Should Ulthera Be Painful?

I have an Ulthera in my office and has been very busy. I also had it done myself. It hurts. I did not have any medication because I did it in between seeing patients. If I repeat the treatment, I will probably take a tramadol and a valium. That is what we recommend our patients now. It seems to take the edge off. The results take time but are worth it. As a plastic surgeon and patient, I recommend it.

Hello, I'll give a little update to a question that was posed several years ago. Pain with Ulthera treatments is absolutely normal. How severe it is varies from patient to patient. It is also dependent on the depth of penetration (deeper transducers seem to elicit more discomfort, especially over bony prominences). In addition, it is not unusual for patients to have mild swelling and even mild bruising in treated areas. This usually resolves in several days, and it is usually subtle enough that it won't keep anyone home from work/school/etc the next day.We have managed most of our patients successfully with 10 mg of Valium and 4-600 mg of Ibuprofen (2-3 Advil) 1 hour before the procedure. This keeps the majority of patients comfortable. Occasionally (especially with full face/neck treatments) we will do injections to block certain nerves to make areas of the face numb as a dentist would. Around 20% of our patients need the nerve blocks, the rest do fine with the oral medications.

Like many physicians, I began using Ulthera 16 months ago with minimal pre-medication for my patients. Following my own personal Ultherapy treatment with no medication, I made the decision to offer local anesthesia to all of my patients.  This eliminates the need for pre-medication, eliminates most discomfort during the procedure, and makes the entire experience more comfortable.  Patients are able to drive themselves to the office for treatment and return to normal activity immediately after treatment with no downtime.  

Thank you for the detailed question. Pain level varies from patient to patient; the areas that are more sensitive are the forehead and the jaw line. We do have a variety of options to help ease discomfort including pre-medication or nitrous gas although many patients choose to do the treatment without any medication and tolerate it well.

Ultherapy is a treatment that can get your attention if you're not prepared.  In general, certain areas will be more tender than others and some patients (especially thinner) can feel the treatment more than others but if the patient is prepared appropriately, then the treatment can be very comfortable.  

In general, I wouldn't have the procedure done the first time without an anxiolytic (anxiety medication such as Xanax) and a pain pill.  You'll find that this might be overkill for the treatment but you'll be relaxed and comfortable.  If you go to have another Ultherapy treatment in a different area (which most people do because of the result), most people skip the pain pill and just go with the anxiolytic as that seems to do the trick. 



Being comfortable is important as it allows the ultherapist to do the best job possible.  In our practice, we over treat by 30-50% to make sure our patients get a nice result and we charge the same as the local medspas but to treat our patients at this level, we do provide the anxiolytic and pain pill at time of scheduling.  It also helps to have soothing music and a comfortable bed to sleep on when having it done as in our practice.  Having this on a sterile exam table isn't as comfortable.

Yes I'd say your experience is typical. Pain is very subject some patients will opt for pain management while others do just fine with nothing.  The tenderness you have post treatment is also a common side effect and can last up to two week in some areas. 

Most of my patients are able to tolerate the Ulthera treatment without any problem. There are certain areas of the face, usually where the bone is closer to the skin, that are the least comfortable. I tell my patients that it's normal to experience slight tenderness along the jawline for a few days post procedure, however if your pain is excessive or not getting better, I would recommend that you contact the doctor who preformed the treatment. Oral pain medication can be used to ensure your comfort during the procedure, an option that many patients choose to utilize. Breaks can also be helpful so don't be shy to ask your doctor for a quick time out from the procedure if you are having trouble tolerating it. Gook luck with your second treatment! If you have any other questions about Ulthera, feel free to call my office or click the link below.

Although there is much information out there on the market, I
can say from personal experience, Ulthera is typically painful without pain
management. In our office we offer both topical numbing and follow it with a
local block so that the patient is completely comfortable and pain free for the
procedure. Cold air and only topical numbing really do not help with this
procedure because the heat is going so deep into the skin. Make sure that the
physician’s office you choose help you to feel comfortable during any
treatment.

Ultherapy is uncomfortable to most and very painful to some. Oral sedation, pain meds and topical anesthetics can make this procedure reasonable. The Sciton Laser treatment SkinTyte seems to be more comfortable with similar benefit.

We instruct patients to take ibuprofen  1 hour before the procedure In the office  Lidocaine gel is applied for approximately 15 minutes. On a scale of 0-10 most patients comment at a 2-5.  There is no need for a stronger pain medication. The beauty of the procedure is that patients can drive themselves to and from the office.

My experience in administering Ulthera and the pain patients feel ranges very broadly. I have some patients who take Ibuprofen only and do well - some teeth gritting, but tolerable. Some patients take in addition valium, and the next step up is adding Demerol. Once narcotic is added in the procedure is tolerated by anyone. If someone has difficulty with pain, the procedure could certainly be performed with anesthesia. Pain perceptions are individual and unpredictable, so the patient and physician need to verbally communicate what's happening. Thank you for the question!