Q. Is Ultherapy vs. Silhouette Lift vs. Sublime laser better to tighten midface/jawline? I am considering Ultherapy vs. Silhouette Lift vs. Sublime laser to tighten slightly saggy cheeks that have also lost some volume and tighten my jawline. I am 5’5″, 127 pounds and have a low tolerance for pain which is why I’ve resisted Ultherapy. Which one of these treatments lasts the longest?
A. Your perception has been heard. I believe that most “laser” tightening procedures fail because the patient cannot tolerate the pain and so the peak temperature required to obtain tightening is not reached; then the patient does not complete the number of sessions required. “Laser” penetration of the powered device (laser, ultrasound, RF, etc) must reach a dermal temperature where the collagen is heated causing shrinkage and damage for the skin to contract and a controlled inflammatory response of secondary collagen formation. This flash-of-power hurts.
Options include other collagen inducing and skin contracting procedures like:
- Retinoids topically
- ThermiTIGHT which is performed under the skin, with a radio-frequency, gradually elevating temperature controlled probe with local anesthetic.
- Use of dermal and sub-dermal PDO and PLLA injectable threads such as EuroThreads. Silhouette InstaLift is also a dissolvable thread used in the deep subcutaneous layer to lift the fat and soft-tissues and its collagen inducing effects are not expected to reach the dermis.
So, totally different modalities for different effects. Surgery lasts the longest and minimally effects skin texture. I recommend EuroThreads at the dermis and SMAS.
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