Read the Ultherapy book provided on the link below.

Daniel Shapiro, MD · Answer

The FDA-cleared Ultherapy procedure has been established to be safe and effective in clinical studies and tens of thousands of patient treatments worldwide. In addition, every Ultherapy practitioner undergoes extensive hands-on training, so you can schedule your Ultherapy procedure with complete confidence. In selecting a practitioner, it is important to find someone who is experienced and has achieved positive results with his or her patients. It does not matter so much whether it is a plastic surgeon or dermatologist, but rather their expertise or experience.

Cameron Rokhsar, MD, FAAD · Answer

ulthera is a technically challenging procedure. It takes experience to deliever a good treatment. I do all my procedures myself and am a firm believer that this is a procedure that should be left in the hands of an experienced physician. You are spending a lot of money and should not settle. Ask for your doctor's experience and proof of it!

Edwin Ishoo, MD · Answer

Im my opinion, if you are looking for a true facial rejuvenation consultation, then the most appropriate specialists will be facial plastic or general plastic surgeons. If you've already decided you want to have a non-surgical treatment with Ulthera, then the most important factor is finding a board certified specialist, dermatologist, facial plastic or general plastic surgeon. None core facial cosmetic providers may not be ideal.

Bruce K. Barach, MD (retired) · Answer

many patients requesting ultherapy would get minimal improvement from it and really need surgery to deal with their issues. if the doc you see can only perform noninvasive treatments, then human nature will likely dictate a recommendation for those treatments he/she  is able to provide. it makes sense to see someone who can do both invasive and noninvasive treatments so as to end up getting what would really be the best treatment for your particular situation.

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