As Ultherapy is not a laser, and its focus is to heat the dermal tissues, there is no injury to the epidermis that normally occurs during the treatment. The focused ultrasound energy travels through the epidermis and is absorbed a few to several millimeters below the epidermis, in the dermis heating up this collagen. The body then produces more collagen as a response to this injury.. There can be a risk of a thermal burn, although this would be very rare, and this could induce a temporary, and in unusual circumstances, long term or permanent, post inflammatory hyperpigmentation. If this were to happen, treatment is available to lighten such pigment and it is often successful.