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Sonic Youth: My Date With Ultherapy


I took the plunge and got a full face Ultherapy treatment.

After speaking with a handful of plastic surgeons and dermatologists, I knew that if I was going to get serious about treating the Bermuda Triangle of Sag (those baby jowls, chin dumpling and neck crepe), Ultherapy followed by fillers was in my immediate future.

As I mentioned in last week’s post, I’m encouraged by Ultherapy versus Thermage because of its specific FDA approval for lifting skin on the neck, chin and brow. It also works differently, using ultrasound (sound waves) that penetrate more deeply and precisely than the radio frequency technology used in Thermage.

However, even the most enthusiastic doctors were quick to point out that Ultherapy doesn’t replace a facelift and that results can vary from subtle to substantial.

Still, I’m considered a worthwhile candidate. I’m not quite facelift material, but have just enough mild sag to give Ultherapy a shot. But the cost gives me pause.  Most people only need one treatment to see results, but with starting prices around $2500, Ultherapy isn’t cheap.

Knowing I was writing this series, the Ultherapy team sponsored a treatment so I could share the experience first-hand. You would think this would be an easy yes on my part, but I’m cautious with new technologies even though Ultherapy has an excellent safety profile.

Enter Dr. W. Matthew White.  A facial plastic surgeon from NYU Langone Medical Center and early pioneer of the Ultherapy technology.  Dr. White made me feel especially comfortable about Ultherapy because he knows the ins and outs of the technology, was involved with the clinical trials and has written two white papers as a result.

Bottom line, Dr. White’s treated a lot of patients and knows what he’s doing.

“What’s the chance of me looking a little strange afterwards?” I asked, knowing the results gradually build over a period of 3 to 6 months. “Let’s say I get Botox the following week, will my eyebrows lift up to some unnaturally high place on my forehead by August?”

“There’s very little risk of over correction,” Dr. White assured me.

“What about the pain?”

“I’m going to use the Amplify protocol, which means we treat at a much lower setting that gets the same result,” he said. “I do a few things during the treatment to lower the pain such as using acupressure points and lifting the tissue off the bone in more sensitive areas”

I felt like a beauty astronaut on the verge of discovering a new planet.

Until my appointment when I realized the internet chatter about how much Ultherapy hurts was screaming at me from deep inside my subconscious.

That, and Dr. White didn’t have Xanax.

“I don’t recommend patients take Valium or Xanax because it can make the sensation more startling” said Dr. White. “With the Amplify setting, you’re better off with nothing expect Tylenol afterwards.”

“Ok, let’s do this” I said reminding myself of all the things that probably hurt more, like child-birth and urinary tract infections.  Still, there was something guillotine-like about a man wearing rubber gloves holding a lot of powerful energy over my throat.

Most terrifying selfie ever.

Feeling a little Anne Boleyn

“Do you want to reschedule?” he asked gently.

“No, I’m fine,” I said, eyes closed and teeth clenched tight.


There was no sensation on my skin, just a small prickle of heat that felt like it was landing on a deeper layer.  Odd yes, painful no.

“Did you feel that?”  he asked.

“Uh…actually, no” I said. “That was it?”

The following 90 minute treatment was a breeze compared to the bottled up anxiety of the imaginary pain. 

The prickling heat sensation culminates after each pass, so Dr. White did one half of my face and gave me a 15 minute break.

Some areas are more sensitive than others, and varies from person to person.  On me there was a gland near the bottom of my cheek that when hit with the Ultherapy pulse, created a hot sensation of wetting my pants inside my mouth.  The outer eye and forehead area can be sensitive for a lot of people, but for me it was fine.

When it was over, I had a mild headache and my jaw felt stiff for a few days, but not unbearable.  I looked fine for public consumption too, just a little redness on my face and no swelling, which I’ve heard is common.

What’s important to know about Ultherapy is that there is a strict map for where it can and can’t be used on the face.  Ultherapy should not be used directly over your windpipe or directly under your eye, only on the outer rim.

Dr. White advised me to avoid ibuprofen before, during and after because there’s some speculation it might interfere with the body’s response to collagen stimulation.

This is where Ultherapy can and can't be used.

This is where Ultherapy can and can’t be used.

The next morning I rolled out bead, marched past the coffee pot and headed straight for the mirror.

I turned my jaw to the left, to the right, then up, then down. Chin pulled in, chin jutting out. I couldn’t keep my hands off my slightly sore neck and jaw, rather enjoying the minor stiffness because it made me believe this just might work, but I won’t know for sure for at least three months, which means August.

Until then, I wait and I hope.  My before plastic surgery mug shots are below.


  1. I’m hanging on your every word over here!

  2. Great blog, thank you!

    Wow, the Ultherapy carries a big price tage, I’m from South Africa and a mini or lower face lift is cheaper here. Very curious to hear about the results.

    I recently complained to a Dr about my bermuda triangle of sag (love your expression) and he reminded me that my reflection in my iPhone (depressing) is not the face the world sees and to smile a lot until ready for the knife :)

    He recons 10 years, I recon 2 max unless your results are fantastic, in which case I’ll go for Ultherapy instead.

    • Hi Kristie – the prices I quoted are NYC, where even the cost of breathing is more expensive than any other place in the world (except London).
      I would imagine it would be less in South Africa.
      I can’t wait to share the outcome of my Ultherapy treatment in August. There will be pictures.
      In the meantime, I’m going to investigate the face lift options in July, because for some patients, that is the better option.


  3. Now this is a dangerous post. Was put off due to people here in the UK saying how excrutiating it was, now though………mind you would also have to add price of flight to NYC to the cost!

    • Hi Helen – the big difference is the Amplify protocol which is a much lower setting than previously used. The higher settings hurt like hell I’ve been told. I’m told the Amplify protocol achieves the same results with much less energy. That said, not all of the Ultherapy doctors I spoke were aware of the new protocol, so it pays to ask around. I’ll do some digging on my end as well.

  4. Way to go! You can get tremendous mileage from Ultherapy, combined with Botox and fillers. In the right hands, Sculptra is truly a miracle product. People are shocked on the rare occasion when they find out how old I am. I have never had a facelift, but at sixty, I can pass for my early forties- no lie. I use sunblock religiously and I have used Retin-A since my early thirties. Obagi Medical products, a bit of lipo around the middle and regular workouts have taken me the rest of the way to a youthful look. Once you get the young looking face, the challenge becomes achieving a younger looking body to go with it. Keeping a semblance of a waist to hip ratio is crucial to an all around youthful look.

    I have a high pain tolerance, but I found Ultherapy EXTREMELY painful– particularly in the forehead and temple area. The lower face and neck was not so bad.

    Good luck, and be patient. It took me at least four months to see my final result. I know you’ll look wonderful!

    • Thanks for the encouragement Yasmine. You are so right about the body, especially the waist to hip ratio. 10 years ago, I could get away with 10 extra pounds because it at least fell in the right places, but apres baby and premature menopause, I’m the shape of an eraser (with boobs). The body section will come later in the summer where I’ll see exactly what my options are (I have a feeling it’s going to be more diet and exercise than anything else).

      So happy to hear you had great Ultherapy results. Do you know if your doctor used the higher settings or the new Amplify protocol?


    • I think that Amplify was rolled out last fall. I had my first treatment last summer. She did double passes at the lower, and then higher settings. I had a small touch up under the chin about a month ago, hoping to improve my platysmal bands. The touch up was much more comfortable. I’m not sure whether it was Amplify. My jawline and neck are really tight now– but I had minimal sagging prior my first treatment.

      • Did you see any improvement on your platysmal bands?

        • The first treatment did not help. I have seen a slight improvement with the second treatment, but it’s only been a month. I’m reserving judgement until another couple of months have passed. I’m not expecting miracles, just a softening of the look of those two pesky bands.

          I’m applying a little extra Retin-A nightly under the chin area. It’s just an experiment to see whether I can boost collagen formation. I figure it couldn’t hurt!

          I’m delighted to know that there is now a less painful protocol. I now plan to keep having these treatments every few years as the aging process continues. Before, I seriously didn’t think that I could ever tolerate having my upper face and forehead treated again.

        • Please keep us posted. My doctor did something akin to accupressure on the eye area, but I can see how before the Amplify protocol it would hurt because that area is so bony. The Retin A is such a great move — that and suncreen are the two most important skin care items in my medicine cabinet.

    • I had extereme pain in the same spots, woke up today with large bruised areas on both jowls, no one mentioned bruising but im looking for to watching the change evolve in the next three months.

  5. You will be posting before and after pics right? Looking forward to seeing the results.

    • Absolutely. I’m waiting for the photographs from my doctor and will upload them here in a few days. I’m also going to post my weight (gulp) at each measurement because I think plump streak or a bad night of wine and dim sum the night before can bloat a face.

  6. Curious as to whether you’ve noticed any changes yet? What was the actual sate of your procedure? Thanks!

    • * Date!!

    • I’ll be posting about this in August, once I’ve given this the full 3 months to see a difference, but the short answer is yes, I’ve seen a small lift in my photographs. What’s more interesting (or depressing) is that I gained 5lbs on vacation and my chin dumpling didn’t inflate the way it normally does when my weight fluctuates.

      More to come.

      • any photo updates yet??? Dying to see the results

        • Yes! Photos and post coming next week:)

  7. I also had Ultherapy in May, and am very concerned w/my results. I believe I have had significant fat and volume loss. I recently had my after pic’s done and they confirmed my fears. I look much worse and older in my after shots. The few people I have shown the pic’s to agree. The exception being the nurse practitioner who did my treatment. She says what I am seeing is “toning”. My biggest fear was fat atrophy and I was assured multiple times that it was not a possibility. My treatment was done at a doctors office that was an early adopter of Ultherapy and they currently train other practices, so they should know what they are doing. The reason I’m telling you all of this, is in hopes that you can ask your doctor, or the other doctors that you have interviewed about the procedure, what the likelihood is for fat atrophy and what can be done after the fact. Thanks.

    • Thanks so much for sharing. You have no idea how helpful this type of comment is because often, when a technology is new, we just don’t know the nuance of all the downsides until more time and people have tried it. Personally I don’t think I experienced fat atrophy, but it was a question I had going in because i know this had come up with Thermage (which has been around for much longer). I couldn’t find anything about fat atrophy in the literature, but a plastic surgeon I respect out in Beverly Hills told me in general he was concerned about any of these devices causing fat loss (he doesn’t use any of them – Thermage, Ultherapy, Titan – in his practice). That said, out of the handful of doctors I spoke to (many of which weren’t affiliated with Ultherapy), he was the one outlier. This is a great point for me to follow up with next week when I post results. Thanks again!


      • Yes, I am also worried about fat atrophy since I have experienced skin thinning with TCA peels. I am very interested to see your results.

        • Update: results will be posted either 9/11 or 9/12

    • Do you have photos?

  8. I went for an Ultherapy treatment today. I have a high pain threshold but this was so painful I had to stop. I managed to grit my teeth to get finished with the neck area. I took 800 mg of ibuprofen before the treatment as they had recommended but could not see any benefit at all
    . I will try again and take a valium and something for pain. Hopefully I’ll make it through the rest. I’m not sure I would have done this if I’d known it would be so painful.

    • Oh Dee I’m so sorry it was painful. Did your doctor use the new Amplify setting? It gets the same results with lower settings so the pain isn’t as bad. I do know the old protocol was very painful. Hope you have a nice outcome at the end of all of this:)

      • They did not use that specific term but did say that “since the new software update” their patients have not been having pain with the treatment. This was done at my dermatologist’s office by an esthetician. She told me that she has performed about 600 procedures and that, aside from 2 patients with fibromyalgia, I am the only one who has had this kind of pain. I don’t get it but I’m going to try to finish up using valium and pain meds of some kind. I hope it’s worth it in the end. Thanks for the encouragement.

      • I wanted to get back to you to let you know that I spoke with the esthetician and my Ultherapy was done with the new Amplify setting. It was excruciating for me. I actually was getting a bit annoyed at the esthetician telling me over and over that no one has pain with this. It was as if she was saying that I made it up. I cancelled the rest of the treatment because I cannot go through another treatment that was as painful and the one on my neck. They only refunded me $2,000 of my $3,000 payment. Oh well. Hopefully the pain management will get worked out better in the near future so I can do the treatment. Thanks for “listening.”

        • Dee I noticed you said you went to see an esthetician.
          Was there any doctor involvement at all?

          It concerns me that so many medi-spas have lasers and energy devices that lack the supervision needed, but the average woman just getting into this stuff doesn’t know what questions to ask (I sure didn’t which is why I started writing this blog).

          For the record, I don’t let anyone near me with an energy device that isn’t a doctor. While perfectly safe in the right hands, there are too many horror stories about what can go wrong.

          I am so sorry your experience was terrible; bad practice management on their part not to refund your money or reapply it elsewhere.

  9. I’m not trying to disrespect you ;) but you look like you are 18 years old
    in your BEFORE pictures……….

    • I love you, you’ve made my day. Feel free to disrespect anytime:)

  10. Really appreciate the blog. Especially addressing the issue of potential fat atrophy. I was scheduled for Ultherapy this next Tuesday then decided to do more research other than the manufacturers and doctors who are advertising….I wanted feedback from people who had actually experienced the procedure. 5 years ago I had Fraxel, and after the third treatment….looked like my face had melted! Eventually it came back -but I’ve had fillers. Overall happy with my face, but thought Ultherapy would enhance what I am now.
    The potential, however slight, of fat atrophy has me reconsidering having it done.
    I live in the Washington DC area and for half face the cost is $3,200. Quite pricey.
    Trust my plastic surgeon explicitly but he does not do this himself, so I think I’ve just talked myself out of having it done!!

    • Carol I had a bad Fraxel incident too a few years ago. More on that in my melasma post coming up.

  11. thank you so much for sharing this experience. what are your thoughts thus far? have you seen improvement?


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