As a cosmetic Nurse Practitioner in Dermatology, I get the question asked all the time by my patients: What would be better for me to look more rejuvenated Ultherapy or injectable fillers? I more often than not answer them with: Why not both! As an Ultherapy specialist and a trained and experienced injector, I have seen how these two different procedures have evolved to help enhance my patients’ facial rejuvenating desires. I have learned that Ultherapy together with some fillers gives my patients the most optimal and natural-looking results. Both of these non-invasive procedures can be done on the same day with minimal discomfort and downtime.    

Skin tightening and lifting

Ultherapy:

If your goal is to produce more collagen in your skin to help lift, tone, and tighten your skin, then Utlherapy is an excellent treatment option. This non-surgical procedure is FDA approved to be used on the face, neck, and décolleté areas. It utilizes ultrasound energy, which delivers lines of heat that stimulates the body’s natural healing response to build new collagen (neocollagenesis), which inherently has improved viscoelastic properties in ones underlying skin.  

Fillers:

Injectable fillers like Restylane or Juvederm products help reverse sagging skin by replacing volume in key areas that tend to naturally hollow out with age. So by adding fillers to areas like the cheek, under the eyes, and/or jawline, we help create a nonsurgical lift effect.   

Helping with wrinkles

Ultherapy:

With Ultherapy we can treat the skin at different skin depths allowing us to not help with lifting but also with softening of fine lines around the eyes, lips, forehead, neck, and décolleté.  

Fillers:

Deeper wrinkles like the nasolabial folds and marionette lines are treated best with fillers. By adding volume to those deeper lines we can plump up those areas for better more noticeable results.  

Best age to do a treatment

Ultherapy:

I educate my patients that we produce collagen naturally and it is most abundant in our youth. Unfortunately, we have discovered at as young as 25 we start to see a decline in natural collagen production, which continues to decline as we get older. It decreases the most after women start menopause. Our lifestyle also determines the rate at which we see a decline in collagen production. Activities such as the amount of sun exposure we get, our eating habits, smoking, being exposed to pollution, and stress all affect our collagen. And even though we can’t completely prevent collagen destruction within our skin, we can slow it down and build some of it back up with Ultherapy. 

So with this in mind, it is not unheard of if a patient in her 30’s wants to do Ultherapy. Collagen is most viable in our earlier decades so for optimal Ultherapy results patients should start early and do maintenance every few years.  

Fillers:

Done by an experienced and trained professional injector, fillers can be done so that patients can enhance their appearance. For example, if a patient has smaller lips, adding a little filler can help give balance to the full face. As well as having a recessed chin, fillers can help give a patient a much better and more proportional profile. During my consultations with my patients, I pay attention to the full face to see where fillers can be added to enhance each of my patients’ best attributes.

Going back to Ultherapy, if started at an early age and maintained then fewer syringes of fillers will be used throughout the years. Too much filler, especially in one specific area of the face, to combat aging can look overdone and odd on a person. I always tell my patients, “No one should ever know that you had fillers done, they should just ask you what you are doing differently to look younger!

Differences

Ultherapy:

An Ultherapy treatment can be customized to meet each patient’s individual concern so that only the areas that really bother them can be treated. The in-office procedure takes anywhere from 60-120 minutes, depending on how many areas are being treated. Usually, 1-2 treatments are required spaced 6 months apart. And while there is minimal to moderate discomfort during the procedure there is minimal to no downtime post-procedure. 

Pain management options, if desired, are discussed before with our Ultherapist specialist. Results can take from 3-6 months to see optimal improvements. 

The duration of the results depends on many different factors like age, lifestyle, overall health, sun exposure, and skin products used at home. On average though results can last 2-3 years, however, we recommend an annual follow up with one of our experienced practitioners.

Fillers:

With fillers the results can be seen immediately, allowing our experienced and trained injectors to show their patients their outcome after each syringe so that they can decide together how many syringes are needed. Depending on which fillers are used and how many, results can last 12-24 months. The risk of bruising is always there anytime a patient gets injected with a needle. 

During the consultation, our trained injectors would go over different options and pre/post care to help avoid/minimize the risk bruising.  

The gold star duo package

Combining Ultherapy and fillers gives patients more of a natural look because it may require using fewer syringes of fillers since we have already enhanced a patient’s skin by stimulating their collagen. Studies have also suggested that fillers can stimulate additional collagen production so that when combined with Ultherapy it creates a great synergistic effect, to help with overall results. Ultherapy together with fillers is an effective and non-invasive natural alternative to a more drastic surgical face/neck lift. 

Marcela is a nurse practitioner at Suzanne Bruce and Associates. Before becoming a nurse practitioner, Marcela had been a practicing nurse specializing in cosmetic dermatology at our office since 2003. Marcela obtained her nurse practitioner degree from the University of Texas Health Science Center in Houston in March of 2015, where she also received her Bachelor of Science degree in nursing with high honors in May 2003. She graduated from Texas A&M University with a Bachelor of Science in Health in 1999. Marcela is a member of the American Academy of Nurse Practitioners and the Dermatology Nurses Association.