Ultherapy Before and After: Read This Editor’s Full Review

Preventative aging treatments, or “prejuvenation,” as experts often call it, are trending younger and younger these days. Consider the fact that, according to the American Academy of Facial Plastic and Reconstructive Surgery, facelift patients are also trending younger to get a sense of our collective culture’s desire to remain youthful looking at all costs. From Botox to hyaluronic acid filler to the use of non-ablative lasers and RF microneedling, Gen Z and millennials are set to be the first generations that have the option to prevent and slow the signs of aging to this degree if they so choose to. Being a card-carrying member of the latter generation, I’ve chosen to try various treatments to maintain the health of my skin as I age. My most recent dabbling in non-invasive preventative procedures has been with the popular skin tightening treatment, Ultherapy. Which, to my surprise, has quite literally taken several years off my face.

Touted as a “non-surgical facelift,” “Ultherapy is the gold standard for non-surgical lifting and tightening when administered by an expert provider,” plastic surgeon Jennifer Levine, MD, tells PS. FDA-approved for treatment of the face, neck, and upper chest, Ultherapy utilizes ultrasound technology at precise depths and temperatures to trigger the body into producing collagen and elastin, which tightens and lifts the overall appearance of the skin. “It is used off-label practically anywhere on the body for skin tightening,” Dr. Levine says. She notes that popular off-label areas include the arms, abdomen, and knees.

Below, learn everything you need to know about Ultherapy and what happened when I tried it out myself.

Experts Featured in This Article

Jennifer Levine, MD, is a world-renowned facial plastic surgeon based in New York City.

Lucia Miranda, LE, CME, is a medical aesthetician at Shafer Clinic in New York City.

Before Ultherapy

How Does Ultherapy Work?

Ultherapy “uses ultrasound waves to penetrate deep into the skin layers, specifically targeting the foundational layers where collagen resides and initiating neocollagenesis,” which is the process of collagen production in the body, says medical aesthetician Lucia Miranda, LE, CME. The device utilizes ultrasound technology twofold: for visualization and for delivering the ultrasound energy into the deep layers of skin to stimulate collagen production. Ultrasound “enables providers to directly see different anatomical layers of the skin that are being treated while safely avoiding bones, nerves, and blood vessels,” says Miranda. Essentially, it acts as the eyes for the provider to see where they need to target the ultrasound energy to get the best results possible for the patient.

The device “delivers micro-focused ultrasound to the SMAS (superficial musculoaponeurotic system) layer, which is the same layer you would lift when doing a facelift,” Dr. Levine says. She points out that Ultherapy is the only technology on the market that is proven to tighten and lift the SMAS layer without surgery.

The energy is delivered in the form of TCP (thermocoagulation points). “This targeted energy heats the selected tissue to 65 degrees Celsius, which is the optimal temperature for production of collagen and elastin,” Dr. Levine says. The heat energy emitted from the device denaturates weak collagen and then triggers the body’s natural healing process, stimulating the production of new collagen and elastin. An additional pass is also delivered superficially to the dermis layer as well. “The patient should expect improvement in skin quality as well as tightening and lifting in the area [treated],” Dr. Levine says.

“For most patients, once a year is needed for maintenance sessions. For older patients who would better benefit from surgery but do not want to go under the knife, the treatment should be repeated every six months,” Dr. Levine adds.

My Experience and Ultherapy Review

I headed to Dr. Levine’s office on the Upper East Side in Manhattan for my Ultherapy treatment. Before starting, Dr. Levine gave me an entire rundown of the process and what to expect during and after treatment. My only concern was that I had heard that Ultherapy was painful. She assured me that while it was not the most comfortable treatment, the results would be well worth whatever discomfort I would endure. And as the old and overused saying goes, “Beauty is pain,” and I was willing to endure it for the results (and also in the name of beauty journalism).

Before the actual treatment, photos of my face were taken from different angles so that I could comparatively see the progressive effects. Afterward, my skin was cleansed to remove my sunscreen and makeup. Numbing cream was then applied to my face and neck, which remained on for about 45 minutes. I had opted to treat my face and neck because I had wanted to lift and tighten both of these areas. Dr. Levine also recommended that I use Pro-Nox (or laughing gas) to make the treatment more tolerable.

After removing the numbing cream, I laid back in the exam chair and Dr. Levine began administering the treatment. The machine itself is brilliant: it not only has ultrasound imaging, but it divides the face and neck into different treatment areas with optimal depths to target the ultrasound energy. Starting with my neck and moving up my face, Dr. Levine treated each area for several minutes. It felt warm to very warm (depending upon the area treated), and there was a spicy sensation deep within my skin. While I wouldn’t call it painful, it was not the most comfortable either. At times, I felt my skin getting very hot, but I knew the device was emitting higher energy levels for optimal results. The Pro-Nox helped tremendously to manage my discomfort. The areas where she went over bone, such as my forehead, were more uncomfortable than my cheeks, which are cushioned by fat. Dr. Levine talked me through the discomfort, urging me to continue using the laughing gas, and reminded me that it’s a serious treatment with very real results. It helped to get me through.

The full treatment took about 45 minutes, and when I looked at my face afterward, I only noticed slight redness and felt a little sore — mostly under my chin and neck. My skin also appeared tighter and lifted almost instantly.

Ultherapy Before and Aftercare

“Patients should avoid Advil [ibuprofen], Aspirin, and Motrin both before and after treatment,” says Dr. Levine. All three of these medications are anti-inflammatories and can hinder the results of Ultherapy as the treatment relies on “creating an inflammatory response on a microscopic level in order for the treatment to cause the body to produce collagen and elastin production.” Other than this, there is zero downtime and no interruption to your daily routine.

To maximize your Ultherapy results, Dr. Levine suggests following a high protein, clean diet and healthy lifestyle. “Sun exposure, lack of nutrients and smoking can all hinder results because they inhibit collagen production.”

I had a little redness and swelling post-treatment, both of which faded not long after walking out of Dr. Levine’s office. My skin appeared noticeably tighter and I experienced a little bit of soreness under my chin and neck. It was by no means uncomfortable, rather, it just felt overly sensitive from the treatment and faded a day or two post-treatment.

Excited to see my results, I checked my face and neck in the mirror daily, waiting to see everything tighten and lift. Dr. Levine describes the process of noticing the results of Ultherapy as “a little bit like watching paint dry,” but around the three-week mark, I noticed, in the most subtle way, that I just looked better. My jawline looked more chiseled, my neck appeared tighter and more firm, and my brows were lifted. The slight drooping at the outer corner of my eye that had bothered me for some time all but disappeared and opened up my eye area.

“Initial improvements can be seen within a few weeks, with the most dramatic results appearing over two to three months as new collagen builds,” says Miranda. Dr. Levine adds that full results of the treatment typically take three months but “closer to six months in patients older than the age of 60.”

I didn’t fully notice my results until I saw the before and after photos taken at Dr. Levine’s office. The approximate two-month difference between the photos was astounding; my face shape changed and appeared less square, my nasolabial folds were less pronounced, my skin was much tighter, and my overall skin quality improved to the point where I didn’t even want to wear makeup anymore — I just wanted to enjoy my Ultherapy glow up, as I called it.

Miranda says that the results can last for up to a year a more, Dr. Levine adds that while the results of Ultherapy do not go away, it’s important to remember that with any treatment, including surgery, the aging process continues and that maintenance treatments can maintain your results over time. For those prescribe to prejuventaion trend (including myself), I plan on maintaining my results by going back for a yearly session.

Who Is a Candidate For Ultherapy?

“Good candidates are those with mild to moderate skin laxity, typically in their 30s to 60s. It’s ideal for those looking to lift and tighten without surgery. Those with very severe skin laxity might not see dramatic results. Additionally, individuals with open wounds, severe acne, or certain medical conditions may not be suitable candidates,” says Miranda. Patients who are allergic to gold or who are pregnant or breastfeeding need to avoid the treatment.

Dr. Levine says that most patients in her practice who receive Ultherapy are between the ages of 32-55. “I have done patients as old as 87 and as young as 25. There is no ideal age, but someone should start this treatment at the earliest signs of laxity if possible.” She adds that a good candidate for Ultherapy is someone who has realistic expectations, not one “who expects a surgical level of total correction rather than improvement.”

Ultherapy Before and After

Is Ultherapy Worth It?

After having tried numerous preventative treatments to keep my skin looking tight and invigorated, including Sofwave, my results with Ultherapy are unlike anything I have experienced before. The before and afters were significant, even after two months since my treatment. Ultherapy is different from other popular non-invasive treatments — it improves overall skin quality, which is not only a key component to youthful-looking skin, but it has a huge impact on the perception of a person’s overall facial appearance. Utilizing Ultherapy as a means of prejuvenation is a smart investment to bank and slow the decrease in collagen and elasticity that comes with aging.

Taryn Brooke is a beauty writer and editor born and bred in New York City who has been in digital media for over 10 years. She is a contributing beauty writer for PS, Allure, Byrdie, and Well+Good.