Ulthera non-invasive skin tightening

Merz Aesthetics is now distributing Ulthera, an effective technology for non-surgical skin lifting.

It was conceived in the laboratory labyrinth of Harvard Medical School, in the Wellman Center for Photomedicine – or the “mecca” of cosmetic medicine, as US facial plastic surgeon Dr Matthew White calls it.

Ulthera, distributed by Merz Aesthetics, is a non-surgical device that uses microfocused ultrasound energy to target the Superficial Muscular Aponeurotic System (SMAS), without harming the overlying skin. The system has been shown to non-invasively lift the eyebrow, neck and sub-mental areas, and can also improve lines and wrinkles in the décolletage and neck.

“Ulthera was the first system
to non-invasively deliver energy directly to the SMAS,” explains Dr White, who was recently in Australia speaking at a series of launch meetings for Ulthera. Dr White was also the lead author on the first article ever published in medical

literature on Ultherapy. “The different transducers of Ulthera can target the deep dermis and superficial dermis, causing thermal coagulation and stimulating the activity of fibroblasts at the treatment site.”

Treat all skin types with Ulthera
Ulthera is unique in the way it delivers energy to specific layers in the skin. Unlike traditional energy- based systems, where greater energy delivery is achieved by upping the intensity on the skin’s surface, Ulthera uses cross beams of ultrasound energy to precisely heat tissue at three discrete depths (1.5, 3.0 and 4.5 mm).

Studies^1,2 have shown that treating the face at 4.5 mm contracts the SMAS and platysma layers, resulting in a non-invasive lift without affecting the skin’s surface.

“The energy is delivered using two ultrasound beams. At the meeting point of these beams (the coagulation point) the optimum temperature to denature collagen is reached,” Dr White explains. “This is achieved while completely avoiding the epidermis and melanocytes – Ulthera is essentially colour blind.”

A clinical study³ has shown
that collagen contraction and denaturation are optimised at temperatures between 60 and
70 degrees Celsius. This causes aggressive neocollagenesis4. The Ulthera System reaches these optimised temperatures (around 68 degrees Celsius) at depth, without causing surface effects.^1,2

The discrete spacing between the thermal coagulation points also helps to promote healing post- treatment⁴.

Ultrasound imaging to assist treatment

Ulthera’s real-time subcutaneous ultrasound imaging allows clinicians to control exactly where energy will be deposited, and avoid structures such as bone and major vessels. “The ultrasound imaging allows you to view exactly what you’re treating, before pressing the fire button,” Dr White explains. “It shows the relative thickness of the dermis and the subcutaneous fat layer, and also helps avoid bone and vessels during treatment.”

Treatment with Ulthera
Typically, one treatment with Ulthera is all that’s necessary to see results, making it a valuable stand-alone treatment and a powerful adjunctive procedure for any cosmetic clinic.

“I often use Ulthera six months to one year after facelifting surgery to maintain and extend the longevity
of the surgical result,” Dr White explains. “Ulthera is an effective combination procedure – with surgical and non-surgical treatments – because it really changes the biology of the skin.”

“Another, major group of patients are those in their 20s to 30s who are looking to ‘bank collagen’ and slow the process of ageing,” Dr White explains. “90 per cent of these patients are after a full face and neck treatment. Others are looking to correct certain areas – for example, counter heavy brows or lift the eye area.”

The nature of Ulthera’s delivery system means it can effectively lift the sub-mental area and jawline. This can carve your practice an effective niche in today’s cosmetic market, as Dr White explains.

“In the US, Ulthera has been cleared by the Food and Drug Administration for lifting under the chin, it is also cleared by the

Therapeutic Goods Administration in Australia” Dr White says. “Ulthera’s capacity to lift the submental area caters for a surprisingly substantial niche of patients of all ages, who are specifically concerned about the neck and jawline.”

According to Dr White, results from Ulthera treatment take three to six months to appear and will last between one and five years, depending on the patient.

A trusted investment

There have been 47 clinical studies on the efficacy of Ulthera performed since 2010. The technology is evidence based, and the ongoing research and development behind the system means each year, new indications for treatment are put forward and approved.

“I originally purchased the device as the market was crashing in
the US several years ago, I was impressed by the physics and

the number of elements that are ‘industry firsts’ in this technology,” Dr White explains. “As a non- surgical treatment, with effective results and no downtime, the Ulthera has proved a huge help to my practice. Ulthera patients are often so happy, they will convert to treat treatment with fillers, anti-wrinkle injections and even surgery. As well as this, Ulthera has complemented my facelifting practice, not replaced it.” AMP

1. White, W. M et al. Arch Facial Plast Surg, (2007). 9(1): 22-9


2. Alam M et al. J Am Acad Dermatol 010; 62(2):262-9.

3. Bozec L & Odlyha M. Biophys J 2011; 101 (1): 228-36


4. Brobst R et al. Facial Plast Surg Clin N Am 2012; 20(2): 163-176

Merz Australia Pty Ltd (ACN:
151 073 559) Sydney, Australia. ULTHERA is a registered trademark of Merz Pharma GmbH & Co. KGaA. Copyright ©2015. Merz Australia Pty Ltd.
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