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Skin Tightening with Ultrasound - Does Ulthera Work?

A facial plastic surgeon expresses his opinion of skin tightening with Ulthera.

Loose skin is one of the most common complaints aesthetic physicians hear from their patients. There are several treatment options available to doctors ranging from completely non-invasive to performing a surgical facelift. Now, Ulthera is adding another tool in the mix by using ultrasound to reach the underlying tissues of the face that previous treatments missed.

"With Ulthera, we go deeper under the skin," says Houston facial plastic surgeon Dr. Haresh Yalamanchili. "We can reach some of the deeper facial structures and some of the connective tissue that we could only get with surgery before. That is truly what's exciting about Ultherapy." As the doctor describes, Ulthera enables the physician to treat deep under the skin in a way that only surgery could before. "We can tighten up some of the deeper muscles and connective tissue without having to use a knife or sutures. Therefore you don't have the downtime or the expense associated with traditional surgery."

Dr. Yalamanchili says that physicians have always tried to walk a fine line between procedures that are comfortable and those that are effective. While patients may enjoy having a pain free option, often these treatments don't provide the kind of results patients desire. "Ultherapy is giving you a result, but there is a some discomfort associated with it," says Dr. Yalamanchili. "There are tricks to make the experience much more palatable and comfortable."

Ultherapy before and after photos
Actual Ulthera Results of Dr. Haresh Yalamanchili


One benefit Dr. Yalamanchili discusses is the DeepSEE technology that allows a physician to see the depth he's reaching with the device. "What is revolutionary to me about this technology is that you're using ultrasound - which has been around for 40 years - and you are, first of all, able to visualize the deep structures of the face and the skin. Now though, we're also able to treat those precise layers in a very exact manner using the same ultrasound." With Ultherapy, the physician can see exactly what facial structure and depth they're treating, eliminating the need to guess and providing better, more predictable results.

While Ulthera is a powerful treatment, Dr. Yalamanchili points out that patients shouldn't expect a facelift like result. They will however avoid the down time and expense. "Ulthera is a treatment where you really don't have any of those issues and you're able to get real results that you can see and modify," says Dr. Yalamanchili.

"Patients who are a bit younger see the best results," he says. "Patients in their late 30s to early 50s would probably respond a bit better and have a more dramatic result. They still have good elasticity and are in the early stages of loose skin." Those who are a bit older may benefit from additional treatment 4-6 months after their original session.
Ultherapy before and after photos
Actual Ulthera Results of Dr. Haresh Yalamanchili


Those with sun damaged skin and a lot of wrinkling are not Ulthera candidates. These patients aren't going to see adequate results and are often better served with more aggressive therapies such as skin resurfacing.

Ulthera is FDA approved to provide a non-invasive eyebrow lift, but many physicians are finding it useful elsewhere. "As you get a little bit older," says Dr. Yalamanchili, "the cheeks that have started to descend or droop a little bit and the jowling and laxity in the neck all respond very well to the Ultherapy. Now there are some practitioners who started saying the same idea can apply to other parts of the body. That's something that people are starting to learn a little bit more about in terms of the belly or the legs and thighs, but it's not something that I think has fully been explored yet."

Treatment is fast and typically lasts about 45 minutes to an hour. It's done in the doctor's office and you can return to normal activity immediately. Some patients see improvement right away, but it takes several months to see the final results. "What you're doing with the ultrasound is actually stimulating the growth of collagen in your body. That process takes several months so you see a gradual change." Many patients like the subtlety that's a result of the natural change over time.

How much does Ulthera cost? Dr. Yalamanchili says that the price varies greatly depending on the size of the area treated. A cost of $2,000 for a smaller area going up to around $4000 for a full face is reasonable.