Will Ultherapy Destroy Existing Fillers?

Question

I have been using fillers (Restylane & Radiese) in the cheek & nasal labial area for a few years. I also have dental implants. His does Ultherepy affect these?

Sabrina Fabi, MD · Answer

There have been a couple of studies examining the tissue effects different lasers and energy sources have on an array of fillers at varying times after placement. In these studies, which have included tissue biopsies, there has been no effect on the longevity of the filler. Although studies using Ulthera specifically over fillers have yet to be published, the focal point of the energy being delivered is at the level of the SMAS (were filler is not injected) and then the dermis (and most fillers are placed immediately subdermally), therefore it should have no bearing. Most practitioners typically wait 2 weeks until treating over a hyaluronic acid or Radiesse, or fill immediately after the Ulthera treatment. Good luck!

Ron Shelton, MD · Answer

I am not aware of any studies that prove Ultherapy ultrasound energy passing through or penetrating to the depth of a filler, either creates an untoward reaction in the filler or hastens its resolution. Yet, I tend to avoid doing Ultherapy directly over the areas of placement of fillers for six months after the filler is injected. If a filler is done to fill out the smile fold, I certainly do perform Ultherapy on the cheek. If a patient is under a time constraint and needs the filler and Ultherapy done soon, then I perform the facial tightening with Ultherapy and will inject the filler immediately after.

Mary E. Hurley, MD · Answer

Rest assured that Ultherapy will not have an effect on your dental implants. In regards to your fillers, Ultherapy usually does not target areas of the face where fillers are typically injected, and it will not affect any previous filler. With that being said, I recommend ideally having fillers injected AFTER your Ultherapy treatment.

Hratch Karamanoukian, MD, FACS · Answer

We avoid Ultherapy in patients who have had fillers for approx 1 month.Having said that, Ultherapy does not target areas where patients have had fillers, except in the upper lip where the new Ultherapy transducers are being used (1.5 mm).In our practice, we recommend Ultherapy followed by filler at the same setting or Ultherapy followed by fillers a week later.

Steven M. Lynch, MD · Answer

Hi,

	  There should be no effect on dental implants with the Ultherapy treatments.  It is possible that fillers can be affected  if the focal points of the therapy go into areas of fillers. 

	  It is possible to see fillers on the Ultherapy screeen and therefore they can avoided as much as possible.  Having said this, it should be discussed with your doctor to make sure that there are no surprises.   Remember too that touch ups with the fillers can always be completed if any change is seen.

Pablo Prichard, MD · Answer

Ultherapy may degrade HA fillers if the filler is placed at the point of maximal focus of the Ultherapy beam, i.e. the SMAS layer or dermis layer.  However, Ultherapy naturally degrades over time (6-12 months).  Either way, you will need more HA filler over time.  Also, may look into sculptra which is longer lasting and is less likely to degrade.

	Best Wishes!

	Pablo Prichard

Cameron Rokhsar, MD, FAAD · Answer

The answer to this questionm has never been scientifically investigated in a well controlled fashion. We know that energy based devices coagulate collagen. by heating up the filler, it is possible that the longevity of the filler may be reduced.

Leonard W. Gray, MD, FACS · Answer

Generally I place filler following the Ultherapy treatment. In over 300 Ultherapy treatments I have not seen a change in previosly placed filler.

Curt Samlaska, MD · Answer

Yes, Ulthera will destroy the Hyaluronic acid (HA) fillers if it is within the 0.5 by 1.8 mm site of thermal coagulation pulse administered into the dermis. It is unlikely to really effect dental implants since the focused energy is directed at the dermal tissue and the deep facial tissue (SMAS) of the face. It is very precise. Having said this you realize that the HA fillers last for around 6-10 months, and will naturally degrade and be absorbed, so I would wait until you are ready for another round of HA treatment, have the Ulthera done first and then have your HA treatments if so desired.

	You could also consider Sculptra, which has a very high melting point and is not diminished by Ulthera treatment. Sculptra also last much longer and stimulates your own collagen to be generated and provides a natural filler, that lasts much longer. Hope this helps!

Will Ultherapy Destroy Existing Fillers?

Answers (9)

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