Can Ulthera Be Done Under General or Twilight Anesthesia?

There are very few cases, but they do exist, where individuals who know their pain tolerance, or lack of tolerance, request sedation for Ultheapy. This can be done, and we have a board-certified anesthesiologist in our accredited office-based surgical practice to administer sedation after they review your medical history. Treatment must be tailored to each individual's needs.

Our usual protocol is to give patients 2 Extra Strength Tylenol tablets and patients do absolutely fine with this method.  I do get an occasional request for having it done under sedation, and we do offer twilight anesthesia in our office at an additional cost.  All patients have different thresholds to pain tolerance, and knowing your own is helpful.

Ultherapy works by focusing bursts of ultrasound energy into the layers under the skin, where it creates very short pulses of heat. The heat is what stimulates the collagen to regenerate, and if it doesn't hit a certain peak temperature - even for a microsecond -  then the effect isn't as good. This means that there is some discomfort with it, and pain tolerance is of course variable. (It won't hurt afterward, just very briefly with each pulse.) Most of our patients do fine without sedation or anesthesia, but some request a pill to make it easier.

We have performed Ultherapy since 2011 in hundreds of patients with high satisfaction rates.Although it can be done with twilight or general anesthesia, no one has requested that in my practice. It is an added expense that is unnecessary as the procedure is well tolerated. I have had the procedure myself and asked my physician assistant to stop twice because of discomfort around the jaw. I pretreat my patients with ibuprofen an hour before and another does of 800 mg immediately before in liquid form and have never had a problem with my patients. I also recommend the use of Swell-X bioflavonoids for 10 days after the procedure.There is no need to write for prescription pain meds after the procedure. Read the Ultherapy book on the link below.

Although any procedure can be done under twilight or general anesthesia, good pain control can be achieved with local anesthesia.  Anesthesia has become very safe, however it is still associated with risks.  Since patients will feel very little of the treatment with local anesthesia, doing this procedure with twilight or general anesthesia wouldn't be worth the associated risks.  Talk to your physician about what measures they take for pain control.

Although I perform most of my Ulthera treatments with only oral medications, we have treated a few patients under twilight anesthesia and under these circumstances the patient will feel no pain whatsoever!

In my opinion for any full face/neck Ulthera treatment my patients all benefit from some type of pain control and relaxation medication given before the treatment (Vicodin and Valium).  In addition while some may be able to get by with just oral pain medication I find that most like the fact that they feel nothing  during if they undergo simultaneous local injection anesthesia.  Ulthera can be performed under general anesthesia or twilight for that  matter as this will not affect the result. but I typically do not recommend it because of the added expense and I feel that local anesthesia and oral pain control and valium relaxation are plenty.  

Having had the procedure done myself without any anesthesia/analgesia, I would agree that Ultherapy is uncomfortable.  Currently, we use local anesthetic or oral sedation and have found that this is adequate for all of our patients.  Because it is possible to obtain adequate pain control in this procedure with either of these methods, I would not recommend general or twilight anesthesia.