Ulthera, Botox and Fillers, Laser Resurfacing. In Which Order Should I Have Them?

I like to relax the musculature first with Botox cosmetic injections, preferably a week or two before, but even one day before is fine. The Botox is bound immediately and there is no evidence of which I'm aware that Ultherapy a day later would interfere with Botox's effect. In this way, after Botox, the Ultherapy's effect of collagen production and lifting can occur in a smoother environment with less active contraction of muscles and pleating of overlying skin. After Ultherapy I then do fillers, both for volume such as Sculptra or Radiesse and layered with more superficial fillers such as Restylane, Juvederm or Belotero.

Ulthera takes some time to see the full effect, and you would not want to treat directly over fillers so it makes sense to do it first. Also, depending on how much lifting is achieved, it could affect the amount and placement of fillers. Botox could be done soon after but best not before.

Ultherapy first and then any laser resurfacing should be done before Botox and fillers.

The heat from Ultherapy and laser resurfacing can interfere with Botox and fillers. The exception to the wait for fillers would be if you were having Sculptra, which works quite well immediately post Utherapy and can be done in the same treatment session.

As far as time between treatments, that can get pretty complicated. It depends on the type of laser resurfacing and the kind of filler.

For instance, in our practice we recommend our eMatrix patients wait a month for fillers or Botox and other relaxers.

You might look at it as a "permanent 1st" and then "temporary 2nd" treatment sequence. Since treatments that alter the skin tissues themselves rely on heat, and the heat-induced subsequent deep tissue inflammation (the desired kind) takes time to subside, temporary cosmetic treatments including fillers like Juvederm, Restylane, Botox or Dysport will integrate better when the dermal tissues have had time to recover.