Question: I have some slight sagging in my face. I’m 42 and I don’t think I’m ready yet for any surgical lifts, but if I can improve my appearance I’d like to. Would ultherapy be a good alternative to surgery for me?
Answer: You sound like an excellent candidate for Ultherapy due to your relatively young age and early signs of facial aging. Ultherapy is an excellent way to create facial lift, but it is certainly limited on the amount of lift that can be achieved and, therefore, in patients with very significant facial aging features I recommend they consider a more significant alternative such as surgery, but in those with very early signs of aging I feel that they are excellent candidates for Ultherapy as a small improvement is all they really need and the Ultherapy certainly has a high likelihood of achieving their goal.
Question: Is ultherapy used on the face and the body? What areas are most often treated?
Answer: Ultherapy is FDA approved for use on the face but many people, including the Quintessa Aesthetic Center, have used Ultherapy off the face and have had some very exciting improvements in areas like the decollete or the upper chest region. We have also treated some upper arms and legs and it is even being used in the underarms for excessive sweating. Essentially, the device can theoretically be used on virtually any part of the body where we want to lay down energy under the skin without injuring the overlying skin itself. Most commonly though we are performing facial treatments in 95% or more of our patients and only a small number of patients are getting off face treatments.
Question: Are skin tightening procedures an effective alternative to the neck lift? How do you know when you really just need surgery instead?
Answer: Overall, skin tightening procedures really are not an effective alternative to a neck lift but Ultherapy, which is used to treat the layer of the face deep to the skin, can be very effective at improving a neck. Ultherapy uses microfocused ultrasound to create small thermal injury zones 3 and 4.5 mm below the skin surface and the new transducer can provide these zone at 1.5 mm under the skin. A combination of these treatments across the neck and face all create new collagen, which tightens and lifts. It is actually the only nonsurgical device ever to be given a lift indication by the FDA. It is, however, most effective in patients with very early signs of aging as it is not going to be able to lift nearly as effectively as a surgical procedure. If you can lift several centimeters on each side of the jaw then you would be much better off with surgery, but if you can only lift a few millimeters on each side of the jaw and this improves your concern then you may be a candidate for Ultherapy.
Question : Does ultherapy remove fat or just tighten the skin? Are the results permanent?
Answer : In reality, Ultherapy neither removes fat nor tightens the skin but, in fact, targets the deeper layer of the face in the area of the SMAS where there is a significant amount of collagen. The ultrasound waves heat the collagen to the point where they denature and this creates a healing response where new collagen is deposited, which in turn then tightens. When we treat an entire face with the Ultherapy device, we will do upwards of 8000 small thermal injury zones where new collagen is going to be deposited and each zone will create a small amount of tightening. When these are all added together, we get brow lifting and cheek lifting and improvement in jowls and laxity under the chin. In my opinion, the results are similar to other devices such as laser resurfacing or even surgical results in that the tissue heals and now we start the aging process from a new reference point so, in effect, the patient that undergoes an Ultherapy treatment will always look better than if they had never undergone a treatment, but they will eventually age out of the improvement that was obtained.
Question: I read recently that Botox can be used to treat hyperhidrosis. How effective is it as a treatment, and does your office offer these services?
Answer: Botox can be extremely effective at reducing sweating in patients that have hyperhidrosis and it is most commonly injected into the armpits, palms, and/or soles of the feet; however, at Quintessa Aesthetic Center, we provide services for cosmetic reasons and if the patient desires the Botox injection for hyperhidrosis to be paid for by insurance then I would recommend that they see their dermatologist. If they are interested in paying for this treatment as a cosmetic service then we can certainly provide this service for them.
Question: I am a woman in my fifties with small wrinkles in my neck. Could Botox be used to fix this?
Answer: It is very doubtful that Botox is going to be able to help small wrinkles in your neck and more than likely a procedure such as a mini lift or a formal facelift may be the best option for you. If you are more interested in a nonsurgical modality then I would recommend the Ultherapy device, which uses micro focused ultrasound to create new collagen deposition which can tighten and lift the tissues and help reduce laxity and wrinkles.
Question: I have heavy sun damage on the back of my neck and my shoulders. In the future, I will be more proactive about wearing sunscreen but what can be done to improve the look of my neck and back now?
Answer: We can treat the neck and back area with broadband light, which will target the abnormal pigmentation in these areas and help the neck and back look much better. This usually requires a few treatments, but we can use this broadband light in a rather intense way to greatly improve these areas with only a few treatments. Another option would be ProFractional laser treatments, which essentially lasers tiny, little holes in the skin and this healing process causes some new collagen deposition, which tightens the skin and can reduce apparent laxity or wrinkling in the skin. This can be safely performed in areas off the face, but I would highly recommend seeking out someone who has significant experience with this; otherwise, the new Ultherapy device, which uses microfocused ultrasound can also be used on the chest, neck, and back if we are trying to improve laxity in these tissues. A personal evaluation would be necessary to determine which treatment would be the most appropriate and in many of our clients, we perform combination treatments where we will combine broadband light, ProFractional laser resurfacing, and Ultherapy to give them the ultimate result.
Question: I am female, 49 years old, and I have fine wrinkles on my upper chest. I am below average in weight so they are not fat related. I am interested in getting laser skin resurfacing in this area. Does this procedure hurt?
Answer: Laser skin resurfacing on the chest must be performed in a very careful manner to prevent any scarring as this area of the body will not heal in a similar way as the face can. With that said, because we have to be very careful with that skin, seldom can we create any significant amount of wrinkle reduction with standard laser resurfacing. We can; however, treat this are with fractionated laser resurfacing, such as the ProFractional laser by Sciton, which lasers small holes in the skin, but leaves the surrounding skin intact and uninjured and therefore healing progresses very quickly and scarring can be avoided. Because the deeper layer of the skin is treated with this type of a laser we do get significant new collagen deposition, which in turn tightens the skin and creates wrinkle reduction. We have had some pretty significant success combining the ProFractional laser by Sciton with an ultrasound-based rejuvenation treatment called Ultherapy, which uses targeted ultrasound to heat the deeper layer of the tissue, about 3 mm underneath the surface of the skin. The combination of these 2 treatments can provide excellent skin tightening and wrinkle reduction in virtually any area of the body and face.
Question: I am 55 and I feel I look pretty good for my age. Everyone always thinks that I am younger. However, over the past year or so my neck has begun to get really saggy. What are my options for improving the contour of neck?
Answer: Well there are a few options for improving neck contour, one nonsurgical option would be Ultherapy, which is focused ultrasound, which lays down thousands of droplets of thermal energy into the deeper tissue causing new collagen deposition which then tightens and lifts. This creates improvement in the jowls and submental laxity, but overall is relatively subtle compared to surgical treatments. Another option would be an in-office procedure, which I call a mini-lift which is essentially a miniature facelift performed under local anesthesia. Small incisions are made in and around the ear and then the soft tissue of the face is elevated and excess skin is removed. This lifts the jowls and gets rid of the laxity under the chin. A much more advanced and more rejuvenating technique would be a high SMAS facelift with platysmaplasty, which is a very sophisticated facelift technique that not only improves the jowl and laxity under the chin, but also can provide some elevation of the cheek or midface at the same time. This is a very elegant technique that can provide an extremely natural and beautiful rejuvenation of an aging face. Ultimately, I think that you need to seek out a board-certified facial plastic surgeon and hopefully one that can provide sophisticated facelift techniques such as those I just mentioned so that you can ultimately get the result that you desire.
Question: My cheeks droop a little bit. Pictures of me make me appear older than I am. Is fat grafting involved in fixing a problem like mine or are non-surgical procedures used?
Answer: Well, I would either have to evaluate some pictures or examine you personally to be able to determine exactly what the issue is regarding your droopy cheeks, but if it is very mild a non-surgical procedure such as Ultherapy, which involves micro-focused ultrasound that is used to cause soft tissue tightening and lifting could be an option for you. Otherwise, most patients would either go for an injectable filler, such as Juvederm Ultra or Restylane or they may prefer a longer lasting injectable filler such as fat grafting. Another option would be the consideration of cheek implants, which would be a surgical procedure, but would provide permanent volumetric augmentation to the cheek area.