11 Months Later: Not Worth It After All

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*Treatment results may vary

I'm planning to keep a log of the healing progress...

I'm planning to keep a log of the healing progress for my Ultherapy treatment, which I had yesterday. A nurse at the clinic performed the procedure.


***IMPORTANT NOTE: I want to alert other users that I had this on the first day of my menstrual period. The nurse said this may explain the extreme pain I felt. I would not recommend booking during your period!***

Shortly after arriving, I was given 4 pain pills--I think 2 were Tylenol and 2 were Advil (I can't remember the brands; they were over-the-counter pills, anyway). I thought this would be fine, since I generally have high pain tolerance, and I had Ultherapy (at another clinic) before and was able to tolerate it well. 15 minutes later, she put some skin numbing cream on my face; my impression was that this somehow put my skin in hyper-sensitive mode. About 15 minutes later, she started the Ultherapy procedure.

DURING: On the first zap, which was under my chin, WOW--EXTREME pain!!! I just about went into shock. She tried two more zaps and it knocked the air out of me. I was grunting so hard, she stopped and asked if I wanted her to get a Percocet. I said yes. She gave me the Percocet and we waited for 15-20 minutes for it take effect. Then she resumed the procedure.

I was still in extreme pain. I was in awe not just because of the sharpness of the pain, but also because in the past I've always tolerated pain very well. The nurse bravely continued with the treatment. I grunted, moaned, huffed, scrunched my face throughout. Each zap felt like extreme energy popping my tissue. For some reason, above my jaw was where it hurt least. Under my jaw and on my lower cheeks, where I have the fattiest tissue, it was excruciating--the opposite of what I've generally read about the most painful areas. Above my brow, the zapping pain seemed to vibrate through the bone, sometimes with electrified "shooting" through the top of my head. I really wasn't sure I was going to be able to make it through the entire procedure. I kept looking up at the Ulthera screen, through the first pass (at 4.5 depth) and the second pass (3 depth). I was sure the poor nurse wanted to slap me out, but she continued with the treatment and asked if I needed breaks. I was pretty delirious from the pain and also all the medication.

AFTERWARD: I was very relieved when it was done. When I got home, I noticed I had one set of raised welts on the right cheek, like a hot fork had been pressed on it. I also had a burned-looking area above the right brow. Later that evening, I noticed that my lower cheeks had swollen quite a bit, and I had a lot of tenderness.


Lower cheeks are quite swollen. (It looks pretty funny, like a moderate case of mumps, although my husband doesn't seem to have noticed anything.) The nurse did tell me that I could expect some swelling, so I'm not surprised. There is a lot of tenderness. It feels very funny to touch the skin; it's a bizarre feeling of a buzzy inflammation. The raised welts to the right of my lips seem to have mostly subsided. There is a "waviness" to the surface generally.

COMPARISON TO FIRST PROCEDURE (2 YEARS AGO): Last time I did Ultherapy, which was at another clinic, I'm sure the doctor didn't do nearly this many passes. He also didn't seem to be marking the passes on the monitor, like the nurse did this time; he just seemed to be circling areas on a printed sheet, and I didn't have the impression he was counting. It was painful the first time, but not nearly as painful as this second time. I didn't have much swelling the first time, and no welts. It did seem to have a good lifting effect over the 8 months that followed, although I started to notice a "sinking" of my mid-face after that, and rapid hollowing of the areas under my eyes, although I believe this was happening due to my age. (I'm now 43.) I believe my jaw area remained somewhat tighter than it would have been if I had never had Ultherapy.

I will keep yo posted on the results of this second round of Ultherapy in the coming weeks and months, and may add a photo of the jaw area only.

DAY 3: Still Swollen after Ultherapy, but Better

I had Ultherapy 3 days ago.

HEALING: Today I woke up with slightly less tingly-numb-prickly feeling, but it's still lingering. The swelling has gone down somewhat. Most of the swelling is in my lower cheeks and under my chin. It looks and feels like I just had my wisdom teeth removed, but it's better than yesterday. :) The little surface-burned patch on my forehead above my right eyebrow has scabbed over; not noticeable. The welted area on my right cheek has also mostly subsided. Definitely looks like things are returning to normal.

EFFECTS: I certainly don't think I'll be able to comment on effects for several months. Right now I look the same, except with puffed lower cheeks. Consistent with the literature on this, I probably won't see a change before at least 3 months.

DAY 4: Bruising, Still Swollen, but Seems Okay

So today the swelling in my lower cheeks has subsided a little more. My husband said to me, "what are those brownish-yellow marks on your face?" and when I looked in the mirror I noticed that both sides of my cheeks have yellowish bruises. It really looks and feels exactly like I had all wisdom teeth removed. It still feels very strange to touch the bottom of my face. When I touch the area on my forehead that had the slight burns, I get a bizarre electric shooting feeling through the top of my scalp. Hard to believe my face is responding like this, but I'm reassured by the fact that others have had swelling/bruising too; doesn't seem to be any cause for alarm.

DAY 6: Bruising and Swelling Continuing to Decrease

Getting better. The swelling and yellow bruises are continuing to decrease. Under my jaw, it still feels bizarre. When I run my hand over the area above my right brow, the strange electric-zap feeling still shoots over the top of my skull. Much too early to report on tightening effects. Will return to report. :)

DAY 9: Bruising Gone, Swelling Mostly Gone, Sensitivity Continues

There's just a bit of visible swelling on my lower cheeks left. There are some sore spots in the upper face, and the nerve-zinger spot on the right forehead area is still there. Along my jawline and underneath is where it's still most sensitive; it still hurts to put on foundation, and it's generally a strange achy-numb-electric kind of feeling.


Now the bruises and swelling are gone. There are still achy areas all around the perimeter of my face, plus my jaw and under the jaw and chin are still quite sore when I wash or put makeup on. There are mild tingling/zapping feelings; feels like the nerves are restoring themselves. Too early to see results.


Now just the tingly soreness remains around my jaw and under the jaw. There are no changes--too early. (My skin texture seems a bit bumpy and my pores look much larger, but I think that may be because I have switched moisturizers.)


I still have the uncomfortable zappy-numb feeling around my jawline and underneath, and it's somewhat painful to put cream/foundation on in that area. Over my cheekbones, I also feel stings when I put cream on. This in itself is only a minimal bother, but I'm concerned that the pain and strange feeling are lingering so long. I hope there wasn't some kind of inappropriate type of burning during the procedure. The little area that "zapped" over my skull still zaps if I touch it, but I think that's improving.

There is no change to my skin's tightness so far, but it's only been a month. Quite a few people have said I look very drawn and tired, and even more ask if I've lost weight. I'm trying not to run away with negative thoughts, but some days it looks like I've got less fat on my face, and I do look very tired all the time. I hope there's no fat atrophy going on. (If this were to happen, when would it happen? Immediately? Over weeks, months? Longer?) It could be a coincidence (and maybe I did lose 5 pounds or so in recent months). I'll report back as more time passes.

3 Months Later - Still Not Sure

It's been 3 months now. I still really don't see a difference when I look in the mirror, but it's possible my perceptions are off. There may have been some slight lift in the jowl area, but I definitely don't look more youthful. I find I look strangely drawn/tired all the time, and I wondered if I had further fat loss after the procedure, but I can't say for sure whether there's a connection to the Ultherap itself. When I saw pictures of myself from last year, I could see I definitely had more dewey fullness in my face back then. People regularly ask if I've lost weight or if I'm tired, with a concerned tone. Hm. Probably not a great sign. It could be a coincidence though! Some doctors have commented that there are further improvements after 3 months, so I'll continue to monitor.

Update - approx 10 months post

I am saddened to finally accept this procedure is absolutely not worth it--at least not for me.

I had it done twice. The first time, it seemed to me the slight lift lasted less than a year, but hoped it was just my imagination, so I tried it again last summer. It was horrifically painful (the distressing experience left me a bit shaken for a long while, strangely). I was swollen for weeks, it took months to see a slight improvement, and then it all seemed to sink downward and deflated again--same experience as last time, despite my exertions to believe it totally works. I am astonished when I see how deeply droopy my face has become, and I'm only in my mid-forties. I may be someone who simply has extremely low collagen levels or something like this. I may even be in a minority whose skin actually gets worse after such a procedure--not sure.
Middleton Cosmetic

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