Thank you for your question.
You're asking Ultherapy vs. Pelleve, and in your question you state that you've heard
horror stories of Ultherapy melting fat out of people’s faces.
You describe your main concern of tightening skin in the arms, and to deal with some cellulite.
You want a lifting of the face, and you stated also that your skin is already very very thin.
Well I can certainly give you some guidance.
I'm a Board-certified cosmetic surgeon, practicing in Manhattan and Long Island for over 20 years.
I have witnessed a lot of technology come and go over these 20 years, and I can certainly
give you some guidance as to getting realistic results.
So, to begin with answering the question, I would simply say neither is a good choice
for you given this case scenario.
The reality of collagen stimulation through heat induction is that there is a limit, and
part of that limit is the actual skin itself.
There is an overwhelming demand for solutions for improving skin quality, for lifting, for
all types of things that help fight a lot of the changes of aging.
I actually wrote a book about this a few years ago, and facial cosmetic surgery, constantly
there's been this battle between non-surgeons and surgeons about the best solution for facial
aging.
The reality is there is some key elements that have to be understood before you offer
solutions.
So for thinner skin, we have to realize that you can only heat it so much before that skin
breaks down.
So the "horror story" of Ultherapy causing fat to reduce in the face is not an uncommon
story, but not just with Ultherapy but with any radio frequency or laser device where
there's a lot of heat being generated.
Because the skin can tighten up to a point, and when you have the intention of "lifting"
the face, well you have to get a proper assessment.
Let's just focus on the face part of the question—in lifting of face, we look at people and we
decide, what are the issues?
Facial aging is manifested by volume loss, such as bone, muscle, fat, soft tissue, as
well as sagging or descent—descent of the skin, descent of the support of the skin,
called the SMAS, or the superficial musculoaponeurotic system.
Now, as a cosmetic surgeon specialist, I do everything from non-invasive, which is Pelleve
(we have Pelleve both our offices), to injectables, to surgery.
In fact, if you do have a relatively thin face, you may not be a great candidate for
surgical face lifting, you may be a candidate for something that we do called a Y Lift,
and this is based on a concept called structural volumizing.
When you're talking about skin that’s thin, it might be better to add volume at the bone
level, and that's an injectable and its a technique, where we're able to accentuate
and restore volume in the structure of the face, and it creates a face lifting effect.
So you don't necessarily have to feel limited to the thermal devices.
When it comes to the technology in the field of cosmetic medicine, dermatology, etc., there
is so much messaging and there is so much hype, that there is no question that a lot
of people, including doctors, get easily seduced by the claims.
And there's always a few hired gun doctors who will make these statements about any device
as long as you pay them.
So people often go from one device, to another device, to another device, looking for the
Holy Grail, and doctors will do the same—doctors will tell a patient let's do this particular
thermal device, and if that didn't work, let's go to this thermal device.
We, in our practice, help rehabilitate the skin by using something called platelet rich
plasma to try to stimulate back some collagen, some soft tissue quality, because of the “damage”
that is done by the aggressive use of thermal devices.
As far as cellulite is concerned, or crepey skin quality of the arms, I would say there's
no good solution for cellulite regardless of what manufacturers of thermal devices or
various technologies will claim.
Patients want to see a dramatic improvement, they don't want to see 5% improvement, and
when it comes to the crepiness of the skin in the extremities, again, there are limitations
and I would advise against any of the devices that are being overhyped.
You'll notice this is a cycle.
There is a device that comes to the market, they reach all the talk shows, and then everybody
starts consuming and then before you know it, that device becomes obsolete and people
say “oh that one is old, let's go to the next device.”
Clearly there's no good solution, otherwise everybody would be doing something more consistent.
So I would advise against both.
I would say do a consultation with doctors about your options, you'll find you'll get
a lot of different opinions, use the smile test, use your gut instinct, but understand
that thermal energy devices have a role but they are overused and unfortunately over-abused,
resulting in not the best outcomes for patients.
So I hope that was helpful and I wish you the best of luck.
Thank you for your question.