Ulthera or Ultherapy for skin tightening and lifting

Ulthera is a face-lift without the surgery. Skin can be tightened and lifted non-invasively with no downtime using focused ultrasound energy.

Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)

Dr. Gavin Chan

Templestowe Lower and Berwick Clinics

Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
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What are Ulthera and Ultherapy?

Ulthera is a device that uses focused ultrasound energy to lift and tighten the skin. Ultherapy, a blend of the words ‘Ulthera’ and ‘therapy’ describes the treatment performed with the Ulthera device. It is a safe non-surgical method to lift and tighten skin without any visible downtime.

How does it work?

Medically, ultrasound is used for a variety of reasons. The term ‘ultrasound’ is commonly associated with pregnancy scans. In these ultrasound scans, high-frequency sound waves are emitted by a handpiece, and the reflections of these soundwaves are recaptured to form an image. Conversely, Ultherapy focuses ultrasound waves to a specific point deep within the skin or beneath the skin. This heats and coagulates proteins that in turn stimulate new collagen formation and tightening or lifting of the skin.  Ultherapy targets the foundational layers of the skin, including the deep dermis and the SMAS layer (or superficial muscular aponeurotic system, the layer that is tightened in face-lifts). This ‘deep heating’ leads to tightening of the skin. There is no visible downtime to Ultherapy treatment as the superficial layers of the skin are bypassed. All of the effects are deep within the skin or beneath it. It is akin to lithotripsy, a procedure that utilises focused ultrasound energy to break down kidney stones for excretion. The ultrasound energy reaches the target (the kidney stone) without disrupting the skin or other structures.

What can be treated?

Utilising the power of focused ultrasound, Ulthera skin tightening can be used to lift and tighten the jaw line, chin, brow, and neck with one treatment. It is not a replacement for a surgical face-lift. Instead, it provides an alternative for those who are looking for a non-invasive treatment to tighten skin and slow the facial ageing process.

In summary, the key benefits of Ultherapy include:

  • Non-invasive nature
  • No visible downtime
  • Neocollagenesis – builds collagen
  • Single treatment 

Who can have Ulthera and what areas can Ulthera treat?

Ultherapy is suitable for most patients concerned about skin laxity. It is most common for those over the age of 35 seeking a lift or tightening, who are not wanting to have a surgical face-lift. It may also be sought by those looking to prevent skin laxity or to slow down the facial ageing process.

The results of Ultherapy cannot be compared to that of a surgical face lift. The results are not as dramatic or visible, and hence this procedure is only suited to those looking for subtle changes. It does not replace a surgical face lift. Instead, it provides an non-invasive alternative for those looking to subtlely fight the progression of skin laxity.

Ulthera works on mild to moderate skin laxity where the skin begins to feel and look less firm. Common areas to treat include loose cheek skin and jowls, sagging under the chin, loose skin on the neck, the forehead to lift lowered brows, and lines or wrinkles on the chest.


The Ulthera procedure stimulates collagen production by delivering focused ultrasound energy to the skin’s foundation layer, typically addressed in cosmetic surgery,  without cutting or disrupting the surface of the skin.

Ultherapy utilises focused ultrasound waves in precise areas from the dermis down to subcutaneous tissue causing thermal coagulation points (TCPs). Thermal coagulation occurs when heat is generated at the site of the collagen, heating to temperatures of 60 – 70 degrees celsius. Intense vibrations are caused at a cellular level, the friction of this leads to heat formation at the localised site, thermal coagulation points. During an Ulthera treatment there are approximately 1600 thermal coagulation points precisely placed into well-defined areas and depths of the skin.

How does heat make my skin tighter?

As we age our collagen begins to loose it’s shape, much like our favourite pants that were once well fitted and now a little saggier around the buttocks and knees. As the shape of collagen begins to change, the foundations on which our skin is supported becomes uneven and lax, this allows for the skin to sag and wrinkles begin to form. When collagen is heated, between 60 and 70 Degrees Celcuis, multiple processes occur to the collagen fibers resulting in tighter and more lifted skin:

  • The heat disrupts and break the bonds holding the collagen fibers in their shape, these are hydrogen bonds. This, like stretching and releasing a spring, allows the collagen fibers to contract, returning it to it’s original tight shape.
  •  A process called neocollagenesis occurs. This refers to the process of new collagen formation. The body registers the TCPs as an injury site which initiates the natural healing response. This response involves tissue repair and creation of new collagen.
  • Reorganisation and cross-linking of this new and existing collagen also occurs at the TCP sites, giving the skin increased elasticity properties and greater resistance to physical stress to the skin.
  • Inflammation from the ultrasound heat triggers a secondary natural response, the release of a specialty cell that comes along to “mop up” any damaged tissue, this specialty cell is followed by fibroblasts. Fibroblasts are responsible for the creation of more collagen, replacing anything that is mopped up with new, tighter collagen.

The Ultrasound energy is delivered between 1.5mm and 4.5mm into the skin’s dermis, ensuring tightening through the deepest layers of the skin to provide long lasting results. Ultrasound imaging guides the practitioner throughout the procedure over the sections of face to be treated. Allowing the different depths to be identified and correctly treated.

Unlike skin laser and surgical procedures, Ulthera bypasses the upper layers of the skin to deliver the right amount of ultrasound energy at the right depths and the right temperature. 

Marking the face with grid lines to guide the treatment is the first step. The treatment handpiece is then systematically passed over the treatment areas. Each position is held for a few seconds to allow the handpiece to fire multiple focused ultrasound points along the skin in a linear fashion. Depending on the area treated, a different number of lines are fired. Usually, 800 lines are fired for a full face treatment. Different levels of the skin are targeted with different handpieces to get tightening at different levels.

One of the main concerns with Ulthera treatment for our patients is the level of discomfort. It can be a painful treatment for some, especially the deeper penetrating handpieces. We do offer nitrous oxide or laughing gas to help alleviate discomfort from the procedure. Numbing cream is not effective for this procedure as it does not penetrate deeply enough to provide anaesthesia for the treatment.

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How long before I see results?

Initial tightening of the skin can be seen immediately after treatment, much of this, however, is from the inflammation caused by the heat. True results appear over 2−3 months as the new collagen formation needs to mature. As maturation occurs collagen is realigned to provide a smooth and well supported foundation for the skin’s surface.

While Ulthera cannot duplicate the results of a facelift, it’s a clinically proven non-invasive alternative for those not ready for surgery.

How long it takes

This will depend on how many area’s you are having treated. The practitioner will carefully mark out your face and systematically treat the desired areas. Commonly treatments take 1 – 1.5 hours in clinic.

Will I need time off work?

After your treatment you will be able to go back to your normal activities. Your skin might appear flushed at first, but the redness should disappear within a few hours. Some patients experience mild swelling of the treatment area or tingling or tenderness to the touch. These are mild and temporary effects.

The first step on your Ulthera journey is to book a consultation, your practitioner will address your concerns, assess your skin and determine if Ulthera is right for you.


ulthera before and after

This patient presented to Victorian Cosmetic Institute wanting the skin on her lower face and upper neck to be tightened. She has noticed that over the years her skin in this area has increased in laxity.  She has started to notice shadowing in her jawline when she catches her reflection or see recent pictures of herself. This picture is is 3 months post Ulthera treatment and will continue to see improvements over the next couple of months. The patient made the following remarks about her treatment to Dr Gavin Chan.

“I am so pleased and cannot thank you and Lisa enough. The results so far are incredible!”

“The definition along my jawline is fantastic”


This patient presented to Victorian Cosmetic Institute for Ulthera treatment to reduce her jowls and to tighten her jawline. This after photo was taken 1 month post treatment. Further improvement will be seen over the next few months.

ulthera before and after

Prices for Ultherapy are listed here;

Prices for skin tightening treatments.

Firstly, there are many clinics who purport to provide Ulthera, but in actual fact do not use the original machine. We use genuine Ulthera machines purchased from the Australian distributor. There are other brands of similar machines using high intensity focused ultrasound which are not the same as Ulthera.

Secondly, our practitioners follow strict protocols for treatment, including the number of lines fired for a given area of the face or treatment area. It is a treatment that our practitioners perform regularly.

Thirdly, we provide analgesia if required. As numbing creams do not penetrate deeply enough to provide anaesthetic for the procedure, we do have the option of offering our patients nitrous oxide (laughing gas) for the procedure should they require it.

Making that first phone call about any cosmetic procedure can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.

Otherwise, you can phone us directly on 1300 863 824.

Dr. Gavin Chan
Dr. Gavin Chan

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