Ulthera, Chin Implant and Fat Fillers. In Which Order Should I Do These Treatments?

Went to 2 plastics surgeons about a face lift. Both said I should get a chin implant along with the facelift. I have lost a lot of weight and I'm 60 years old. I'm second guessing the facelift at this time. I was wondering if I did ultherapy and the chin implant plus fat grafts down the road, would it work for the next best thing? Also witch should be done first and how long to wait between each treatment? Also how well does ultherapy work? Thank you for your advice Cher

Doctor Answers 6

Ultherapy and a Facelift are not comparable

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Ultherapy and fat injections would be a relatively poor substitute for a facelift at 60 years of age. You are not going to substantially lift sagging skin by either of these techniques. Chin implants are commonly done at the same time as a facelift for a more defined jawline effect.

Chin implant and Ultherapy

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Thank you for your question.

You should have the chin implant (if appropriate) and Ultherapy at the same setting, while you are under anesthesia. Should consider fat grafting at the same session or in a delayed fashion.

Best regards,
Dr. Karamanoukian

Ultherapy to be done before chin implant and fat transfer

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Ideally, it is best to perform the deep focused ultrasound treatment of Ultherapy for facial tightening and lifting, then have the chin implant and fat transfer / grafting.


Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

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Ulthera instead of a facelift

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Ulthera works great for select patients.  It is not a "replacement" for a facelift.  In San Antonio, I was the first to offer Ulthera and now have almost 2 years of experience with the treatment.  In my experience, most patients who have lost a lot of weight, surgical facelift is a much better option.  Do either of the surgeons you saw offer Ulthera?  If not, I would seek out a Board Certified Plastic Surgeon in your area who does perform Ulthera.

As far as chin implants go, I have had good success using fat grafting for the chin and that is something you may consider.  If you are a candidate for the Ulthera, here in San Antonio this is what I would do: 

  1. Ulthera and possibly Sculptra to the cheeks
  2. Fat Grafting of the cheeks and possibly chin
  3. If you still need more chin prominence after the above, then chin implant.

Good luck!

Ultherapy is a good procedure for some one who does not want surgery but is not ware near a good as a face lift

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While Ultherapy works it only is about 35-50 % effective. If you want the results of a face lift and brow lift and eye lid surgery you need to have the more extensive surgery. If you are a candidate for a chin implant that would give you an additional spectacular result. When ever I do a brow lift and face lift and eye lid surgery I almost always add extensive fat grafting to the jaw line, the lips, the medial nasolabial fold, the check bones, the lateral eye brow and the temple. This is necessary to get the more youthful look you used to have. As we age there is soft tissue absorption and bone remodeling in these areas. This combination will give you the best results and make you look much more like you used to look when you were younger. If you are going to have a chin implant and fat grafting surgery it would be far better for you to have the Face lift, brow lift and eye lid surgery at the same time then have Ultherapy instead. Again I think Ultherapy is great but it certainly will not give the result of the surgery. 

Ultherapy versus Facelift

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Although I use Ultherapy frequently in my practice, it comes in as a distant second to a Facelift in terms of rejuvenating the lower face.  At 60 years of age, my general inclination would be to second what your two previous Surgeons have told you.  Consider the result you would like to have in a year and then work forward.  If you are going to have surgery (chin implant), I would advise that you proceed with the Facelift at the same time.  If you are sure you want to proceed with Ultherapy, I would recommend this procedure several months prior to considering fat transfer or Sculptra.

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.