Expert Doctor

Ulthera and Sculptra

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Perry Liu, MD

Beverly Hills, CA

Ulthera and Sculptra

There are three main categories of non-invasive facial treatments for patients who are looking to turn back the clock.  The first is Botox, or comparable muscle relaxant, which is used to treat wrinkles that are formed due to muscle contraction and facial movement.  The second category involves fillers such as Restylane, Juvederm, Radiesse, and Sculptra, which serve to replace lost facial volume that result from age and fat atrophy of the face. Finally, the last category involves non-surgical skin tightening, through procedures such as Ulthera that use ultrasound energy and heat to stimulate collagen production and tighten skin.  These treatments help patients look years younger by restoring lost facial volume, tightening loose skin, and relaxing the facial muscles.



Sculptra is a filler that naturally restores facial volume by stimulating the growth of the body’s own collagen to restore facial volume lost with age. This type of non-surgical rejuvenation treats natural signs of aging such as sunken cheeks, depressed skin, and even deeper lines or wrinkles.  Sculptra eliminates some wrinkles and fills out the hollow areas of the face by restoring volume which is needed to stretch out the skin.



Sculptra restores patients’ own natural collagen, producing results lasting longer than more traditional fillers such as Restylane and Juvederm.  Restylane and Juvederm are temporary fillers where volume comes from the product itself and is not the result of stimulating collagen growth. Radiesse is similar but has crystals derived from calcium hydroxyapitate particles, which stimulate very limited biological collagen production.  The degree of stimulation cannot compare to Sculptra, which stimulates collagen growth in sufficient quantities and restores lost facial volume using only the body’s own tissue, without the help of plant or animal-derived substances. Another difference between Sculptra and chemical fillers is that while traditional fillers offer immediate results, results generally last only 7 months to a year whereas Sculptra can last at least 2 to 3 years.  

Sculptra also produces better aesthetic results.  Chemical fillers may look stiff and unnatural, especially when patients animate their expressions.  Patients who touch their face are often able to feel injected product after receiving traditional filler, whereas with Sculptra, patients do not feel any foreign material in their face. They also notice their face is more dynamic and natural to the touch.



Sculptra is a much more cost-effective option because patients benefit from greater volume restoration for the same price than they would with traditional fillers.  Since patients are able to grow their own collagen, they receive the same benefit from just 2 or 3 vials of Sculptra that they would from 10-12 syringes of Radiesse or Juvederm.  With those Hyaluronic Acid fillers, patients end up paying more in the long run for multiple treatments to maintain their results.



Doctors’ preferences have changed over time since Sculptra was introduced to the market. Two significant differences that have developed are the way doctors dilute Sculptra and how long they premix the formula before they inject it. When Sculptra treatment was first introduced, there were more complications than there are now since doctors had not yet found the best way to refine using the product.  As doctors gained experience with the product, they discovered they could reduce side effects by adjusting dilution techniques to prevent side effects such as clumping or granuloma formation.

It is important to find a doctor who is very comfortable with the technique of injecting Sculptra. The more experienced and skilled the physician is, the less likely it will be for a patient to have an adverse result and be dissatisfied with their treatment. Treatment using this product requires special skill and is very technique-dependent.  It is important that a patient sees a board certified dermatologist or plastic surgeon who is experienced in using Sculptra for facial volume restoration and rejuvenation.



After the treatment, patients will not feel pain but they may feel some soreness and may notice a tightening sensation in their face which may last for several weeks.  After each treatment session, the face will be a little swollen and this will last 2-3 days. After that, it will look as if the patient did not have anything done. The swelling will not be awful looking. In fact, most patients like this look and wish the swelling would not go away. Once the swelling goes away, the face slowly fills in over the next 4-6 weeks as collagen is stimulated and regrows on its own.  



There are two major non-invasive facial rejuvenation devices that restore volume. Thermage is a radio frequency device that works by administering heat to the patient’s face where there is loose skin, in order to stimulate collagen production. Ulthera is a similar procedure that uses an ultrasound device that provides a stronger and more powerful source of energy.  It is more effective in penetrating the layers deep beneath the skin and also easier to adjust the energy being implemented by the device to target the most appropriate areas.

Laser therapy can be an effective treatment, but it is more invasive.  With laser treatment, there is greater risk of penetrating and damaging the skin.  A patient may run the risk of having post-imflammatory hyperpigmentation of the skin from these treatments. Radio frequency and ultrasound devices are the only non-invasive procedures for collagen build-up and skin tightening.  However, of the two, Ulthera is the preferred method since it uses ultrasound which is a stronger energy and provides deeper penetration.



There are no real side effects other than occasional muscle soreness.  There may also be a tightening sensation in the face, which can last for several weeks. During the treatment, patients will feel some heat and prickly pain, which may be somewhat uncomfortable, but never unbearable. Immediately after treatment, patients will not feel any pain but may feel some soreness. A tightening sensation in the face is a sign that the procedure is working the way it was intended. The patient can usually feel when the treatment is working even before the results become visibly noticeable.



Thermage and other procedures that use radio frequency devices often require multiple treatments.  Although patients may see immediate benefits, the results are more transient with patients going back to the way they were only a few months after the procedure.  

Patients will still see an immediate result after Ultherapy, but the result may not be as dramatic at first since it takes about month or two to naturally build up collagen and tighten skin and deep facial tissues.  However, with Ultherapy, patients are able to maintain their appearance for up to a year and a half after only one procedure.



Patients can achieve an even more natural and youthful look by combining Ultherapy with Sculptra.  Some Sculptra patients will still have some looseness of the skin as a result of not being able to restore enough volume.  However, this can be corrected through Ultherapy which will tighten the skin on top of the restored volume. This combined procedure also helps to reduce or eliminate wrinkles which result from too much sagging.



Both Sculptra and Ulthera are effective anti-aging treatments that cost comparatively less than similar non-surgical facial rejuvenation procedures and require fewer treatments.  When combined, the results are synergistic and will make the patient look younger and more refreshed than they thought possible. Most importantly, they deliver longer lasting results that look more natural since they stimulate growth of collagen, which allows the body to regenerate its own tissue, restore facial volume, and tighten saggy skin.


Written by Cosmetic Town Editorial Team

Based on an exclusive interview provided by Dr. Perry Liu of Pacific Aesthetic Institute in Beverly Hills, CA.