Ulthera and Fillers

Because of some uneven facial liposuction, I was left with uneven contours in the mid/lower face and along the jawline. In an attempt to correct this, I have had fillers (Juv & Restylane) placed in the hollow areas to even everything out. Not wanting a lift, but feeling it would help more than fillers, I am ready to try Ulthera but was wondering whether or not I should have the fillers dissolved first with Hyl Acid? I am concerned the fillers would prevent maximum tightening results from Ulther.

Doctor Answers 9

Ulthera and fillers

Ulthera will work with fillers in place. It may dissolve some of the filler. You can re inject fillers after the Ulthera treatment. You should also consider fat injections to correct the depressions.

West Palm Beach Plastic Surgeon
5.0 out of 5 stars 23 reviews

Ulthera and fillers

You can have Ulthera after fillers.  You should wait at least 2 weeks to minimize dissolving the filler that is there.  Even after that time, you may see the filler dissolve to a certain extent.  I would wait 3 months after the treatment to see how the Ulthera is lifting before re-injecting, if you need it.

Angela Sturm, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Ultherapy and Fillers

We prefer to perform Ultherapy face and neck skin tightening prior to filler injectable procedures. However, we have had experiences with patients who have done just fine and get good results from Ultherapy having had fillers previously (as short as 4 weeks prior) and have seen very modest degradation of the prior filler injection. Bottomline is we do not know how much of the filler may be degraded from ultrasonic energy delivered by Ultherapy and thus I have a preference of performing Ultherapy first prior to filler injections.

William Ting, MD
Bay Area Dermatologic Surgeon
4.8 out of 5 stars 12 reviews

Ulthera Use After Fillers

The concern with using Ulthera over an area that has had filler injected is that it can dissolve the filler.  You certainly will see some tightening of the area but there is no guarantee that it will eliminate all of the contour problems.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Ultherapy and Fillers

We prefer to perform Ultherapy first, prior to injecting fillers. The ultrasound therapy could potentially degrade the dermal filler. Although, it is common for patients to have the Ultherapy after dermal filler injections (ideally this needs to be 4+ weeks no sooner).  They could experience mild filler degradation but still tend to have good results. Ultherapy and dermal fillers are great in combination and work harmoniously. The Ultherapy works to tighten the tissue, while dermal fillers replace volume loss. 

Steven Gabel, MD, FACS
Portland Hair Restoration Surgeon
5.0 out of 5 stars 12 reviews

Fillers and Ulthera

I would not dissolve your fillers before your Ulthera result, unless you are unhappy with the fillers regardless of whether you planned to have Ulthera.  I would make sure that your filler treatment is done several weeks to a month before your Ulthera treatment.  The other procedure you may want to consider if you have facial asymmetry after surgery is Sculptra.  It might be a more versatile tool in the right hands to help build more symmetry in the face.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 36 reviews

Ultherapy after uneven liposuction - Williamsville, NY

A picture s worth a thousand words ...

Please repost your clinical question with some pictures.

Read the Ultherapy book that I have written on the link below.


Dr Karamanoukian

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Ulthera and fillers


  Ulthera works by tightening the skin at the deeper levels. You mentioned Hyl acid to dissolve the fillers but I think you are referring to  hyaluronidase.  The latter works as a dissolver of injected hyaluronic acid injections....Restylene/Juvederm.  It does not work for Radiesse.

  Assuming you had Rest/Juvederm, this is still not a necessary step.  You can do the Ultherapy and if there is loss of a filler component of any type, then you can always reinject after the skin is tightened.

              Steven M. Lynch, M.D.

Steven M. Lynch, MD
Albany Plastic Surgeon
5.0 out of 5 stars 18 reviews

Ultheapy for lifting of the face after liposuction and fillers

You must be seen in person for an evaluation.  If you had liposuction of the face, then fillers, then hyaluronidase enzyme to dissolve the fat, then Ultherapy to improve the appearance, I would be concerned about too many procedures being done shortly after one another, almost the Yo-Yo effect.  Lifting with Ultheapy should not help a volume deficit problem.

Before you chase one problem and cause another and create a viscious cycle, I would suggest you allow all the fillers to dissolve normally. Then reevaluate your condition by seeing another opinion. S

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

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