The introduction of Ultherapy® into the facial cosmetic realm has stirred a great deal of interest, with features on “The Doctors” and “Dr. Oz” offering a breakthrough form of facial rejuvenation. This technology utilizes focused ultrasound waves to stimulate collagen production and facial soft tissue tightening. The question is: How good is Ultherapy®?

 

Although the search for the fountain of youth is first credited to explorer Ponce De Leon, this quest has never really abated. American culture has been fascinated with looking younger for generations, and this fascination has only grown stronger with time. The popularity of cosmetic procedures is the United States is born out by a number of recent surveys.

 

The American Society of Aesthetic Plastic Surgery (ASAPS) reported that more than nine million surgical and nonsurgical procedures were performed in the United States in 2011. The American Academy of Facial Plastic and Reconstructive Surgery reported in 2011 that member surgeons performed an average of 1,000 surgical and nonsurgical procedures in 2011; of these, three quarters were nonsurgical cosmetic procedures.

 

If one was to look back 30 years to the 1980’s, the topic of nonsurgical aesthetic procedures was a very short chapter in any Facial Plastic Surgical textbook. However, with society’s desire to have improved appearances without downtime, and hence without surgery, there has been a proliferation of nonsurgical options.

 

This trend started with Botox®, and quickly moved on to fillers (Juvederm®, Restylane®, Radiesse®). However, since these minimally invasive procedures are capable of achieving specific targeted goals without reproducing the comprehensive results seen with more invasive procedures like Facelift, Brow Lifts, or Laser Resurfacing, the search continues.

 

In the last decade, a technique known as Thermage®, a form of facial soft tissue tightening achieved with radiofrequency, was introduced. Unfortunately, results were mixed and unpredictable, making it clear that this procedure was not the “nonsurgical Facelift” many had sought.

 

Other devices, such as Titan® (infrared), and Pelleve® (Radiofrequency) have since been marketed in the United States, but have not attained the status of “goal standard” of minimally invasive facial tightening procedures.

In the last several years, a device known as Ulthera® was introduced, which utilizes focused ultrasound energy to cause deep tissue heating and subsequent collagen stimulation. Unlike its predecessors in the field of minimally invasive devices, Ultherapy® has received an FDA indication for soft tissue tightening (specifically in the ability to achieve a nonsurgical brow lift).

 

 

 

Ultherapy® is typically performed in the outpatient setting, with oral sedation and takes about 60 to 90 minutes to perform. The target areas for soft tissue tightening include the lower cheek, jowl area, neck, and brow area. Since Ultrasound has been used for decades as a soft tissue imaging modality, the depth of tissue penetration is more standardized than with radiofrequency devices like Thermage®. In fact, the device has two target depths, 4.5 mm which targets the fibro fatty tissue beneath the skin known as the SMAS (superficial musculo-aponeurotic system), and 3.0 mm to target the deep dermis; the device has imaging capability, allowing for visualization of the treated tissue during treatment. Results are gradual, taking a minimum of two months and as long as six months to unfold, lasting an average of 24 months.

 

The initial response to Ultherapy® has been favorable for facial tightening and brow elevation. A review of patient reactions to Ultherapy® on a plastic surgery website (www.realself.com) reveals an approval rating of 83 percent among 143 patient reviews as of press time (Thermage® has an approval rating of 39 percent among 250 patient reviews).

 

The main criticisms of Ultherapy® have been twofold. The treatment is moderately painful, albeit tolerable utilizing mild oral pain control. The second, via anecdotal reports, has been that Ultherapy® works better in patients in their late 40s to late 50s much better than it does for patients in their mid 60s and older.

 

This leads to the conclusion that Ultherapy® appears to be the most effective minimally invasive soft tissue technique in its class, although not really a “nonsurgical Facelift”. In fact, most Facial Plastic Surgeons are skeptical of the words “nonsurgical” and “Facelift” within the same sentence, viewing such phraseology more as marketing than reality.

 

Ultherapy® can be viewed as an advance in minimally invasive soft tissue tightening, as an effective tool when applied to a patient with appropriate indications and expectations by an experienced Facial Plastic Surgeon. As far as the fountain of youth….. the search continues.

 

Stephen Prendiville, M.D., is the only Fellowship Trained and double Board-certified Facial Plastic and Reconstructive Surgeon in Lee County.

For more information, visit www.drprendiville.com  or call 239-437-3900 for a complimentary consultation.