Ultrasound or Radiofrequency: Which is the Best Skin-Tightening Treatment?

When we reach a certain age, it might feel like everything sags. Our jawline softens and jowls sag from the sides of the face. The cheeks flatten and sag. The eyebrows descend downward to the upper eyelids, making the eyes look tired, sad, or angry. Sagging is a very real and very frustrating problem. If you don’t want to undergo invasive plastic surgery, you may feel a bit lost as you try to navigate these changes to your facial structure. Here at Bucay Center for Dermatology and Aesthetics, we have some impressive nonsurgical skin-tightening options, including Ultherapy and RF microneedling. In this post, we will discuss the question of which is best. 

Is “Best” Really the Right Measurement?

Google is inundated with “best” type questions every day. When discussing the value of Ultherapy vs. RF microneedling, this may not be the way to go about it. Something that every person seeking skin-tightening should know is that both ultrasound and radiofrequency stimulate collagen production. It is the prolonged production of collagen that remodels the skin so it becomes firmer and tighter. That said, there are unique benefits to each modality that may make it “best” for a given situation. 

About Ultherapy

  • Affects the SMAS layer of tissue with ultrasound energy. The SMAS is the plane in which plastic surgeons work during a facelift. 
  • Ultrasound therapy has been proven safe through many years of clinical use as a form of imaging. 
  • Ultrasound energy passes through the skin and lands in deeper layers of tissue, which results in zero trauma to the epidermis. 
  • Ultrasound guidance is essential to the success of Ultherapy treatment, as it determines the precise depth of tissue into which ultrasound energy should be deposited. 
  • This technology is designed to achieve profound results in one treatment. In clinical trials, most people noticed significant improvement after one session. Some people may gain the most from two sessions.
  • Downtime is minimal. Swelling, bruising, flushing, and tenderness may fade gradually over a few weeks. 
  • Results build over a few months and can last up to two years. 

About RF Microneedling

  • RF microneedling is a powerful combination of two modalities used in tandem. Microneedling the uppermost layers of the skin provokes collagen proliferation. The delivery of radiofrequency energy through tiny needles enhances the collagen-remodeling effects. 
  • Treatment can be enhanced via the addition of special serums that aid in tissue repair. 
  • Generally, RF microneedling is considered more comfortable than Ultherapy. That said, an experienced provider has ways to mitigate the inherent discomfort of either treatment. 
  • RF microneedling downtime is minimal. Side effects like redness and tenderness may resolve in about a week. 
  • While some degree of benefit is gained after one treatment, it usually takes a series of two to three sessions to achieve optimal skin-tightening effects. 
  • RF microneedling may need to be performed more often as a touch-up treatment than Ultherapy. 
  • The cost of RF microneedling may be less per session, but may be more overall depending on the number of sessions needed to correct tissue laxity.

Both RF microneedling and Ultherapy are available in our San Antonio practice. Contact us to schedule your consultation. 

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“Very comfortable environment, all staff very were very professional, and Dr. Bucay was a delight. She is an artist with the skills and compassion that focus specifically on the clients needs. Dr. Bucay is amazing.”

–Jorie K.


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Talia Noorily MD

A Message from Dr. Bucay: Champions for Change Gala

This year I am honored to join the committee for the Champions for Change Gala, taking place on May 10, 2023 at Ziegfield Ballroom in NYC.

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