I'm 52, thin and looking to shape lower face ulthera?

I have met w three doctors so far. The one I am leaning towrds using the program pre-amplify..(the others use 1 and 2). He seems more caring and experienced. He suggests 480 lines. Does this sound reasonable? What is the pain protocol? He said sedative and OTC..and numbing shots. Thank you

Doctor Answers 9


Without a picture it is difficult to commend on the number of lines that was recommended for you.  Studies demonstrate Ultherapy’s beneficial effect on droopy necks and brows. In addition, Ultherapy can improve jowling and tighten cheeks for a refreshed appearance and rejuvenated facial contours.  Our patients generally take over-the-counter pain medication or if sensitive to pain, prescription medications. You can check the Ultherapy website to learn who is a legitimate provider in your area.

Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Ultherapy for facial tightening and how I address energy with amplify in my NYC practice

Ultherapy uses focused deep ultrasound energy to heat the infrastructure of the skin and tighten the face and other areas of the body. This is energy that depending on the exact location of the pulse of energy, can feel warm or for that split second before the treatment moves to a new spot, can hurt. The Ultherapy device was upgraded to treat with less energy per pulse if desired by the physician, but the number of lines of energy delivered should be more than the protocol recommended with the older more energy packed treatment. In my practice, if I have a patient that tells me they don't tolerate pain well, I will use the lower energy. If they can tolerate pain better than average, I will use the older protocol of higher energy per pulse but still don't tend to lessen the pulses as I was already delivering more pulses per facial treatment with the old treatment protocol than recommended. 

In my NYC practice, I offer and usually treat my Ultherapy patients with medication to lessen their pain and make them feel more relaxed.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews


Without photos and an in person exam, it is difficult to determine the exact amount of lines necessary to treat you.  As for the pain, pretreatment with ibuprofen should be sufficient.  Good luck

Ultherapy for Lower Face

Hi and thank you for your question!

Hard to make specific recommendations without a photo and an in person consultation. If your concern is definitely skin laxity and sagging, more so than crepey/thinning skin and textural concerns, then Ultherapy is a great option for you.

As stated below, you would want the practice to have the Amplify upgrade. Not sure why they would have pre-amplify, as most practices have been upgraded. The number of lines depends on how much area will be treated and on each individual patient. For lower face (cheekbone to mid neck) we would do at least twice, incorporating all 3 transducers into the treatment (4.5, 3.0 and 1.5mm). As far as pain control, we suggest oral narcotics and sedatives, such as Percocet, Xanax and Valium, along with Ibuprofen and Neurontin. Feel free to call our office or visit for a complementary consultation.


Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 145 reviews


Thank you for your question. It's difficult to give exact recommendations without photos or an in person consultation. That said, Ultherapy is a good option for skin tightening around the neck and jawline. I recommend my patients use nitrous during the treatment to combat the pain. Some patients are happy with just Valium and Percocet.  You should make sure you're working with a board certified plastic surgeon for precise recommendations. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews

Ultherapy for the Lower Face

There is no question that Ultherapy provides soft tissue tightening for the lower face. The biggest problem is that many patients have expectations that exceed the capability of the technology, seeking a  facelift result with a noninvasive modality.  The number of lines seems very low to me to achieve any type of meaningful result.  

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Shape Lower Face/Ultherapy--SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, Kybella, CoolMini

Ultherapy works best in combination with other treatments for best results. In my practice we do VASER and ThermiRF in combination with ultherapy to get neck lifting and tightening.  Please see an expert for options.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Lower face tightening and shaping with Ulthera, noninvasives and other options

Using Ulthera alone to get any kind of significant results commonly causes big problems.  The lower third of the face is the only area of the face that Ulthera can be used safely in my opinion.  When I perform tightening procedures I do not use one modality alone as this limits results and increases shances of complications.  I use a procedure called MMT which uses focused ultrasound in combination with four different radiofrequency technologies, infrared light based tightening (skintyte) and laser to get a synergistic result by achieving treatment threshold of each technology at different depths in the skin and subcutaneous tissue.  I do not really recommend using ulthera alone.  It is also important to see a practitioner with an open mind that can assess you and help decide what is best for you.  For example it is very rare that aesthetically speaking, the lower third of the face takes priority over the upper third.  What I mean by this is that most people will see much more aesthetic benefit from treating the upper third with well placed volume ( what I call Aesthetic Facial Balancing) before intervening on the lower third.  Find a  surgeon that can give you a sound aesthetic assessment instead off going after a device that has been marketed directly to you.  I hope this helps!

All the best,

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 73 reviews

Ultherapy protocols...

Thank you for your question.  There are not multiple different Ulthera programs.  Ulthera released a software upgrade a few years back called Amplify which decreased pain and increased efficacy.  Any physician that is using a genuine Ulthera device and has been appropriately trained will be using Amplify/Ulthera 2.0, etc.  The issue becomes especially in South Florida many providers using black market devices or second hand machines that have not been updated.  Please check on the Ulthera find a physician website to make sure you are seeing a genuine Ulthera provider.  Pain tolerance is an individualized treatment protocol, some can tolerate without the need for medication, others require much more, that is a discussion you should have with your board certified Dermatologist prior to having the Ulthera procedure.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 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.