Should Ultherapy Be Done by a Doctor or is It Ok That One of His Assistants is Doing It?

Some physicians elect to be the "technician" on all technologies. Others appoint nurses or physician assistants to treat. Often, if a treatment has a high safety profile, delegating the treatment to other staff is perfectly fine.

Since Ultherapy is noninvasive, staff with experience and education are frequently just as capable - and since their time is less in demand, they can usually spend a bit more time with patients than a doctor who typically has a more pressing schedule.

As to having non-medical personnel perform the treatment, if you are uncomfortable with that option, then finding a practice that only uses medically trained technicians would not be hard. Or you could request a nurse to be your treatment provider.

In our office we elect to provide Ultherapy only by nurse, physician or physician assistant.

Depending on the state governance, some physicians may elect to direct the treatment and have a nurse, physician's assistant, medical assistant or aesthetician peform this ultrasound treatment.  Currently I or one of our plastic surgeons in our practice, peform the treatment but once we have a well-trained physician assistant or nurse involved, I would be very comfortable with them performing the Ultherapy.

In my practice, I provide Ultherapy treatments but also work closely with my aesthetician who is very skilled at delivering the treatment.  I believe the quality of results depends heavily on the planning and treatment plan.   For patients who receive treatments with my aesthetician, I am very involved in patient planning and I often modify and customize the standard treatment protocols prior to the treatment.  For example, I often notice asymmetry in patients face and will change the treatment energy delivered on one half of the face compared to the other.  It is this planning where I think Plastic Surgeons are able to differentiate themselves compared to other physicians who are trying dabble in aesthetics (e.g. family practice or emergency room physicians).

The legal answer to your question most likely depends on the state in which you live.  Assuming that it is legal for a non physician to perform Ultherapy, I would recommend the following:


A trained physician should asses each patient to make sure that he or she is a good candidate.

The trained physician should map out the areas to be treated and set the treatment parameters.  

A well trained assistant could then perform Ultherapy safely and effectively.


The Ulthera company goes to great lengths to ensure that the physicians who purchase their Ulthera devices and the staff who perform Ultherapy are qualified and well trained.  Head to their website where you will find a physician locator for a registered practice near you.

In our practice, Ultherapy is done by the physician or physician assistants, not cosmetologists or aestheticians. It is after all, a medical procedure and ultrasound energy is being used. Although safe and FDA cleared, it is best to adhere to the ALARA principles when using ultrasound devices. Use the lowest energy to prevent potential tissue injury 'as low as resonably achievable' ..