If you've thought about having a facelift, but having surgery made you think twice, consider Ultherapy.
Using ultrasound technology, FDA-approved Ultherapy lifts and tightens facial and neck skin -- without surgery!
Reza Momeni, MD, board-certified plastic surgeon with Summit Medical Group, share details on this exciting treatment and who can benefit.
Selected Podcast
Ultherapy: A New Non-Surgical Procedure
Featured Speaker:
Reza Momeni, MD
Board-certified plastic surgeon, Reza Momeni, MD, has expertise in cosmetic surgery of the face and body, as well as extensive experience in hand surgery and cancer reconstruction. To achieve natural and functional results that enhance his patients’ lives, Dr. Momeni consults with patients to understand their needs and provides honest and personalized recommendations to each patient, keeping treatment safety and effectiveness in mind. Dr. Momeni is particularly interested in minimally invasive aesthetic techniques and nonsurgical facial rejuvenation using Botox®Cosmetic, Juvederm®, SculptraTM, Fraxel®, and Thermage®. Transcription:
Ultherapy: A New Non-Surgical Procedure
Melanie Cole (Host): Have you ever thought about having a facelift but you really don’t want to go in for surgery or under the knife? My guest is Dr. Reza Momeni. He is a board certified plastic surgeon with Summit Medical Group. Welcome to the show, Dr. Momeni. Let’s talk about Ultherapy treatment. What is that, and who would it benefit?
Dr. Reza Momeni (Guest): Well, thank you for having me, Melanie. It’s a real pleasure to be able to do this for your listeners and also for the medical group. Ultherapy is a really exciting treatment that has now been FDA approved in the US after having been available around the world for a couple of years before it became available here. Ultherapy is a way of lifting and tightening the skin without doing surgery. What it works as, is it works as an ultrasound technique. Everybody knows ultrasound. Everybody who has ever been pregnant or known somebody who has been pregnant has heard about ultrasound. Ultrasounds have been used forever in medicine as a diagnostic tool to try to look inside the tissues without radiation and without cutting open or putting any needle inside anybody’s skin to see what is going on within the tissues. What the inventor of Ultherapy has done is they have come around and used the ultrasound waves, the sound waves, as a way of creating heat energy, not at the skin but under the skin, so that we can focus energy exactly where we need it, below the skin, at the layers that actually hold up and support the skin. By delivering the energy exactly where we need to deliver the energy, what we can do is we can cause small, little areas that the skin will be heated and tightened up so that the collagen, over two to three months, will give a lifted appearance to the skin.
Melanie: So you’re controlling kind of the tension and the skin’s smooth, youthful appearance and lifting that up. Is this something used for dramatic changes? Is it more of a mild improvement procedure?
Dr. Momeni: Well, that’s a great question. As we always say to patients, beauty is in the eye of the beholder. Certainly, if someone has in mind having a surgical result, then Ultherapy procedure may be too little for them. This is not really something that will supplant a facelift or replace a facelift, but just as you said in the beginning of the program, for people who are looking to have a little bit less of an improvement than a facelift but they do just want to see a visible improvement, for people who are considering having something done but either for emotional reasons or financial reasons or just logistic reasons, they don’t want to go to the operating room or have any major surgery done. This is a really great tool. This is an alternative that, up to the point where it became available, we had nothing to offer those patients. It was surgery or nothing. So yes, certainly, you can’t go into Ultherapy treatment thinking that you’re going to get a facelift. But it is a very nice tool to have available for those patients who are a little bit less drastic in their wishes for how much improvement they need and also want to keep the treatment simpler, safer, and not to have to ever step in an operating room.
Melanie: What areas of the face are you generally targeting? Is this something that can be used for the neck as well? I know that’s a tough area to do cosmetic procedures on.
Dr. Momeni: It is a tough area. If you go back to the evolution of cosmetic treatments over the past two decades or so, something really interesting has happened. If you went into a plastic surgeon’s office back in the early 1990s and asked them to do something for signs of aging—let’s say lines around your mouth, or cheek, or the jowls, or the neck—the only thing that the plastic surgeon had in the ‘70s, ‘80s, and ‘90s was surgery. It was surgery or nothing. Sure, we had some peels. Sure, in the ‘90s, some laser started to come in, but it really wasn’t until the year 2000 when the FDA approved Botox that this new revolution in plastic surgery started to take off and the less invasive treatments became available. But with the development of Botox and the dermal fillers in the last 10 years, we were able to do a lot for the face. But the area that you mentioned, the neck and jowls, were really left far behind. Injections don’t really work for that area that well, and the only thing we had in the last decade for the jowl and the neck was still surgery. That’s were Ultherapy comes in. Ultherapy is the first and only FDA-approved treatment in the US that is indicated specifically for lifting of the skin. To answer your question, Ultherapy can be done in any area of the face or the neck. Some patients will choose to focus on an area; many other patients will have it done from all the way up in the forehead to all the way down to their collarbone. It really depends on what the patient wishes to have and which areas need to have improvement.
Melanie: As I understand it, it encourages your own collagen to continue to grow, correct?
Dr. Momeni: That’s exactly right.
Melanie: So does this continue to work after the procedure? Is this something that, as time goes on, you might even see a little bit more improvement?
Dr. Momeni: Absolutely. The way that the Ultherapy device works is very different than what patients expect and what patients are used to with cosmetic surgery. In cosmetic surgery, a patient expects that they’re going to come out of the operating room tightened and lifted. Yes, they maybe bruised or swollen—that goes away after a few years—but the results are immediate. The Ultherapy device works very, very differently because the energy that is delivered to the collagen, the energy that ends up tightening the collagen initially only causes some local injury. These are tiny little spots of heat, 1 millimeter—that’s about 25th of an inch—that are induced. During the course of a single treatment, we may induce up to 10,000 of these tiny little spots onto a patient’s skin and soft tissues. What happens over the next two to three months is really the ultimate tightening results. So the typical patient, when they have this treatment done, may feel a little bit tingly or a tiny bit swollen or a little bit red for an hour or two or, at most, a day after the treatment. But the next day, they look almost exactly the same. In a lot of ways, this is the advantage of this device because many patients who are considering having Ultherapy done are exactly those patients who don’t want to look like they had cosmetic surgery. They don’t want to go through that bruising period of surgery, and they want to have the improvement happen very gradually so that at best, maybe the comment that they get from their friends or family is maybe they lost weight, or maybe they have been working out or they came back from a nice vacation, and nobody can really put their finger on exactly what is going on. The typical treatments with Ultherapy will only take about an hour or two, but the typical full result won’t set in for about two to three months. Those results usually will continue to hold up over the years. What I usually tell my patients is, “Look, with Ultherapy or with plastic surgery, what we’re doing is we’re turning back the clock.” We don’t have a way of stopping the clock from ticking. That would be the Holy Grail of cosmetic surgery. But we don’t have it yet. But by rolling back the hands of a clock, we can set you back a year or two and, from there, the aging slowly continues. So, in a way, you could think of it as, well, you will forever look better than if you’ve never done the treatment. But studies have even shown that even a year after treatment with Ultherapy, the patients still have some of that new collagen that’s been built up. And over time as the aging continues, they may decide to come for refresher treatments or additional treatments, but it is designed as a single treatment.
Melanie: Now, are there any contraindications to getting this procedure if you had previous surgery of any kind, cosmetic surgery, if you’ve done fillers or injectables before? Are there any contraindications to this?
Dr. Momeni: That is a great question. One of the paradoxes of cosmetic surgery is that if you do cosmetic surgery on someone -- let’s say you do a neck lift or a jowl lift on a patient, and let’s say after a year or two, their skin starts to age a little bit and relax and it’s not so bad that one would say to a patient, “Let’s do the surgery over again.” That would not be really wise. But up to this point, we really haven’t had anything to offer that patient. So, in fact, Ultherapy becomes a great device to use for a patient who has had cosmetic surgery in the past and now they’re seeing just a little bit of laxity or a little bit of the aging come back in, not so much that you would redo the surgery but enough that you would want to tighten things up again and get back to the original results of the surgery. So to answer your question more directly, previous cosmetic surgery is not really a contraindication for Ultherapy treatment. But there are contraindications, and there are certainly items in the patient’s history that we would be very, very careful about and in some cases even be a little nervous about. You have to remember that Ultherapy is not a laser, so we’re not treating the superficial parts of the skin. We’re actually bypassing the top layer of the skin, and we’re delivering the energy about a fifth of an inch into the deep tissues. Those are exactly, by the way, the tissues that we cosmetic surgeons, plastic surgeons work on when we’re doing a facelift. A facelift is not just pulling the skin; it’s actually tightening the under layers of the skin and tissues that hold up the skin. So what Ultherapy does is it delivers the energy exactly where you need it. However, that’s also the layer where nerves run, and therefore, let’s say that somebody has a history of migraines and their migraines are in the frontal area, in the forehead area, then Ultherapy will be contraindicated for that patient because the layer of the energy being delivered is almost exactly the layer of the nerves that run and induce the migraines. There is a list of items that we go through with every patient that are specific contraindications, and we make sure that we don’t treat patients if they have any of those contraindications. But the good news is that most patients don’t have a lot of contraindications, and better than 90 percent of the patients that we consult with are good candidates for Ultherapy.
Melanie: So in the last 20 seconds or so, Dr. Momeni, please wrap up Ultherapy for us and, really, the best parts and your best advice.
Dr. Momeni: Well, I would say for patients who are realistic about the type of results they want and are not ready or do not need a facelift but are starting to see those aging signs that we all see after we turn about 30 or 35—some looseness around the jowl, the old turkey gobbler, some softness of the double chin, as some people call it—this is really a fantastic new treatment to try to give the patients an alternative to surgery where we have had no option before. It offers it with no downtime and in a single treatment. And for the patients who are realistic about the types of options they want and the results they want and not looking for a surgical lift, this is a fantastic treatment.
Melanie: Thank you so much for listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. This is Melanie Cole. Thanks for listening.
Ultherapy: A New Non-Surgical Procedure
Melanie Cole (Host): Have you ever thought about having a facelift but you really don’t want to go in for surgery or under the knife? My guest is Dr. Reza Momeni. He is a board certified plastic surgeon with Summit Medical Group. Welcome to the show, Dr. Momeni. Let’s talk about Ultherapy treatment. What is that, and who would it benefit?
Dr. Reza Momeni (Guest): Well, thank you for having me, Melanie. It’s a real pleasure to be able to do this for your listeners and also for the medical group. Ultherapy is a really exciting treatment that has now been FDA approved in the US after having been available around the world for a couple of years before it became available here. Ultherapy is a way of lifting and tightening the skin without doing surgery. What it works as, is it works as an ultrasound technique. Everybody knows ultrasound. Everybody who has ever been pregnant or known somebody who has been pregnant has heard about ultrasound. Ultrasounds have been used forever in medicine as a diagnostic tool to try to look inside the tissues without radiation and without cutting open or putting any needle inside anybody’s skin to see what is going on within the tissues. What the inventor of Ultherapy has done is they have come around and used the ultrasound waves, the sound waves, as a way of creating heat energy, not at the skin but under the skin, so that we can focus energy exactly where we need it, below the skin, at the layers that actually hold up and support the skin. By delivering the energy exactly where we need to deliver the energy, what we can do is we can cause small, little areas that the skin will be heated and tightened up so that the collagen, over two to three months, will give a lifted appearance to the skin.
Melanie: So you’re controlling kind of the tension and the skin’s smooth, youthful appearance and lifting that up. Is this something used for dramatic changes? Is it more of a mild improvement procedure?
Dr. Momeni: Well, that’s a great question. As we always say to patients, beauty is in the eye of the beholder. Certainly, if someone has in mind having a surgical result, then Ultherapy procedure may be too little for them. This is not really something that will supplant a facelift or replace a facelift, but just as you said in the beginning of the program, for people who are looking to have a little bit less of an improvement than a facelift but they do just want to see a visible improvement, for people who are considering having something done but either for emotional reasons or financial reasons or just logistic reasons, they don’t want to go to the operating room or have any major surgery done. This is a really great tool. This is an alternative that, up to the point where it became available, we had nothing to offer those patients. It was surgery or nothing. So yes, certainly, you can’t go into Ultherapy treatment thinking that you’re going to get a facelift. But it is a very nice tool to have available for those patients who are a little bit less drastic in their wishes for how much improvement they need and also want to keep the treatment simpler, safer, and not to have to ever step in an operating room.
Melanie: What areas of the face are you generally targeting? Is this something that can be used for the neck as well? I know that’s a tough area to do cosmetic procedures on.
Dr. Momeni: It is a tough area. If you go back to the evolution of cosmetic treatments over the past two decades or so, something really interesting has happened. If you went into a plastic surgeon’s office back in the early 1990s and asked them to do something for signs of aging—let’s say lines around your mouth, or cheek, or the jowls, or the neck—the only thing that the plastic surgeon had in the ‘70s, ‘80s, and ‘90s was surgery. It was surgery or nothing. Sure, we had some peels. Sure, in the ‘90s, some laser started to come in, but it really wasn’t until the year 2000 when the FDA approved Botox that this new revolution in plastic surgery started to take off and the less invasive treatments became available. But with the development of Botox and the dermal fillers in the last 10 years, we were able to do a lot for the face. But the area that you mentioned, the neck and jowls, were really left far behind. Injections don’t really work for that area that well, and the only thing we had in the last decade for the jowl and the neck was still surgery. That’s were Ultherapy comes in. Ultherapy is the first and only FDA-approved treatment in the US that is indicated specifically for lifting of the skin. To answer your question, Ultherapy can be done in any area of the face or the neck. Some patients will choose to focus on an area; many other patients will have it done from all the way up in the forehead to all the way down to their collarbone. It really depends on what the patient wishes to have and which areas need to have improvement.
Melanie: As I understand it, it encourages your own collagen to continue to grow, correct?
Dr. Momeni: That’s exactly right.
Melanie: So does this continue to work after the procedure? Is this something that, as time goes on, you might even see a little bit more improvement?
Dr. Momeni: Absolutely. The way that the Ultherapy device works is very different than what patients expect and what patients are used to with cosmetic surgery. In cosmetic surgery, a patient expects that they’re going to come out of the operating room tightened and lifted. Yes, they maybe bruised or swollen—that goes away after a few years—but the results are immediate. The Ultherapy device works very, very differently because the energy that is delivered to the collagen, the energy that ends up tightening the collagen initially only causes some local injury. These are tiny little spots of heat, 1 millimeter—that’s about 25th of an inch—that are induced. During the course of a single treatment, we may induce up to 10,000 of these tiny little spots onto a patient’s skin and soft tissues. What happens over the next two to three months is really the ultimate tightening results. So the typical patient, when they have this treatment done, may feel a little bit tingly or a tiny bit swollen or a little bit red for an hour or two or, at most, a day after the treatment. But the next day, they look almost exactly the same. In a lot of ways, this is the advantage of this device because many patients who are considering having Ultherapy done are exactly those patients who don’t want to look like they had cosmetic surgery. They don’t want to go through that bruising period of surgery, and they want to have the improvement happen very gradually so that at best, maybe the comment that they get from their friends or family is maybe they lost weight, or maybe they have been working out or they came back from a nice vacation, and nobody can really put their finger on exactly what is going on. The typical treatments with Ultherapy will only take about an hour or two, but the typical full result won’t set in for about two to three months. Those results usually will continue to hold up over the years. What I usually tell my patients is, “Look, with Ultherapy or with plastic surgery, what we’re doing is we’re turning back the clock.” We don’t have a way of stopping the clock from ticking. That would be the Holy Grail of cosmetic surgery. But we don’t have it yet. But by rolling back the hands of a clock, we can set you back a year or two and, from there, the aging slowly continues. So, in a way, you could think of it as, well, you will forever look better than if you’ve never done the treatment. But studies have even shown that even a year after treatment with Ultherapy, the patients still have some of that new collagen that’s been built up. And over time as the aging continues, they may decide to come for refresher treatments or additional treatments, but it is designed as a single treatment.
Melanie: Now, are there any contraindications to getting this procedure if you had previous surgery of any kind, cosmetic surgery, if you’ve done fillers or injectables before? Are there any contraindications to this?
Dr. Momeni: That is a great question. One of the paradoxes of cosmetic surgery is that if you do cosmetic surgery on someone -- let’s say you do a neck lift or a jowl lift on a patient, and let’s say after a year or two, their skin starts to age a little bit and relax and it’s not so bad that one would say to a patient, “Let’s do the surgery over again.” That would not be really wise. But up to this point, we really haven’t had anything to offer that patient. So, in fact, Ultherapy becomes a great device to use for a patient who has had cosmetic surgery in the past and now they’re seeing just a little bit of laxity or a little bit of the aging come back in, not so much that you would redo the surgery but enough that you would want to tighten things up again and get back to the original results of the surgery. So to answer your question more directly, previous cosmetic surgery is not really a contraindication for Ultherapy treatment. But there are contraindications, and there are certainly items in the patient’s history that we would be very, very careful about and in some cases even be a little nervous about. You have to remember that Ultherapy is not a laser, so we’re not treating the superficial parts of the skin. We’re actually bypassing the top layer of the skin, and we’re delivering the energy about a fifth of an inch into the deep tissues. Those are exactly, by the way, the tissues that we cosmetic surgeons, plastic surgeons work on when we’re doing a facelift. A facelift is not just pulling the skin; it’s actually tightening the under layers of the skin and tissues that hold up the skin. So what Ultherapy does is it delivers the energy exactly where you need it. However, that’s also the layer where nerves run, and therefore, let’s say that somebody has a history of migraines and their migraines are in the frontal area, in the forehead area, then Ultherapy will be contraindicated for that patient because the layer of the energy being delivered is almost exactly the layer of the nerves that run and induce the migraines. There is a list of items that we go through with every patient that are specific contraindications, and we make sure that we don’t treat patients if they have any of those contraindications. But the good news is that most patients don’t have a lot of contraindications, and better than 90 percent of the patients that we consult with are good candidates for Ultherapy.
Melanie: So in the last 20 seconds or so, Dr. Momeni, please wrap up Ultherapy for us and, really, the best parts and your best advice.
Dr. Momeni: Well, I would say for patients who are realistic about the type of results they want and are not ready or do not need a facelift but are starting to see those aging signs that we all see after we turn about 30 or 35—some looseness around the jowl, the old turkey gobbler, some softness of the double chin, as some people call it—this is really a fantastic new treatment to try to give the patients an alternative to surgery where we have had no option before. It offers it with no downtime and in a single treatment. And for the patients who are realistic about the types of options they want and the results they want and not looking for a surgical lift, this is a fantastic treatment.
Melanie: Thank you so much for listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. This is Melanie Cole. Thanks for listening.