Back in early May I vented about my Bermuda Triangle of Sag; that treacherous intersection of my chin dumpling, emerging jowls and jawline that seems increasingly unable to resist the siren song of gravity.
I’ve been told his gift from Mother Nature is a perfectly normal part of how the face ages. Just like menopause and oh, I don’t know…death.
The difference is, I think can do something about my sagging lower face (or at least I hope I can).
So earlier this year I went on an adventure I called “Laser, Needle, Knife or Nothing” to understand exactly what a girl is supposed to do.
I wasn’t ready to confront the scalpel and thankfully was told I was too young. Lunchtime laser energy devices caught my attention though – Thermage! Gwyneth! But from what I had read, the results were mixed.
Finally hope emerged in the form of a trade booth during the ASAPS ‘13 conference in NYC.
It was Ultherapy, the only device FDA approval for actual lifting and tightening of the skin around the neck. It works differently than Thermage by using ultrasound energy that reaches the SMAS (the muscular sheath that loosens as we age) with more precision, depth and heat which radio frequency can’t do. (Click here to learn more about the trade-offs between Thermage and Ultherapy)
Is ultrasound truly better than radio frequency? Not sure we know the full answer yet because the science in the cosmetic setting is still in its infancy.
Still, if I can get some noticeable lifting and tightening during my lunch hour, sign me up.
To find out, I made myself the guinea pig and underwent a full face Ultherapy treatment, gratis of Ultherapy and W. Matthew White. M.D., back in May (you can read about the treatment here). The full face Ultherapy is designed to also lift your eyebrows a smidge, but my real goal was to diminish my jowls and reduce my chin dumpling, that little pocket of fat.
Drum roll please…..
A few caveats and disclosures:
1. Before/after photography is tricky. Dr. White and I tried painfully to replicate the exact position of the head and exposure of the photograph. We came close, but I’ve noticed that even the slightest change in angle can make a result look better or worse (we sorted thru many). Here are some helpful tips from the team at Ultherapy who are keenly aware of the nuances in before/after photography:
- Eye alignment: Sometimes, photos are taken at different sizes, so when evaluating photos, look for ones where the eyes are the same size and line-up in the same position. If the eyes are aligned, chances are the rest of the photo will be as well.
- Nose positioning: Oftentimes, the chin may be in a different position or the angle may be slightly off when comparing the Before & Afters. One tip is to look at the nose’s position, which can tell you if the patient is positioned the same in the Before and After.
- No make-up: Many times, patients want to look their best in the “After” photos, so they wear makeup. This does hinder the ability to objectively evaluate photos. If the patient is wearing makeup in one of the photos, take the time to look at the photos more closely.
- Look for consistent lighting: Different lighting can pose a problem, because inconsistent shadows in 2-D photography won’t accurately portray results. If lighting is different in the Before & After, take the time to look at the photos more closely to see what impact the lighting had on the photos.
- Don’t just rely on photos: Many practices excel in cosmetic procedures, but aren’t necessarily the best photographers. Ask about other patient experiences; many times, practices will share patient testimonials or even put you in touch with another patient. Remember that 2-D photography oftentimes doesn’t show all of the benefits from the procedure.
2. Filler and/or Botox can impact results. In my case I had Botox in my forehead and crows feet a week after my first Ultherapy treatment, so right now it’s hard to tell what is Ultherapy and what is Botox in terms of the lifting around my eyebrows (which is why I didn’t show the results right now).
I’ll reveal the full face in November, when it will be easier to see the lift without the benefit of Botox.
Dr. White also gave me filler in my jawline and mid face. Not a lot, but as you can see in the first two pictures, I had notching along my jawline, that doctors refer to as the “pre jowl sulcus”. He used Radiesse to fill in the notch and Juvederm to take care of some of the marionette lines. This is why my face looks smoother, more rounded in the last photo; that is filler.
The subtle chin dumpling lifting however, was all Ultherapy.
4. Weight gain/loss can impact visible results. I’m a masochist so I’ve recorded my exact weight for all to see. Good times considering I gained a little (but I’m working on it, see Trim Down Tuesdays).
But this is important, because you need to know that weight gain/loss does in fact impact the visible results. If you lose weight, laxity increases due to the volume loss, especially in older patients. If you gain weight, it may be harder to appreciate the lifting and tightening that was accomplished.
However, this does not mean Ultherapy didn’t work. The new, more elastic collagen that Ultherapy created will still be there, so the tissue may have a higher likelihood of snapping back and tightening that it would have otherwise.
5. You may or may not be the right candidate for Ultherapy. For instance, I may have been a little less than ideal. While I’m the right age at 45 (many women get it as young as their mid thirties) I was told I don’t actually didn’t have that much skin laxity and my signs of aging weren’t as pronounced.
For context, here are some other examples of people with more dramatic results than mine. As you can see there is more visible skin laxity:
Further, Ultherapy doesn’t replace a facelift. It physically cannot do what a facelift can, rather it’s a stop gap. Ultherapy cannot change your anatomy either. Some people are just made with a very short jawline, where the chin seems connected to the neck. Ultherapy will not address this issue in a meaningful way.
Lastly, because Ultherapy is so new, the medical community is still learning exactly what type of results different types of patients can expect.
6. Results take time, and sometimes aren’t visible for a full six months. I’ll be reporting back in November to see if my results have increased, but in the meantime here’s another patient who saw results after a longer period of time.
So what do you think, would you give it a try? According to Real Self, respondents seem bullish on Ultherapy which is holding at a 73% worth it rating.
I notice a subtle lifting of my chin dumpling, and was encouraged after my one month photograph, but was hoping for more lift than I got at the three month mark. My skin does feels tighter, firmer (even my eyebrow sculptress noticed but wasn’t sure what I had done), and my jawline looks smoother, but remember I had filler.
If you’re tempted by Ultherapy, remember to ask your doctor what type of results you can reasonably expect and if you’re the right patient type. If your doctor has any pause, ask if they would consider a second treatment at a lesser cost (or free) if the results aren’t measurable (this is not necessarily standard practice, but I think it’s a fair request).
And lastly, remember to ask about whether they use the Amplify setting, which is the newer indication that achieves the lift without the intense pain from previous settings. You want to use only as much as needed, otherwise there’s more risk of stuff going wrong than right.
To be continued in November.
In the meantime, bring on the comments and questions.