Is Ultherapy painful? Can it firm sagging skin without melting fat? I was recently invited to try out Ultherapy treatment at Cutis Medical Laser Clinics in Singapore and like to share a review of this non-invasive facelift procedure.
You’ll read about my first-hand experience going through this non-invasive treatment. I’ll also share facts and uncover myths about this ultrasound procedure, part of which is made possible through an intimate chat with an experienced doctor.
My Skin Concerns: Why I’m a Suitable Candidate for Ultherapy
Since turning 40s, I’ve noticed more pronounced sagging of my cheek and jawline. Even my underchin area that used to be tight and firm due to my slim profile has started to show signs of laxity.
When I tilt my head down, I could feel an extra bulge threatening to present itself as a double chin. It has made me develop a new habit of supporting my chin with a bolster when I sleep. I am hoping that doing so would prevent my head from tilting too low and hence delay the formation of an age-induced double chin.
With a sagging lower face, I think I’m a right candidate for Ultherapy as this “no-scalpel & injection-free” treatment has been known to firm skin with mild to moderate laxity.
Should people in their 20s undergo Ultherapy?
I think they could if they experience premature aging. But based on my observation and personal aging experience, I believe Ultherapy would benefit someone only after they have hit their mid-30s or 40s.
This is the period when the skin starts to show signs of mild sagging. If you look at promotional materials on Ultherapy or reputable clinics’ website, they often feature mature folks, probably in their 40s or older.
As such, it troubles me when I see those with youthful and bouncy-looking skin going through High-Intensity, Focused Ultrasound (HIFU) treatments, some with the purpose of melting fats on their face.
Is Ultherapy intended to melt facial fats?
Based on what I’ve read, I do not think Ultherapy – one of the HIFU treatments available – is intended to melt fats. In fact, fat-melting has often been listed as a side effect and unwanted result that is said to be caused by malpractice.
But I’m not an expert in this area. I only know that I wouldn’t want my facial fats to melt – it’s the worse thing to do to counter aging, in my humble opinion. :)
Alternate Use of HIFU: I understand that some doctors may alter the usage to treat patients with excessive facial fats. This I think is okay as long as it’s meant to improve the patients’ aesthetics instead of making quick bucks from people who do not need the treatment.
So, enough of the fat-melting discussion. Now, let’s see if Ultherapy is able to treat my skin concerns and do so without melting fats, LOL! I’ll walk you through in chronological order my “facelift” experience at Cutis Medical Laser Clinics.
Ultherapy Review: Arriving at Cutis Medical Laser Clinics
I arrived on time at Cutis Medical Laser Clinics, an aesthetic clinic in Singapore that I have patronized way before this blog was born.
As a long-time customer, I felt at-home and comfortable with the staff and Dr Sylvia Ramirez who have always impressed me with their professionalism and focus on safety and results. You’ll know what I mean if you have the chance to speak with the team.
Preparation for Ultherapy Treatment
After being served a cup of hot green tea, I was given an Ibuprofen tablet, which is an anti-inflammatory drug commonly used to decrease swelling, pain and fever.
Fan, a long-time staff at Cutis Medical Laser Clinics then cleansed off my makeup before applying numbing cream on my lower face.
“Why not use icing to minimize the discomfort?”
I was told that icing isn’t suitable for Ultherapy treatment as the skin would be heated during the procedure. Fan then gave me a thorough explanation of what the Ultherapy treatment entailed, such as pain level, risks, side effects and recovery process.
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After signing the consent form, Dr. Sylvia Ramirez entered the treatment room and gave me a more in-depth explanation of the treatment. I felt honored as it was like a one-on-one educational session with a professor.
For info, Dr Sylvia used to work as an assistant professor at the National University of Singapore. She also holds a Masters at the Harvard school of Public Health (see full credentials).
Let me take the chance to share with you what I’ve learnt about Ultherapy from various sources, including information gathered directly from experienced professionals.
What is Ultherapy?
Ultherapy is an aesthetics treatment that uses ultrasound energy to lift and tighten skin naturally. It is FDA-cleared and said to involve no downtime.
A hand-held device, controlled at 65 to 70°C is used to deliver focused ultrasound energy to varying depth of the skin depending on the patient’s needs. This heat energy will cause intended thermal damage to the skin and stimulate new collagen to grow while strengthening the weakened ones.
In other words, Ultherapy is said to achieve a gentle and natural-looking face lift without going under the knife or needle.
Take a look at this video which will give you further explanation on skin’s aging process and what can be done to firm the skin without surgery.
FAQs on Ultherapy (Answered by An Experienced Doctor)
1. Is Ultherapy Painful? How Painful is it?
Many online reviews described Ultherapy to be painful. Dr Sylvia and her team also warned me that the pain level would be beyond that associated with botox or filler.
“It may feel like multiple hot pins hitting the face.”
When I told them that I would try to sleep through the procedure, I was told that the discomfort would prevent me from dozing off. Dr. Sylvia added that a good way to manage the pain is to keep oneself distracted, such as watching a video.
Did I cope well with the pain? Read on. :)
2. What Areas can be treated by Ultherapy?
Ultherapy has been used to lift and firm these areas:
- Under the chin
You can refer to the official website and see how each of these areas can benefit from Ultherapy.
Hey, since we have access to an experienced doctor who has treated numerous patients with Ultherapy, why don’t we ask Dr. Sylvia Ramirez the following question:
Q: Which area of the face is likely to see the most significant improvement with Ultherapy treatment?
“Although collagen building is beneficial for all areas of the face, combination treatments are still necessary as changes due to aging are only partially attributable to collagen loss.
With this in mind, areas of the face where volume loss is the dominant issue, such as the undereye area, cheeks, and loss of bony support around the chin respond best to fillers.
On the other hand, lack of jawline definition, sagging under the chin, droopiness of the eyelids, where loss of collagen is a key factor respond well to Ulthera.”
3. Which Areas should be avoided?
The central vertical portion of the face has lots of nerves sensory and should not be treated. Hence, Ultherapy would not be used to treat areas such as nasolabial folds (laugh lines) and glabellar lines (frown lines).
It also isn’t effective against surface lines, such as lip lines commonly seen on habitual smokers.
4. Can Ultherapy replace botox and filler?
No. They target different areas.
Ultherapy targets the skin dermis and SMAS level (a fibrous network that connects facial muscle to the dermis) while Botox and filler go deeper into or under the muscle.
5. Ultherapy Downtime & Recovery
I’ll walk you through my recovery process in a while. But generally, Ultherapy involves no downtime.
I was told to expect numbness and “invisible” swelling (those only visible to myself) that would last for 3 to 10 days. In some instance, bruise can occur although it would likely be a light yellowish tint than the obvious bluish tints you get from fillers or botox. Click here to view full list of side effects and risks.
6. How long does it take to see results?
Ultherapy is not a quick-fix treatment. Many would see results within 2 to 3 months.
I’m in my third-week while writing this post and am tracking my progress. You’ll get to see my before-after photos in a bit.
7. How long can Ultherapy results last?
Collagen would continue building up to one year from Ultherapy treatment date. As such, this treatment is mostly repeated every once a year.
8. How safe is Ultherapy?
Ultherapy is a US FDA-cleared procedure. Furthermore, it uses real-time imaging to precisely deliver ultrasound energy to skin’s foundational layers.
If you go for similar High-Intensity Focused Ultrasound (HIFU) treatments, please ensure that the equipment used meets the same safety standards.
10. Will Ultherapy end up melting fat?
We’ve discussed this earlier. The answer is ‘Yes, if it’s done incorrectly’. That’s why having a properly-trained doctor and reputable clinic perform such HIFU procedures is extremely important.
With so many ultrasound machines of dubious origins flooding the market, we cannot be certain if all of them have been properly tested for safety and effectiveness. You’ll definitely want to ask about the safety certifications and whether those machines come with real-time imaging.
Based on my personal experience, it’s not worth going for the cheapest deal when it comes to aesthetics treatment.
True Story: Know how I ended up with so many grid-like micro pores on my face (and why I get pimples all the time)? It was due to a botched CO2 Fractional Laser treatment that I did about 10 years ago. I wanted to reduce my pore size, but ended up getting more pores than I could handle.
Many years later, I read from the news that a patient died while having liposuction at the same clinic. God knows what kind of machine was used to shoot laser on my face then.
*As at this point in time (3 weeks post-Ultherapy-treatment), I have not witnessed any fat loss and I’m keeping my fingers crossed that it would stay this way.
Ultherapy Treatment Begins at Cutis Medical Laser Clinics
Now that we are done with the FAQs and theory, let’s see what my actual experience with Ultherapy treatment is like.
Would I experience deep discomfort? Would my face reddened to resemble a lobster? Could I resume my normal activity immediately after treatment or do I have to hide from the public? These questions will be answered in this section.
How is it like going through Ultherapy?
After the numbing cream was left on my face for 20 minutes, I was ready to receive Ultherapy treatment.
I’ll be treated on my Lower Face which would extend from the upper cheeks all the way down to under my chin. As mentioned earlier, the central vertical column would be excluded for safety reasons.
The Ultherapy machine can treat skin at three different skin depth levels, namely 1.5mm, 3mm and 4.5mm. In my instance, Dr Sylvia told me that I would receive treatment at the 3mm and 4.5mm levels.
Deepest Level First at 4.5mm
Dr Sylvia told me she would start Ultherapy treatment at 4.5mm, which is the deepest skin level the machine can target. This would treat the SMAS layer (superficial muscular aponeurotic system) which is an organized fibrous network that connects the facial muscles to the dermis.
Sure, I’m perfectly fine with “先苦后甜” (suffer first, enjoy later).
She then drew white markings on my face to guide her on the precise placement of the hand-held device, and to avoid interaction with the central face column that is rich with nerve and sensory endings.
I was slightly nervous as everyone was telling me how painful Ultherapy would be. But when the device was placed over my numbed face, I could only feel mild heat and slight pressure, like someone pressing against your face with warm fingers?
Unaltered Reality: Hey, check out my really flattering “alien” head. This is unaltered reality and I appreciate a clinic that focuses on safety than what looks good on photos (or Instagram).
Not Painful Except for Two Spots
Phew! It wasn’t as bad as I’d thought. I could smile and chit chat at the same time. The pain to me was mostly zero with some parts being 2/10 – very bearable in my opinion.
I wouldn’t even rank it as being more painful than botox or fillers (maybe because those were done without numbing cream), with the exception of two spots under the chin.
The pain level felt under the chin was quite intense (Pain: 8/10) as the skin there is thinner and closer to the bone. It felt like someone was pressing really hard on my bruise. Thankfully, it was a fleeting pain and affected only two spots.
Dr Sylvia was empathetic towards her patient’s comfort as I observed her deliberately spacing out the shots in the sensitive area instead of completing the required shots in one go.
Pain distraction efforts: Thank you to the team from Cutis Medical Laser Clinics who distracted me from the pain using various methods. Fan placed a hand-held electronic massager on my shoulder while Dr Sylvia kept me engaged in conversations.
I was also semi-distracted by my work as I was asking questions, taking photos and jotting down notes while receiving the Ultherapy treatment. Is this why my experience has been very bearable?
Out of the many shots, I only experienced the “multiple pin” effect on one spot, on my right cheek. It was like a very faint pin effect that I wouldn’t even describe as being painful or uncomfortable. More like mild sensation of blunt pins.
So, is Ultherapy Painful or Not?
Judging at the rather comfortable experience I’ve had with Ultherapy, I wonder if it’s because I’ve been “numbed” well, have a high tolerance for pain or was simply too distracted (by work and the Cutis Medical’s team distraction effort?).
In any case, I understand that this 2nd-generation Ultherapy device is more comfortable than the first-generation device as it produces similar results at a lower temperature of 65 to 70°C versus 90+°C.
Although my Ultherapy experience has been a comfortable one, I believe it would do you good if you walk in expecting the treatment to be very painful. It would manage your expectation well just like how mine was managed. For all you know, I just might have a very high threshold for pain or very thick skin. :)
Second Round: Target 3mm Skin Depth
After the 4.5mm treatment, the 3mm felt like a breeze. I only felt mild pressure against my jaw and that’s it.
I was so relaxed that I could even observe Dr Sylvia attentively glancing at the real-time imaging to ensure proper targeting of ultrasound energy to my skin tissue.
This Ultherapy treatment felt so much more comfortable than other treatments I’ve had that involved multiple needle injections or burning skin (chemical peels).
How the Skin Looks Like After Treatment?
With Ultherapy being able to reach deep into the skin tissue and associated with heat, can you face the public immediately after treatment?
The answer is yes. You can do anything you’ll normally do. There’s no need to hide from the public.
This photo is taken immediately after being treated. You’ll notice slight flushing which faded off by the time I walked out of the clinic.
Slightly flushed immediately after Ultherapy treatment (Ignore pimples on chin)
Ultherapy Duration for Lower Face Treatment
Ultherapy treatment was completed in 1 hour for a Lower Face treatment. All in all, I spent 2 hours at the clinic which include time spent on preparations and logistics.
I was also told that I’ve received a total of 660 lines/pulses for this Lower Face Ultherapy treatment. Take a look at the image below and you can see the number of pulses required per area of the face for a 3mm skin depth treatment.
After Ultherapy Treatment: What to Expect?
Great. I’ve shown you my experience going through an Ultherapy treatment at Cutis Medical Laser Clinics.
In case you wonder, I could put on makeup immediately. The face looked perfectly normal with no visible redness or swelling and I functioned as per normal thereafter.
In my next post, I’ll share with you Ultherapy’s Recovery Process and Results. Remember, it’ll take 2 to 3 months for the collagen-building effect to show. So, stay tuned! But I can reveal first that I did not experience any downtime or discomfort post-treatment. I slept like a baby. :)
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