Are You Heading South???

A few weeks ago, I blogged about Ultherapy, a new technology using ultrasound, to lift and tighten the skin.  It was performed on an audience member by Manhattan plastic surgeon Dr. Haideh Hirmand, on Dr.Oz's daytime show.  Dr. Oz sure carries a lot of cred!

The phones at the New York Group for Plastic Surgery immediately rang off the hook, with patients clamoring for more information.    After thoroughly interviewing Dr. C. Andrew Salzberg and his Physician's Assistant Courtney Dunavant, I decided to try Ultherapy on my neck and to see if I could achieve a lift to my right eyelid, which was beginning to head south.

 Below are some pictures and a recap of my interview with them, to help you evalutate whether this lower cost, non-invasive, no down time, tissue lifting procedure may be right for you.

(Pre-Ultherapy Nov. 17, 2010.  My right eye (pictured left), looks smaller than my right).

DD: Ultherapy is certainly creating a lot of beauty buzz! The N.Y. Times just did a lengthy article on it too, (http://www.nytimes.com/2010/12/23/fashion/23Neck.html?ref=style).  What has people so intrigued,  is that this technique is being embraced by plastic surgeons, you guys after all, earn your living by cutting sagging skin!.  Can you comment on this?

AS: Absolutely! As plastic surgeons we are biased towards a scalpel, however , this non-invasive technology really mimics certain aspects of surgical procedures we perform. Having ultrasound thermal energy administered to the deep tissue layers of the face and neck is very similar to what we actually do in surgery with cauterization. Both induce heat to the tissue, which causes the tissue to shrink. Additionally, in response to the thermal energy, your body will lay down new healthy collagen in the area treated. This subsequently tightens and lifts the skin above the treated areas! A non-invasive measure to achieve this type of physiological process is remarkable and is an excellent option for many patients.

DD: How does Ultherapy differ from Thermage? I was surprised when I researched Thermage that they shared similar claims, ie. improvement over time after just one session and the stimulation and rebuilding of the collagen that supports the skins structure.

AS: Ultherapy is a micro-focused, ultrasound thermal energy delivered to the deep layers of tissue and results are generally achieved in just one treatment. Thermage is bulk heat delivered by radio frequency through the skin to effect tissue just below the dermis and may take more than one treatment to see results depending on the patient and area treated. Ultherapy is the only product that uses ultrasound to deliver thermal energy and has two very important advantages:  Not only is it a very safe modality to use, but it allows the physician to actually visualize the areas of treatment in order to target deep tissue. Thus, with Ultrasound you are able to by-pass the skin and delivery heat exactly where you would like to see the "lift and tighten" occur. By avoiding bulk heat to the skin, you greatly reduce the risk of skin burns and are able to precisely target you treatments.

DD:  Wow!  That is an amazing distinction! Ultherapy is reportedly considerably less painful than Thermage. Why is that? Is any type of anesthetic necessary? Are certain areas of the face more uncomfortable for patients than others?  

AS: Most patients rate the discomfort during Ultherapy as a 4 out of 10. Because heat is not directly applied to the skin as in Thermage, the discomfort is often reduced. Additionally, Ultherapy treatments are generally shorter in duration. Every patient is different and sensory responses vary greatly. If patients have a low tolerance for discomfort, many practices will give patients oral medications to reduce anxiety and/or pain.

DD:  It's interesting, but pain is certainly subjective, so it makes sense.  I would rate the treatment on my neck as a 1, it barely registered, but the treatment on the brow was quite uncomfortable.  It was over so quickly, I am not sure I would bother with medication in the future.  The best part was that I drove straight to work!  Which  brings me to my next question... Do all patients receive the same amount Ultherapy or does it differ from patient to patient?

CD:  The areas treated with Ultherapy depend on where the patient desires the "lifted and tightened" appearance. Ultherapy has been FDA approved to treat the following: brow, lateral orbit, infra-orbit, cheeks, and neck. Ultherapy has a treatment protocol for each of these areas that is standard, however this can be customized for each patient.

DD: Where did Ultherapy start and how many years of patient history and results do you have?

AS:  Ultherapy began in Europe about 8 years ago. Results in this market have been shown to last approximately 3-5 years. Ultherapy is designed to slow the aging process. Unfortunately, your body will break down the new collagen that has formed in response to treatment, however this takes a significant period of time and varies among patients. The FDA granted approval to Ultherapy in the US in 2009. To date, results in the US have been shown to last approximately 18 months, however as we collect data in the years to come, we expect this to lengthen as we have seen in the overseas markets.

DD: Who is the ideal candidate for this procedure?

AS: The ideal candidate is a patient with mild to moderate skin laxity generally between the ages of 35-65. Even if you are not "an ideal candidate" you can still have Ultherapy and will see results, however you may require more than one treatment.

DD: Can you give me a range of the cost? Do you save money by doing the entire face and neck at one time?

CD:  The pricing is based on the number of thermal energy lines delivered in a treatment area. Thus the price increases with larger areas. Treatments start at approximately $475. When you combine areas or treat your entire face, there are significant savings!

DD: Can Ultherapy be used on different parts of the body? I think I could name 50 women who would have their upper arms tightened tomorrow!

AS: Ultherapy is FDA approved to treat the face and neck at this time. Treating other areas of the body is something that we all want and Ulthera is currently working on developing protocols for additionally areas. We are eagerly awaiting the ability to treat the upper arms as well!!

DD: What are typical side effects and down time?

AS:  The side effects are very minimal and there is NO downtime. Most people experience a mild heat and tingling sensation during the treatment. This can last 3-5 days after the treatment, however most patients state that is hardly noticable. Redness of the skin can happen during the treatment, but is typically gone by the time you leave the office. Tenderness has been reported in the areas of treatment, but is rare, mild, and does not interfere with going about and living you life! You may resume your normal skin care regimen and daily activities after treatment.

DD: Who is qualified to perform this procedure?

CD: Ultherapy is only sold to board certified dermatology and plastic surgery offices. Licensed health care practitioners (MDs, PAs, RNs, astheticians) within these practices may pe rform treatments after extensive training.

So there you have it!  My thanks to both Dr. Salzberg and Courtney Dunavant for taking the time to answer all of my questions.  Additionally, Dr. R.Michael Koch and Dr. Tae Ho Kim are also performing Ultherapy on their patients at The N.Y. Group for Plastic Surgery in Tarrytown, N.Y. (914-366-6139).

5 weeks later, I am delighted with my crisp looking neck, (which was fairly crisp to begin with (!) and the visible lift in my right eye. Results don't even peak until 3 months!!!  Would I do it again?  Yup!!!...with both arms raised!!!

Food for thought, for a beautiful you in the New Year!

xox,
DD