Date Modify : 2015-07-14 15:14:25


is a non-invasive ultrasound thermocoagulation treatment which biostimulates the body to produce new collagen in the deep skin and therefore tighten it and elevate. It is known as the “non-surgical face and eye lift.

The ageing face and ageing skin can look dull and tired. The deep layers of the skin lose their elastin and collagen with age, which adds to the tired appearance. Approaches to rejuvenation include good skin care with serums, moisturising and increasing cell turnover.  Ulthera is a non-surgical ultrasound treatment to counteract the effects of ageing by working on the deeper layers of the skin. Ulthera is practical and quick hence attractive to the active person who does not want a surgical face or eye lift.

How is Ulthera done?

 Ulthera is done under local anaesthesia with anaesthetic cream on the face and around the eyes plus oral Ibuprofen and Paracetamol tablets 45 minutes before (please inform the doctor if you are allergic to either of these and an alternative will be found). 


Are there any possible side effects?

There may be slight redness for up to an hour or so following the treatment and a small percentage of patients may have slight swelling, tingling or tenderness to touch, but these are mild and temporary in nature. As with any procedure, there is always the possibility for side effects. These however are very uncommon and usually settle without any implication. These can include possible bruising, skin discoloration, prolonged stinging, numbness, or tingling and the appearance of skin welts. Thankfully, if and when these do arise, they are usually temporary and dissipate over the first few days to weeks.

At Pewdee Clinic, no patients under 60 years old have experienced any bruising. In rare cases of patients over 60 years old who never had any treatment or laser before, we seldom see one or two spots of bruises

Ulthera was the only thing in the USA to achieve in 2011 the highest FDA certification as a method of non-invasive face-lifting and tightening of the skin and deep, subcutaneous structures thanks to the non-invasively delivered energy.

Ulthera–rejuvenation of the face without the intervention of a plastic surgeon, without convalescence, after one session. The effect of rejuvenation of the face is comparable to surgical face-lifting and is the only non-invasive technology with the result to matching plastic surgery actions.

 Following Ulthera treatment, face-lifting has immediate effects and furthermore leads to the massive growth of collagen over the course of 3 months and thereby distinctly strengthens the skin, lowers the occurrence of wrinkles and improves the elasticity of the skin.

It is suitable for women and men up to 65 years of age, and also for younger clients 40- and 40+, where a surgical face-lift is not yet suitable or unwanted due to scars and convalescence.

Ulthera has a number of advantages in comparison to classic surgical face-lifts–it does not require anesthesia, it is incomparably less painful, scars do not form, you do not need time to recover.

Ulthera uses it’s focused Ultrasound-energy to renew and stimulate the body’s natural collagen building process to areas treated Ulthera can be used to treat the entire face and neck improving the appearance of your

- Brow/Forehead

- Eye Region

- Cheeks

- Chin

- Jowls/ Jaw line.

- Neck, Submental Area

- Abdomen

- Forearms

All of these areas are treated without invasive surgery.


Ulthera is the only FDA-cleared procedure to 'lift' skin on hard-to-treat areas using ultrasound. Treatment takes between 60 - 120 minutes

Ulthera can go 4-5mm deep, allowing heat from the ultrasound from Ulthera to reach deep level of SMAS that covers the muscles. Thus, Ulthera can lift the cheeks and neck the same way surgeries do.

Delivers energy to the deep dermis and superficial soft tissue deep to the skin.The thermocoagulation helps stimulate the growth of new collagen.  The superficial part of the skin called the epidermis is not affected by Ulthera and hence unlike many lasers there is no associated redness.  The Ulthera specifically targets the deep foundation layers of the tissue which doctors usually address by surgery.  The smooth applicator delivers the energy at a depth of 3.5 mm and 1.5 mm around the eyes and up to a depth of 4.5mm on the cheeks, jowls and upper neck where the skin is thicker.  This specific targeting forms an essential part of the Ulthera, to diminishes side effect 


How long should the results last?

Although Ultherapy is relatively new, studies carried out so far have reported effects lasting up to 18 months to 2 years or more. It is therefore conceivable that patients may seek another treatment closer to this time if they feel they would like to maintain their rejuvenated appearance. As with all anti-ageing treatments, time never stands still. You will naturally continue to age according to the laws of time and physics. Interestingly, the improved software and energy settings on the Ulthera devices are allowing us to deliver more energy to the tissues in order to optimise the results even further. As a result it is not unreasonable to suggest that we may in the future find the effects lasting even longer.


 Who has Ulthera?

 Anybody who wants to have tighter, less wrinkly looking skin around the eyes, cheeks, jowls and upper neck can benefit from Ulthera.  The treatment takes between 30 and 60 minutes, depending on which areas are treated. Ulthera has very little downtime; there may be mild swelling, but very little redness and no bruising, the skin may tingle for a few days.  The effect of the biostimulation starts 6 to 8 weeks after the treatment and continues for several months before stabilising.  Therefore a gradual skin tightening and firming occurs, resulting in a natural lift of the deeper tissues over time.

 How doesUlthera work?

The Ulthera delivers energy to the deep dermis and superficial soft tissue deep to the skin.The thermocoagulation helps stimulate the growth of new collagen.  The superficial part of the skin called the epidermis is not affected by Ultherapy and hence unlike many lasers there is no associated redness. The Ultherapy specifically targets the deep foundation layers of the tissue which doctors usually address by surgery The smooth applicator delivers the energy at a depth of 3.5 mm and 1.5 mm around the eyes and up to a depth of 4.5mm on the cheeks, jowls and upper neck where the skin is thicker.  This specific targeting forms an essential part of theUlthera, to diminishes side effects


How does Ultherapy differ from Thermage or Pelleve and other treatments?

 Thermage and Pelleve are based on radio frequency. Ultherapy is based on penetration of ultrasound to affect the deep dermis and substructures of the face called the SMAS.

What is an Ultherapy treatment like?

Each patient is first assessed by the oculoplastic surgeon with whom they discuss their concerns about their ageing face and what the best options are.  OftenUltherapy will be recommended in conjunction with other treatments, such as Botulinum Toxin to the forehead and glabella,  upper eyelid blepharoplasty and dermal or facial fillers.  Ultherapy can help rejuvenate the lower eyelids without surgery by its effective skin tightening.  If there are prominent little fatty pads protruding, this may still require an eyelid operation.

 Is Ultherapy safe?

 Ultrasound energy has a proven track record with over 50 years of use.  Ultherapy has been shown to be safe and is the first and only FDA approved non-invasive device for structural tissue lifting.


What is the cost of Ultherapy?

The cost depends on which areas are treated and how much Ultherapy energy is delivered. It is much cheaper than a face or eye lift!

The Ulthera system received U.S. FDA approval in 2009 through the de novo process, creating a new category of device. It is the first and only non-invasive technology to receive an FDA indication for lift. Unlike traditional laser and radio-frequency devices that heat tissue through the skin’s surface, Ultherapy delivers micro-focused ultrasound energy below the skin’s surface. This targets the foundational layers of the skin, precisely heating tissue to the optimal temperature for neocollagenesis (>60°C), without affecting the epidermis. Significant results, including skin tightening and lifting, can be achieved from a single 60-minute session, with no patient downtime.


About the ULTHERA Tool

According to FDA certification, Ulthera also aims for similarly deep, subcutaneous structures–“superficial muscular aponeurotic system” (SMAS)–like plastic surgery through a classic surgical face-lift. Ulthera, by using an ultrasound application unit–transducer–applies multiple passes of energy to various depths of the skin and therewith forms a 3D matrix of thermal coagulation points (TCP) at the desired locations and depths. This leads to the visible effect of the face-lift and the strengthening of the skin and further to the effect of neocollagenesis–the production of new collagen–this protein is responsible for the strength of the skin and its youthful look. Ulthera enables a precise subcutaneous aiming of ultrasound energy and allows for the ultrasound imaging of the zone of the treatment at a depth beneath the surface of the skin.

Ultherapy thus fills the gap on the market for both dermatologists and plastic surgeons as a comparable alternative for clients who are not yet prepared or do not want to undergo a surgical face-lift.

Ulthera has neither competition nor comparison–no other tool applies energy and warms up the tissue so deep–thus such awesome results.

Ulthera will give you a lift, tighten and strengthen your skin after one session, which lasts from a half-hour to an hour and a half according to the extent of action.


Course of Treatment

The Ulthera head is laid on the skin. On the Ulthera monitor, a detailed image of the skin is shown, the instrument precisely plans treatment. Exactly aimed ultrasound pulses are subsequently sent out by the ultrasound head of the Ulthera instrument into the depths of the supporting tissue–up to 4.5mm, where the best lifting results are reached. The upper layers of the skin remain undisturbed. The skin reacts to the given energy by contracting and at the same time produces new collagen, thanks to which the skin gradually strengthens and tightens. During the entire period of ultherapy, the monitor shows the exact location (up to 8mm deep) where there is movement and where the energy is focused.

Ultherapy treats not only the surface of the skin, but mainly its deep layers precisely with excellent results without convalescence.


Soreness of the Treatment

In the course of the thermal effect of ultherapy, a slightly unpleasant feeling of tension or burning can be felt, though this is different for each individual patient and only temporary, as well as signalizes that the correct layers of the skin have been reached. For more comfort, painkillers can be used about an hour before treatment.


After Treatment

No special measures are necessary after treatment. You can continue with your normal activities. Only temporary and slight redness will retreat over the following hours. In the few days following treatment, feelings of the tightness of the skin, sensitivity to touch, and isolated cases of temporary swelling are all typical.

This treatment is safe and approved by the government agency which determines what you can claim to patients about treatment or instruments–the U.S. Food and Drug Administration (FDA)–Protecting and Promoting Your Health. This government agency verifies the veracity of published claims, the reality of results, and the safety for clients. In conclusion, it is possible to move to long-standing clientele studies. The results of Ulthera technology are completely approved by this organization.


Results of Treatment

After one treatment session, the regeneration process will start in the skin. The strengthening and tightening of flabby skin develops throughout the following 2 to 3 months. Visible and proven results show the strengthening and tightening of the skin of the face. Ultherapy further activates the production of new collagen, which lasts up to 5 years.

FDA studies showed that 9 out of 10 clients received significant lifting of the eyebrows and therewith achieved a younger-looking face.

Treatment will bring you:

- visibly stronger and tightened contours of the face

- improvement of skin quality

- reduction of wrinkles

- tightening of neck skin


Ulthera™ System

Ultrasound energy used for non-surgical lifting, tightening and firming of lax skin

What is Ultherapy?

Ultherapy is a new type of nonsurgical procedure that uses medical ultrasound for cosmetic improvement of the skin. Ultherapy works deep below the surface —without harming the outer layer of skin—for firming, tightening and lifting. Tightening of skin on the forehead can reduce the sagging skin on the eyelids and promote a more open, refreshed look in general. Overall improvements in skin texture and evenness of color—as well as strengthening and adding more collagen “cushion”—can be additional benefits.


How does it work?

As with other ultrasound procedures, a smooth applicator placed upon your skin projects an image onto a screen. This same applicator is then used to deliver low levels of focused heat at just the right depth below the skin to achieve a positive effect, leaving the surface of your skin undisturbed.

Your skin’s response to the energy is to stimulate the growth of new collagen. You will observe some immediate tightening and lifting that will ultimately result in a natural lift and conditioning of the skin over time.


How is this procedure different from other non-surgical skin tightening procedures?

Ultherapy is the only skin rejuvenation procedure that uses ultrasound to image and treat the skin. The ability to utilize an established technology—to both see below the skin and then treat it with great precision—helps ensure both safety and satisfying results.

How many treatments will I need?

This will be determined by your practitioner, but we have had good clinical results based upon just one or two treatments. In addition, we like to schedule a follow-up visit to take photographs and track your progress.

What does it feel like?

Comfort levels vary from person to person. Many patients describe the sensation as momentary prickling or heat beneath the skin. This is the ultrasound energy being delivered into the tissue, which is how Ultherapy lifts and tightens the skin. Most of our patients opt to have some local anesthesia to make the treatment comfortable.

What areas are treated?

We only recommend using the Ulthera System for eyebrow lifts. Although it can be used on other areas, such as the lower face and neck, the results are not as predictable.

What kind of results can I expect?

The regenerative process is initiated right away, but the full effect will build gradually over the course of two to three months or so.

In the FDA clinical trial, nine out of ten patients had a noticeable, significant lift of the brow line. The average change in eyebrow height as assessed by measurement of photographs at 90 days was 1.7 mm. This resulted in a more open look to the eyes and a more youthful appearance overall.  A smoother texture and more even skin color are also possible side benefits.

What can I expect afterward?

You are able to return to your normal activities right away, and there are no special measures you need to take. Your skin may appear a bit flushed immediately after the treatment, but any redness should disappear in a matter of hours. You may also feel mild tenderness under the treated areas, which is normal. This indicates that the healing process is underway and that new, healthier collagen is being generated.

How long do the results last?

Of course, your skin will continue its natural aging process, so you may need to schedule an annual touch-up visit to maintain your results. The Northwestern University study followed patients up to 10 months, and improvement was still noticeable.

Can anyone have the treatment?

A good candidate is someone with skin that has ‘relaxed’ to the point of sagging and feeling less firm. A lowered brow line or loose skin on the eyelids, for instance, is often the first sign of  “maturing” skin. We will evaluate if you are an appropriate candidate at the time of your consultation.

Is Ultherapy safe?

Ultherapy uses ultrasound energy, which has been used in medical imaging and therapeutics, such as sonograms, for over 50 years, and clinical studies have confirmed the safety of this latest application. As with any medical procedure, there are general safety considerations, which your practitioner will review with you.


Ulthera is a non-surgical, non1-invasive treatment that uses focused ultrasound energy from a device to cause very precise and specific deep tissue heating without disturbing the surface of the skin. As a result of this heating the tissues undergo 'remodelling' which leads to new collagen formation, shrinkage and firming, with tightening of the skin and deeper muscle layers.


All the studies and initial trials that have been completed for the Ulthera treatment have been on the face and neck regions, with noticeable results on the brow, cheek, jowl areas in particular. Ulthera was cleared for use on the chest quite recently and according to the manufacturer there is no reason why other parts of the body such as the arms, abdominal or skin above the knee, might not benefit from the Ulthera treatment. It's just that not enough formal studies have been done yet to prove its effectiveness in such areas.


Comfort thresholds will vary from patient to patient but you should expect mild to moderate pain during treatment when the ultrasound energy is being delivered. We often try to minimise this by administering combination pain killers 45 minutes prior to the procedure to provide pain relief. At our London clinic, which is based with The Hospital of St John & St Elizabeth, we are able to use some additional pain relief in the form of Entonox (commonly known as gas and air) to help you past any strong levels of discomfort. Once the treatment is completed however there is no pain and patients typically leave comfortable and excited about the benefits to come!


Ulthera is beneficial for rejuvenating tired-looking or sagging skin, a lowered brow line and other signs of maturing skin.

The ideal candidate for Ulthera is typically someone who has some mild to moderate degree of skin laxity that wants to improve his or her skin firmness and volume and perhaps is not fully ready for a surgical skin tightening procedure such as a face lift. Typically, those in their thirties and early forties who have a good quality of skin are the best candidates. Patients who have more advanced levels of skin laxity (sagging) are sometimes advised to consider a face lift procedure to ensure a better result. Nonetheless patients with more advanced and obvious laxity of the skin-but who have already ruled out an invasive surgical face lift, for any of a number of reasons, may also benefit from the Ultherapy procedure, however these patients will need to understand that Ultherapy in these circumstances can never mimic or achieve the results obtained with a surgical face lift and therefore have to be prepared to curtail their expectations.


How is Ultherapy different from lasers?

Lasers use a light wave based source to direct energy via a laser beam to its target. Depending on the type and wavelength of the laser it has many uses. These include skin resurfacing, hair removal, tattoo removal and facial rejuvenation. Instead of light waves, Ultherapy uses Intense Focused Ultrasound or sound waves to deliver energy to its target tissues. Lasers typically address issues in the superficial layers of the skin (e.g. fine lines, wrinkles, pigment changes). Ultherapy addresses the deep skin layer and the foundational layer addressed in cosmetic surgery that lift and lend support to the skin.