Ulthera or Thermage help reduce facial volume? I'm 35 with very full face, would like to reduce the volume in the lower cheeks.

Question

I had buccal fat pad removal many years ago but my face still is really full. At this point, it seems my only option is facial lipo but the risk of nerve damage and irregularities concerns me. I have read that Thermage and Ulthera could melt fat in the face if applied in a certain way. Although for most patients that's a negative outcome for me that is what I want. Are there any doctors here that have experience using Ulthera or Thermage in this manner? If yes, which is better for this?

Richard Baxter, MD · Answer

Neither Ultherapy or Thermage is designed to reduce facial fat. Sometimes what appears as fat reduction has more to do with tightening and lifting. If done with precision, liposuction is sometimes a good option for facial fat, though it would not be used for further buccal fat reduction.

Rebecca Fitzgerald, MD · Answer

You are wise to be concerned about nerve damage. Our facial expressions make us "us" and risking permanent distortion is a high risk indeed.There is no technology that will melt fat on the face so Ulthera or Thermage won't accomplish that goal.Not seeing a photo of your face, it's hard to tell what might be a good option. But consider a couple of examples:
Early volume loss or genetics could give you a facial shape that is more narrow in the temple area...thus calling attention to the lower face.Many women lose volume in the temple area and that tends to then make the lower face appear heavier. If your situation is a comparative volume loss or volume deficiency, then the areas "lacking" could be brought to higher volume levels with Sculptra or a hyaluronic gel.Another possibility is the enlargement of the masseter muscle which can make the lower cheek and jaw area appear square and larger. This particular problem is frequently treated with Botox to prevent the action that causes the enlargement (typically clenching the jaw or teeth grinding). Over a period of time that muscle returns to its normal size and shape because it is prevented from being "over worked".

Roy A. David, MD · Answer

Dear marie, thank you for your question. Ultherapy
is the only FDA approved  noninvasive
device for lifting the face and neck.  It
uses focused ultrasound to target the deep tissues above our muscles, as well
as more superficial layers.  Our San
Diego  facial plastic surgeon and nurses
are experts in Ultherapy and offer customized treatments for each client.

Douglas J. Key, MD · Answer

The secret here may be that you don’t want to bust more fat, but instead add some shape to where there is less. The pleasing youthful facial shape is shape more like a heart, broader in the cheek bones and thinner in the cheeks, an upward V. You may not want to take away more in the cheeks, but add shape, perhaps with Sculptra or Voluma to the cheek bones to give a sense of lift to the upper face. I would have you check out Botox for cheek muscles, the masseters, because when they’re enlarged can give a “block-like” look to the lower face.  The underchin can have a fullness that can give an unwanted heavy look to the face as well. Removal of fat and tightening with a new procedure ThemiTight&trade; might be the magic touch.  Lastly, there simply is no fat busting with Ulthera, tightening yes, but fat busting, no!

Daniel Shapiro, MD · Answer

Ultherapy is not meant to "melt" facial fat away. It is used to lift and tighten areas of the face, not reduce fat.

Hratch Karamanoukian, MD, FACS · Answer

Ultherapy uses focused ultrasound and when properly used causes tightening of the skin and the SMAS layer under the skin to tighten and lift the face and neck as an alternative to surgical face lifting. It does not 'melt fat away' when appplied in a therapeutic manner to the cheeks (buccal) areas. Read the Ultherapy book by accessing the link below if you are interested in knowing what Ultherapy does and what Ultherapy is not expected to do.

Ulthera or Thermage help reduce facial volume? I'm 35 with very full face, would like to reduce the volume in the lower cheeks.

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