Ulthera Vs. Long Term Retin-A Use

I've been using Retin A since my twenties and I'm now 42. Since tretinoin increases collagen, I'm wondering if Ulthera would render any improvement for someone like me? I'm starting to lose volume in my face which I actually don't mind because I finally have cheek bones! But I don't like the sagging around my jaw and mouth. Would Ulthera give me any improvement or would it be redundant since I already am using a product which stimulates collage?

Doctor Answers 5

Ulthera goes under the skin, tretinoin goes into the skin

Ulthera uses highly focused ultrasound energy to stimulate collagen about 3 to 4 millimeters (about an eigth of an inch or so) under the skin, for a lifting effect. For this reason it has less of an effect on the surface layers of the skin so Retin-A (tretinoin) is useful in addition. Many patients also benefit from some sort of volume replacement with fillers or fat transfers to complement the cheekbone structure while maintaining a youthful look.

Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Ulthera produces deep collagen; retin-a produces superficial collagen

Retin-a (tretinoin) and ulthera are both clinically proven to incite collagen formation, but they do so at different levels:

  • Retin-a works at the uppermost level of the skin, exfoliating dead cells and creating collagen in the papillary dermis.  This results in a reduction of fine lines and a fresher complexion.
  • Ultherapy creates collagen works at the deepest level of the skin in the fat and the muscle.  This collagen acts to acts to buttress the skin, resulting in an overall lifting of the skin

In summary, both treatments create collagen (which gives our skin a tight, firm appearance, and which we lose as we grow older), but at different levels of the skin.


Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Ultherapy and Retin-A - Williamsville, NY

Here are some things you need to know about Ultherapy and Retin-A versus RR Retinoid Repair Cream from Kare Skin

. It is an FDA cleared technology that uses high intensity focused ultrasound energy
. It is unique in that the system uses B mode US imaging during energy delivery, making it a focused treatment, unlike RF or other technologies.
. Energy is delivered in the skin (most superficial) and deeper structures that support the skin (4.5 mm)

. Retin A is most likley to benefit the very superficial layers of the skin and it will be great for maintenance therapy after Ultherapy.

. I recommend a product called RR Retinoid Repair Cream from Kare Skin.

Read the Ultherapy ebook provided on the link below. It is free access and located in the ebook section of the website.

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

Ulthera provides deep tissue tightening, Retin-A superficial tightening

You can think of the aging process taking place at multiple levels of the facial tissue.  The most superficial is the outer skin, which bears the brunt of harsh environmental exposures such as the sun.  Retin-A is one of many treatments that can address the superficial skin by encouraging the outer skin to shed and stimulate new skin growth.  Ultherapy works by stimulating collagen formation at two deeper depths (3 mm and 4.5 mm) and depending on the thickness of the tissue, it may even stimulate tightening of facial muscles.  By combining this deeper tightening with superficial treatments such as Retin A, peels, etc., you can enhance really optimize these non-invasive approaches to maintaining a youthful look.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Ultherapy is a good complement to long-term Retin A use

The collagen in your dermis that you have obtained from Retin-A,  is more superficial to the 3 and 4.5 millimeter depth that Ulthera penetrates and causes collagen to be deposited and the depth at which it tightens the S.M.A.S. connective tissue layer. The topical therapy you've been using helps the appearance of the surface of the skin and can continue to be used along with an Uthera treatment which can help lift and tighten the deeper tissues.

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

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.