The Truth About Ultherapy: Updated Treatment Review

(Updated, July 2025 by Alice Hart-Davis)

I’ve just updated this article on Ultherapy and the controversy around it because this post, and the accompanying video, have had so much interest. My views on the treatment haven’t changed, the technology is still hugely popular – AND there is now a new version of the technology called Ultherapy Prime, which some of you have been asking about, so I’ve added that in here. Also, there is still widespread concern about whether this treatment ‘melts fat in the face’. Read on for the latest version. 

I get lots of questions about Ultherapy – a non-surgical treatment that uses focused ultrasound to tighten and lift the skin (and yes, I’m aware that ‘lift’ is a contentious word in aesthetics, but Ultherapy has FDA clearance for lifting the skin on the brow, neck and under the chin, so…). I’ve also filmed a video (which is over on my YouTube channel and further down in this post), talking about why it is seen as a controversial treatment, whether it hurts as much as people say it does, and why I like it. This video is from 2018, but my views still hold: this is a great treatment, as long as it is in the right hands.

The controversy bit

It doesn’t take much Googling to find people saying things online like ‘Ultherapy melted my face’. Not what you want to hear about a treatment you might be considering for facial rejuvenation! Merz, the company behind Ultherapy, says any treatments that gave this sort of result were not done with genuine Ultherapy machines. Is that too glib an answer? Like most people I tend to think there’s no smoke without a fire, but the practitioners who do a great deal of Ultherapy say absolutely not – you get no problems if you follow the treatment protocols and, obviously, use genuine machines (Counterfeiting is as much of an issue in aesthetic medicine as in any industry.).

Yes, ultrasound energy can melt fat

In the past few years, there has been increasing awareness of how energy-based devices can reduce fat beneath the skin. Whether that energy is radiofrequency, RF needling or ultrasound, if it is aimed into the fat layer beneath the skin, it certainly has the power to melt it. So, if practitioners are looking to stimulate collagen with Ultherapy, they need to use the visualise tool – which shows at what depth in the skin they are working – with great accuracy.

On the other hand, if you actually want to reduce fat in the face, this can be helpful and some practitioners use Ultherapy specifically for this purpose. ‘ I would only use Ultherapy for fat reduction using a 4.5mm and 3mm transducer on lower face and chin,’ says Dr Jinah Yoo. ‘I would use other devices for collagen stimulation; different ultrasound-based energies can give different results but I would mainly use Ultherapy for fat reduction.’

Caption: With Esther Loughran, a leading aesthetic nurse who has been doing Ultherapy for years.

What is the new ‘Ultherapy Prime’?

Just launched in spring 2025 in the UK, Ultherapy Prime bills itself as a more advanced skin tightening and lifting treatment than ‘normal’ Ultherapy, though tbh, I’m slightly struggling to see the difference. To be sure, the new device has a larger visualiser screen, which I’m told gives a clearer view of the layers of the skin, and can show deeper layers of the skin with greater precision, but apart from that?

‘In my humble opinion, it’s identical – in a new box,’ says Dr John Quinn. ‘Having had Ultherapy for a decade, it is still one of my favourite treatments and we use it in clinic every day, though I can’t say I see any difference with the new machine. The transducers which deliver the energy are actually identical. They haven’t changed the physics of how the treatment works, so it simply can’t be different.’ His favourite trick with Ultherapy, by the way, is to combine it with Morpheus8. Wowsers. Or maybe Yeowzers – neither treatment is exactly comfortable. But Dr Quinn says they work a treat together. ‘I like the precision of the micro-focused ultrasound that Ultherapy produces, and I like the improved skin quality that Morpheus8 gives,’ he says, unrepentant. So now you know.

Does Ultherapy really hurt that much?

It’s not the most comfortable treatment but it’s not intolerable, particularly not now that clinics offering the treatment provide decent pain-management protocols, which may involve diazepam as well as ibuprofen and paracetamol. (I go into this in more depth in the video). The first time I tried Ultherapy, it was more uncomfortable, but that was with the first version of the machine, which used a much higher intensity of focussed ultrasound (I wrote about this Ultherapy experience back in 2013). The newer version of the treatment is definitely more tolerable. In the video, you can see I’m not flinching or wincing; I had ibuprofen and paracetamol to take the edge off the pain, but not the diazepam which was offered because a) I was cycling home and b) I had a speaking engagement later that day so needed to keep my wits about me.

Why do I like Ultherapy?

Because it works. I’ve tried the treatment three times (in 2013, 2015 and 2018) and each time have seen the instant tightening effect that you get (small yet noticeable). But, what really brings the improvement is the way the collagen in the face is boosted and remodelled over the next few months after treatment. It really does seem to be helping my neckline, which otherwise would be going south with age. I’ve only tried it on my face and neck, but I know practitioners are using this technology to tighten up saggy tummies and knees, too.

Other pros and cons of Ultherapy?

It is expensive – at around £3,000 for the whole face – but then it’s a one-off treatment that should keep you going for 18 months. Also, people who take a ‘no needles’ approach to face-maintenance can just about square this with their consciences.

There are a couple of similar treatments using focussed ultrasound. I haven’t tried a full course of HIFU (high intensity focused ultrasound); many practitioners love it, though I’m wary of the way the practitioner has no way of knowing precisely which layer of skin or fat the energy may be hitting. Fine if you want skin tightening and/or a bit of fat loss, but if you’re hanging onto facial fat for all you’re worth, I’d give it a miss.

I have tried Ultracel (with Dr Sarah Tonks at The Lovely Clinic) which combines ultrasound treatment with radiofrequency treatment (for a shrink-wrapping effect on skin collagen). This was much more comfortable than Ultherapy, but then it may have been on a lower setting, and it did again gave an instantly visible result. Here’s a video about Ultracel with Dr Rita Rakus, if you’d like to know more.

I have more recently tried Sofwave, in 2022, which showed me a visible result – here’s the article and video about my Sofwave treatment.

I had my 2018 Ultherapy treatment with Esther Loughran at The Cosmetic Skin Clinic. Esther has been working with Ultherapy for years so she is a very safe pair of hands, and the Cosmetic Skin Clinic has for many years running won the award for being the #1 clinic for Ultherapy in the UK and Ireland. Take that as your reminder that you should only book in for Ultherapy with a skilled and experienced practitioner. You can find one near you on our practitioner map.