"Welts" a Side Effect with Ultherapy?

I have an appointment the week of the September 27th and my provider says that they have had patients experience "welts" with this procedure and that those welts have taken weeks to resolve. I have found this on the Ulthera site or any questions here. Does this sound right? This is a new procedure for my provider, even though they have done Thermage for years.

Doctor Answers 9

Ultherapy side effects

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Thank you for your question.

Temporary welts can occur if the transducer is not kept perpendicular to the skin.

Injury to the marginal mandibular nerve can be caused if the energy setting is not lowered during treatment when or if patients complain of pain near the jaw. This usually resolves. 

Bruising can occur near the corners of the mouth. 

Ultherapy Welts

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"Welts" can appear with the most superficial level of the Ultherapy treatment.  I would estimate only 1 of every 5 treatments will experience welts.  They can last a couple hours to a couple days.  Typically that are coverable with makeup and are undetectable unless you specifically point them out.  No worries, they will resolve with time.  If welts persist after a few days, consult your surgeon for closer evaluation.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 19 reviews

Welting can occur but should resolve without long term complications

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Welting can occur but should resolve without long term complications. Usually this occurs by poor tranducer contact, treated too superficial or an inexperienced practitioner. I recommend going with a practice that has experience and advanced training. I would also recommend you discuss your situation with your treating provider.

James Chan, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

Welts after Ultherapy treatment?

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Rarely, welting may occur if you are treated with the superficial 1.5mm transducer. Welting is caused by poor contact, overlapping a treatment area without waiting the appropriated amount of time or treating a patient who has very thin skin. I have received advanced training on this specific transducer. I would recommend looking for another provider in your area and make sure to ask about their training.

Pamela Gallagher, MD
Long Island Plastic Surgeon
3.9 out of 5 stars 16 reviews

Welts can be a side effect of Ultherapy, but are easily treated and go away quickly

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Welts can happen at times with Ultherapy, but luckily they are brief (about 1 week or so) and generally resolve even quicker than that.  In our practice, we avoid high energies around thin areas of skin (like around the eyes) and this leads to better results and happier patients.  

If at any time during the procedure you are experiencing significantly higher amounts of pain you should tell the person who is doing the procedure this and they can adjust the energy accordingly.  Studies have even shown that the highest energy levels don't always correlate with best results, so there is a little 'wiggle room' in how much energy must be used.  

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.9 out of 5 stars 48 reviews

Although welts from Ulthera are uncommon, they may be seen more with the new 1.5mm transducer

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Ultherapy and the focused ultrasonic energy can sometimes cause skin dermal injury with a welt if the interface with your skin is altered or a patient pulls away from the transducer when it is firing. Ulthera recently launched the 1.5mm shallow transducer targeting the skin itself and not the deeper layers traditionally targeted. Hitting the actual skin dermal layer may lead to a higher incidence of welts - but these should resolve quickly. And hitting this layer of skin may soon prove efficacious toward wrinkle reduction and improved skin tightening.

Christopher S. Verbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 17 reviews

Welts and ultrasound

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Welts are seen rarely after Ultherapy and should spontaneously resolve with no long term issues. Welts would be caused theoretically by superficial rather than deep absorption of the ultrasound energy which induces heat.

The time it takes for them to go away could be minutes, to hours or up to several days. One or two isolated welts might be caused by a lack of good contact with the Ulthera's transducer or ultrasound gel placement. If there are a myriad of welts, then the technique or transducer might have been suboptimal. You should let your doctor know so he can evaluate you now and notify Ulthera.

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

Welts from Ulthera

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Welts can occur from having to much gel on the face, causing the handpiece to not be in direct contact with the skin.  It can also be caused by rebound of ultrasonic energy from bone.  Essentially, what is happening is extra energy is being delivered to the more superficial layers of the skin, causing the skin to react in a welt.  The welts will resolve with no long term side effect.

Leif Rogers, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 26 reviews

"Welts" can occur but resolve without long term problems

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Our practice experienced some patients getting "welts" after treatment to the forehead.  They did resolve without long-term effects.  This seems to be related to the thickness of the skin and its relationship to the underlying bone as all of our patients experienced this on the forehead and had thin forehead skin.  This also occurred with the very first patients who went through the procedure and there have no subsequent events.  Like all procedures, experience matters and so it may be worthwhile to wait until your provider has a little more experience under their belt.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon

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.