Ulthera, Ulthera, Arcadia Plastic Surgeon Dr George Sun


One Session Non-Surgical Skin Tightening Treatment


Non-surgical face lifting refers to skin tightening technologies which tone, lift, and contour the face and neck without surgery. These technologies can re-build collagen, condense unwanted fat, and tighten the superficial muscular layer of the skin. Specifically, these technologies tighten loose skin on the brows, eyelids, the jowls and neck, and under the chin.

Fundamentally, all skin technology uses focused deep heat to achieve skin tightening. Currently, there are three ways of achieving the skin tightening: laser, radiofrequency (RF), and ultrasound. Each modality targets different depths of the skin, emits different type of heat patterns, and thus produce different clinical benefits for different conditions.

Commonly, combination of laser, radiofrequency, and ultrasound produce faster and better results. And further combining with botox and fillers create the best overall results.

Ulthera deploys highly focused, precise ultrasound energy to tighten and lift the skin.

This treatment stimulates collagen of superficial, medium and deep depth, and tightens the fibromuscular fascia of the skin.
Correctable conditions include early stages of saggy brows, crow’s feet, droopy cheeks, nasolabial lines, saggy jowls, double chin, upper neck laxity, lower necklines, and texture.

As the more costly option, this program is particularly suitable for thick or thin skin, heat-tolerant, wrinkled individuals who desire one single session to receive the best results.

1. one time treatment
2. Multi-layered tightening targeting all different skin depths
3. Penetrate more deeply than Lasers
4. Target multiple skin depths than radiofrequency alone
5. Appropriate for heat tolerant individuals
6. More economical solution than surgery

1. Thick or thin skin
2. Saggy brows
3. Nasolabial lines
4. Saggy jowls
5. Neck laxity

1. Patients with realistic expectation
2. Patients in good healthy conditions
3. Stable weight without frequent or excess weight gain or loss

1. Patients with unrealistic expectation
2. Patients with low blood sugar, dehydration, acute disease, autoimmune disorder, blood disorder, cancer, or on bleeding thinning medications.

The whole face and neck are treated.

For the ultrasound, the targeted areas for contouring and lubricated with gel. While imaging the skin layers, transducers are then applied onto the skin to emit highly focused and precise sound energy to the medium and deep depths of the skin. Multiple passes are performed in a directional lifting manner. Heat sensation will be felt.

Generally, a single session treatment is required.

The treatment takes about a hour in an outpatient clinic setting

Oral anesthesia may be used.

1. Better brow position
2. Smoother crow’s feet
3. Lifted jowls
4. Tighter upper neck
5. Smoother lower neck lines

The number of shots for ultrasound will vary around 650, while the time of radiofrequency lasts about a hour. The energy targets only the necessary areas of thick collagen and fribromuscular layer. Areas with thin collagen or absent fibromuscular layer will often further flatten down with heat energy and thus intense energy to the deep depth to these areas is not needed.

The short answer is “yes” for areas where one wants flattening. The answer is “no” for areas where one does not want loss of volume.

For these areas which excess plumpness or volume is not desired, more energy via more pulses, shots, or lines to these areas will flattening the areas down.

Areas where plumpness or volume is not desirable and thus enhanced energy may be warranted include:

  1. lower cheeks
  2. nasolabial prominence
  3. jowls
  4. double chin.

For areas which plumpness or volume is not desired, more energy via more pulses, shots, or lines to these areas will actually decrease the flattening the areas down, and produce more hollowed appearance.

Areas where plumpness or volume is to be maintained and thus excessive energy is not warranted include:

  1. Forehead
  2. Temples
  3. upper cheeks

With combination technique, both ultrasound and radiofrequency energies are performed, all on areas where flattening where contraction is desired. Combination results are better than single modality ultrasound or radiofrequency alone.

Thus, where the skin tightening is targeted affects the aesthetic outcome and can either rejuvenate or age your look!

Does skin tightening with a single modality of laser, radiofrequency, or ultrasound provide the best skin tightening result?

The short answer is combination technique, not single modality, produce the best results.


  1. focused columns of superficial heat energy, with gaps of no energy between columns
  2. targets superficial collagen


  1. uniform, radiant, circumferential, wavelike heat without gaps
  2. targets deep collagen and fat more comfortably


  1. focused columns of deep heat energy, with gaps of no energy between columns
  2. targets deep collagen and muscle with intense heat.
  3. While ultrasound can also be used for fat, monoploar radiofrequency provides far more uniform heat for better fat reduction.

The efficacy of skin tightening depends on:

  1. Levels of heat: superficial heat(superficial collagen), deep focused heat(deep collagen and muscle), and deep radiant heat(fat contraction).
  2. Amount of heat
  3. Sessions of heat
  4. Combined treatment with other modalities such as laser, radiofrequency, botox, and fillers.

The results will be seen gradually within two months. After the swelling subsides with few days, the results will look more and more natural.
Results long one year or more. Duration of effect is similar regardless of sessions of treatments, but the magnitude of change will be determined by the number of sessions.
Additional maintenance is required.
Healthy eating and exercise are helpful to enhance results.
Further treatment may be recommended to further results
Recovery lasts one day.
Mild redness, swelling, pain, and occasional tingling are expected.
Prescription pain medications are generally not necessary.
Most people return to work and activities in one day.
Cost of treatment options ranges from three to four digits. An in-person consultation with your specialist physician will help to determine the best suitable solution to your own individual needs.