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People approaching their 40s are the prime candidates for Ultherapy. This non-invasive procedure helps tighten the skin on the face, neck, and décolletage. Hear from Dr. Elizabeth Roche, founder of Elizabeth Roche MedSpa, as she discusses the benefits of Ultherapy. Listen or read more to see if Ultherapy is right for you.

John Maher: Hi, I’m John Maher. I’m here today with Dr. Elizabeth Roche, founder of the Elizabeth Roche, M.D. MedSpa in Bergen County, New Jersey, a medical aesthetics center committed to providing people with the most advanced procedures available to restore youth while preserving the beauty and functional health of your skin. Today our topic is Ultherapy. Welcome, Elizabeth.

Elizabeth Roche: Hi John, thanks for having me.

John: Sure. Elizabeth, what is Ultherapy?

Elizabeth: Ultherapy is a treatment that we do in our office to help tighten skin and lift skin. The name Ultherapy comes from basically what it is — it’s ultrasound therapy. Ultrasound waves cause a heat spot under the skin and that heat results in collagen tightening. When you have tight collagen under your skin, you get tightness and lifting of, it could be the full face or certain areas. It’s a noninvasive procedure that tightens skin over time.

Ultherapy is a Safe Procedure to Tighten the Skin

John: Do those ultrasound waves, do they damage the skin or, what does it actually really doing?

Elizabeth: Yeah, so it’s really interesting because it bypasses the surface of the skin and we’re treating layers underneath. We’re treating the fibromuscular layer. You ever see a piece of meat and that white collagen on top of it?

John: Mm-hmm (affirmative).

Elizabeth: We’re able to get down to that layer and because we have that too in our skin on top of the muscle, we have that collagen fiber. When we heat that up, it contracts and tightens and then we do a second pass and we’re treating the collagen that’s just beneath the skin surface in the dermal layer of the skin.

You leave without any peeling. There’s really no redness. If you do, maybe it’s there for 15, 20 minutes. You can put your makeup on. You can put your sunscreen on. You can go back out. You can jump in a pool. You can go swimming. It’s a great treatment because all of the energy is under the skin and all the work is being done under there and there’s no surface changes. It’s a very popular treatment in our office.

Benefits of Ultherapy

John: Okay. What is it used for? You said that it tightens and lifts the skin.

Elizabeth: Yeah. Let’s say, John, you’re noticing your lower face is starting to fall forward and you’re getting those jowls or your under-eyes look like you’re getting herniated bags. When we do this treatment, it’s almost like tightening up the envelope. You’re tightening up that outer surface so everything underneath looks better. When you tighten the skin, you get a lifting of it and your whole appearance looks refreshed, rested. It’s not a face lift, but it’s probably the next best thing to a face lift in terms of the results that you can get.

John: Who can benefit from Ultherapy?

Elizabeth: I think that anyone who . . . especially if someone’s approaching their 40s it’s good to start thinking about doing certain areas. I think that’s when people start to see the aging process beginning. I tell patients, if let’s say your lids, you’re starting to see them get a little heavy, just work on that at first and then you can go to another area and do your lower face or under your chin or any of these areas will be beneficial and it’ll help prevent the aging process.

I often call it our . . . you’ve heard of a college bank account, this is your collagen bank account. You’re going to store your collagen so that when you’re aging you’re going to have that fresh new collagen to keep that youthful appearance going.

John: Okay.

Elizabeth: Yeah, so people from 40 on, that’s usually the age where they start to do it.

Preparing for Ultherapy Treatment

John: Okay. What can I expect from an Ultherapy treatment when I actually get it done?

Elizabeth: The treatment itself, we have patients come a little bit earlier or else they can apply some numbing cream at home. It is a little bit uncomfortable and pain is always very individually perceived. I have some patients that are completely comfortable and nothing’s bothering them, and other patients that find the procedure feeling a little electrical stimulation.

We have them take Ibuprofen if they are able to take 800 milligrams a good 40 minutes before the treatment, put some numbing cream on. They’ll come in, if we’re doing a very large area, which could take close to two hours, which would be the full face, full neck. We sometimes administer a little bit of Xanax to help them relax through it because it’s a long time undergoing the treatment.

But we go from section to section and the feeling or the sensation, sometimes it’s really not bothersome at all and there could be some other areas that are a little bit more sensitive. As I said, depending on the area that we’re doing, it can take 15 minutes or two hours depending on how large the area we’re doing. Then when we’re done, there’s an ultrasound gel that we’re using, we clean that off, we put some sunscreen on, and the patients can go right back to work or go out that evening without any downtime.

Over four months, you’re going to see that collagen remolding occur. Gradually over a four-month period of time, that’s when you see the results. Some patients are a little slower responders, and it may take six months, but at the four month time we have them come back in and we do comparison photos, and it’s amazing what happens over those four months.

John: Do you find that people come in and they say, “Yeah, I don’t really think that it really did anything,” and then all of a sudden they look at the before and after pictures and they’re like, “Wow, that’s amazing!”

Elizabeth: Yes, John. It’s so funny because we have a few patients that are like that. When you’re looking at yourself every day in the mirror, you don’t see those changes. But when you have a photo from four months ago or six months ago and you look younger now than you did before, it’s quite, quite impressive, and patients will sign up for another area that they were concerned about.

Yeah, we do have some patients like that and we have some patients that immediately, they call us up in two months they’re like, “I’m seeing my jawline again. I’m seeing my neck, it looks great.” Depending on the age and the starting point, the quality of the skin at the starting point, the results can vary a little bit.

Ultherapy for Areas Other than the Face

John: You mentioned that people sign up for another area to be done. What are the areas of the face or body that people use the Ultherapy treatment for?

Elizabeth: The Ultherapy machine is FDA cleared to be used on the face, neck décolletage. So, any areas on the face, whether it be the brows, around the eyes, the cheeks, the mouth, the upper neck, lower neck, the chest, but we actually have been using it on other body parts. A common area that women complain of is the area above the knees. They start to get horizontal lines and creased skin there, so it works great on that. We’ve done thighs and buttocks and arms, abdomens. You can use it anywhere you need skin tightening.

What to Expect During and After Ultherapy

John: Is there any downtime? I think you mentioned that people can get the treatment and then just go right back to their regular activities.

Elizabeth: That’s right. There’s really no downtime. That’s why it’s a very popular treatment too. What we had before, we only had lasers to deliver this type of heat in this depth of the skin and the lasers came with downtime. People would like the results but they had to take time off of work.

With Ultherapy, you don’t need to take time off from work, you don’t need to worry about your social schedule. We’ve done thousands of these treatments and very rarely has there been an area where there’s been possibly a bruise. That usually happens if there’s a superficial blood vessel, usually around the eye area. They may get a little bit of a bruise, but it’s not a common occurrence or at all.

Some patients reported slight swelling appearance. Some patients get off the table and say, “Wow, this looks great.” I tell them, “It may be swelling from the heat, don’t get too excited,” but it’s very, very subtle and there’s really very little downtime.

John: Okay. What does the treatment feel like? I know you said that some people do have a little bit of a pain sensation or a little electrical stimulus or something like that. What else do people tend to feel when they’re getting the treatment done?

Elizabeth: Yeah, that’s the common . . . some areas are a little more sensitive than others, but in general it feels like we pressed the button and you hear this noise coming out of the transducer. It sounds like “doo doo doot”, and that’s the treatment line. Then we move the transducer slightly and we press the button again, “doo doo doot”.

First we map out the areas on the face or their columns, let’s say going down the cheek. In one column we may do 60 lines of energy deep and another 40 lines of energy more superficial. When we press that button, some of those patients feel a little bit of a zing, and some others you don’t even feel at all. It depends on where in the face it is, but it’s very tolerable and are our patients get through the treatments without any problem.

John: Other than, you said taking a little bit of a pain medication perhaps before they come in, is there anything else that people need to do to prepare for a treatment?

Elizabeth: We always tell patients just avoid using any harsh retinols or glycolics on their skin that may make them a little more sensitive just a couple of days beforehand. Other than that, just the Ibuprofen, clean face, numbing cream. It’s quite easy to prepare for this as well.

When to Expect Ultherapy Results

John: How often does Ultherapy need to be done? Do the results disappear over time and then you might have to come back in again and have it redone?

Elizabeth: Well, John, we are always aging so it will disappear over time.

John: It never stops, yeah.

Elizabeth: It never stops, right. I usually advise my patients if they have a treatment we have them come back for the four-month checkup or comparison. They usually fall into one of three categories. One, they’re absolutely ecstatic, they’re happy, they’ve got great results. I advise them, “Don’t let more than two years go by before having a full treatment.”

Some patients at the one-year mark will have what we call a booster treatment to keep the process going. Those are patients that usually their skin is younger or they had a good response and they’re pretty good to go, they’re set.

Then there’s another category of patients who they’re a little bit older, they had results but they’d maybe like to see more. At that point I recommend to do the booster treatment within the next month or two and they’ll get that extra little jump and that extra little push to get their skin a little bit tighter.

Then there’s the third category is when people are older or they’ve had a lot of photo damage, sun damage. They have a lot of crepiness, a lot of looseness to their skin. We wait until the six-month mark and then I tell them, “Let’s do a second treatment.” That second treatment, that’s the one that like just gives them the pow and it makes them have results that maybe a younger person with one treatment had. It all depends on the starting point and the age but that’s usually the three main categories.

But I tell patients, “You’ve invested in this, you’ve made results, don’t let them fade away and start at ground zero again. Come back in at six months, a year and get something done or get some other skin tightening treatments that aren’t as intense to keep the process going.”

Ultherapy Alternatives

John: If somebody doesn’t want to do Ultherapy or if it’s not the right treatment for them, are there alternative treatments for them to tighten skin?

Elizabeth: Yes, there are alternative treatments to skin tightening. We have several different lasers in the office. We have laser peels. We have a treatment called Skin T-Y-T-E, Skin Tyte, which is a great alternative Ultherapy but that requires a series of treatments. There’s treatments like microneedling will tighten the skin. There are several different treatments to get to an end point. We’ll discuss different treatment options with that patient if they are looking for something other than Ultherapy.

John: All right. Well, that’s really great information Elizabeth. Thanks for speaking with me today.

Elizabeth: Thank you, John.

John: For more information about Ultherapy or other treatments, visit the website at elizabethrochemedspa.com or call (201) 505-1020, that’s (201) 505-1020.

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