Can ultherapy to face and neck be pain free?

I had mild tingling sensations and not much else.. it was all fine, no what I would say was pain.. is this normal? people keep wriitng about the pain. I am nearly 4 weeks on from my treatment and no major result yet...

Doctor Answers 11

Ultherapy results

Yes, I have had several patients who have experienced the procedure with little discomfort.  Each person has a different pain threshold.  Our office also practices a variety of distraction techniques during Ulthera treatments, and we provide OTC pain medication.   We do not use nerve blocks or lidocaine injections to numb the area.
As far as seeing results, give it time.  I  recommend doing a follow up at 3 months from the procedure date.  It can be hard to see results yourself as the improvement occurs gradually over several months, and improvement can still continue for up to a year.  Typically photos are taken before and then again several months after the procedure for comparison, and you should notice a significant difference when these photos are compared side-by-side.

Washington Dermatologic Surgeon
5.0 out of 5 stars 21 reviews

Ultherapy discomfort post treatment

Many of our patients report mild tenderness over the areas treated following the procedure.  The best measure of results is by having your doctor's office take photographs at 3 months and again at 6 months.  Our patients say that they can see results on their own prior to that time usually, but the pictures generally speak for themselves! I'd make sure to return to your doctor to do those photographs and compare your "before" pictures to them.  Best wishes and thank you for your question. 

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 59 reviews


Our patients report various degrees of pain depending on their individual pain tolerance.We offer each patient prescription pain medication in combination with Ativan or, alternatively, if a patient prefers, they may take over the counter pain medications. Ultherapy results are most noticeable after six months.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

Ultherapy discomfort

Hi and thank you for your question!

We medicate our patients for Ultherapy because we find everyone needs some sort of analgesic. We typically give a blend of narcotics and sedatives, such as Percocet, Xanax or valium, along with an NSAID. With this blend of medications, our patients do OK the treatment. The results take a few months to start to see and by 6-7 months is the final result. We have our patients back for post treatment pictures around 3 and 6 months. I would suggest you go back to the practice for the follow up photos at that time.  


Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 147 reviews

No Ultherapy is PAINFUL if performed correctly.

Firstly, it is painful. Secondly, if you do not experience pain, you either have an extraordinary pain threshold or the procedure was not performed correctly. Thirdly, it is HOW to decrease pain that is the key. 

I have had Ultherapy, 4.5 mm and 3.0 mm to my cheeks and below the orbital rim. It was painful. I always get a procedure done so I know what my patients feel when I perform the procedure. Ultherapy pain can be tolerated, however in my practice I always give miild sedation. Why? Because if I can not deliver the necessary lines, I won't get the results!

It is how your Specialist address the pain that is the important factor as well as correct patient selection. 

All the best

Dr Davin Lim 
Laser and aesthetic dermatologist

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Ultherapy pain

Everyone has a different pain sensation and tolerance.  That being said, Ultherapy is related with a certain degree of pain, especially when it is performed over a bony area and when the power is increased.

Ultherapy treatment can hurt. From my personal experience

I had Ultherapy twice- once in 2012 when we were the first in the Capital District to get the machine, and once again a year a go to maintain the results.  I have loved the results in that Ultherapy lifted toned and tightened my skin and jawline.  I am 60 and look 50 with no cosmetic surgery!  The first time I took a narcotic analgesic pill and there was no pain during the treatment.  In fact I laughed through it.  The second time I decided to try it without the pain pill- just taking some motrin.  I don't consider myself to be a wimp but it really hurt the second time!  I'll take the narcotic pain pill the next time.  And that is what I recommend to my patients. There is no need for local anesthesia injections.  The pain pill works just fine.  Just have someone drive you home- after your treatment, if you take the narcotic.  There is absolutely no pain after the treatment.  Although results are dependent on the expertise of the technician who gives your the treatment, it will likely take 3-4 months to start seeing improvement and this will continue for up to a year before you see the final result.  Hope this helps! and best of luck!

Steven Yarinsky, MD
Albany Plastic Surgeon
4.9 out of 5 stars 29 reviews

Ultherapy pain

Ultherapy performed properly is PAINFUL. I have always performed local injection blocks; otherwise, it could be intolerable. What many providers do is turn down the power or perform fewer lines to reduce discomfort which is suboptimal for cosmetic outcome. Oral sedation and narcotics is not a good idea as you will be impaired during and after the procedure and it really does not mitigate the pain. Also, some locations will claim to perform Ultherapy but are using an off brand focused ultrasound machine which does not work (usually from china). make sure you request to see the serial number of the machine and get a print out of the treatment administered to you. Look up your provider on the Ulthera main website to confirm they are legitimate. My motto especially with cosmetic machines is "if it didn't hurt, it won't work" since we are delivering destructive or ablative energy by sound, light or radio frequency. Any energy strong enough to destroy tissue (hair, skin surface or subcutaneous fat) will be sensed by the brain as pain. In my opinion, it is nonsense to claim that Ultherapy may not be painful.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews


There will always be some discomfort from Ulthera especially when working around the bone.  But everyone will tolerate the pain differently.  We have patients take some ibuprofen before hand.  Some offices will use even stronger pain meds but that is usually not necessary.  Results are not seen for at least 2 months and will improve over 6-12 months. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 28 reviews

The pain from an Ultherapy treatment is tolerable

Thank you for your question.  Many people have different pain tolerances.  Also, if your practitioner is treating at the correct tissue depth, the procedure actually isn't that painful.  However, if you have an Ultherapist that is not reading the ultrasound correctly and treating at the incorrect tissue depth, they could be hitting bone and muscle which is excruciating and is a non-therapuetic treatment. 

If patients do experience pain, we use a cooling device which helps tremendously. 

I think it it is a good sign that the procedure was tolerable. The results from an Ultherapy treatment work in a two-step process. The first stage is the contraction and denaturing of collagen, which causes an immediate tissue tightening, and resultant lift. The second stage occurs over time while the body’s healing response builds new collagen (neocollagenesis). New collagen production is generated over 2-3 months and often continues for 6 months after the treatment. Full results are visible after 3 to 6 months.  You should see results in time. 

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 96 reviews

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.