Interviewer: What is Ulthera and can you explain how it works?
Dr. Samlaska: Ulthera aesthetic ultrasound is essentially a non-surgical facelift technology using focused ultrasound. Ultrasound is basically soundwaves.
We’ve used ultrasound for years to look at deeper structures. For example, it is used during pregnancy to visualize a developing fetus to analyze the reflection of soundwaves through tissue.
So, Ulthera technology focuses those soundwaves into discreet, channeled areas— .7 millimeters wide by about 1.2 millimeters long—which causes thermocoagulation (using heat produced by high-frequency electric current to bring about localized destruction of tissues) of the deeper tissues.
With Ulthera ultrasound, we can actually see those layers and treat them directly. For example, the SMAS layer is the area of muscle features of the face (Superficial Musculoaponeurotic System) is where plastic surgeons will cut down to and undermine that, lift it, pull it up, and then hang it on your ears. That’s essentially what a facelift is.
Ulthera is very discreet—done in a line of 20 little thermocoagulation points.
The rest of the interview can be watched at the end of this post.
We use an instrument called a transducer. The oblong head puts down 20 little dots focused into deeper structures. We place it up against the face so that we can lay down those lines and do a nice formatted mesh pattern what essentially shrink-wraps—it just brings everything back to where it was.
Interviewer: You mentioned ultrasounds when looking to see a fetus. How is this type of ultrasound different than that? Is it more directed? Do pregnant women who get an ultrasound lose wrinkles on their belly? Without getting too deep into the science and technology that I probably wouldn’t understand anyway; can you explain how Ulthera is a different kind of ultrasound?
Dr. Samlaska: Well, it’s focused. The soundwaves in a regular transducer that is used to look at a fetus are blasted down in a linear pattern. The Ulthera transducer focuses those soundwaves into a channel which is focused right at the point of interest, right where you want to do the treatment. So in some ways it’s kind of like a CAT scan. A CAT scan is focused into a pattern to analyze tissue.
Interviewer: What kind of results can someone expect to get with Ulthera? How fast will they see results? I know it’s probably hard to measure, but are lines visually just gone and does the treatment last for a long time?
Dr. Samlaska: Well, we’re effectively treating connective tissue, so tissue remodeling occurs. The patient will see ongoing contraction and improvement over a number of months, it can even last a couple of years. They see immediate improvement because thermocoagulation causes that tissue to crack immediately. It does work very well. We use it to do brow lifts, forehead lines, cheek wrinkles, and even to treat the neck down to the clavicle. We also use this technology to treat other areas of the body such as getting rid of slackness under the arms, etc.
Interviewer: You said patients will see results immediately—will they also experience any side effects immediately?
Dr. Samlaska: Sometimes there might be a little pinkness to the skin. That’s the main thing, and that lasts for a few hours. It usually goes away pretty quickly.
Interviewer: So Ulthera is nonsurgical; no cutting, no scars, no blood, no pain?
Dr. Samlaska: Well, we are treating skin tissue, so I have developed a technique of doing pain blocks. I put a bead of anesthesia along the jawline and around areas of bone where the most discomfort can be. I do an infra-orbital block too—it’s the same kind of block that a dentist will do, so the upper lip gets pretty numb. I also put a little bit up on the forehead to block those main nerves. Patients can really be quite comfortable with the treatment when they’re blocked.
Interviewer: Last question, Dr. Samlaska—obviously you can treat any age. Is there an age group where you might advise a patient to wait a little longer because their face will be changing, or does that even matter?
Dr. Samlaska: Well actually, the younger they are, the better the results, because then the tissue is more elastic and responsive to this kind of therapy. When the skin loses elasticity into age 70s and 80s, a lot of the elasticity is gone, so the degree of improvement isn’t as good. I think that goes across the board with most cosmetic interventions, other than fillers.
Interviewer: So anyone can do Ulthera treatment and most everybody will probably get some improvement from it. Is there a targeted age group such as 40-50, 50-60?
Dr. Samlaska: Yeah, 40, 50, 60, we’ve even done the procedure in 70-year-olds too, but usually that 40-50 year age group is the best. I have created a two-part video for anyone who wants to know more technical information about Ulthera.