Dr. Rotskoff

“You know when you pull your hair back in a ponytail, and everything just looks a little better? That’s what I was after. Nothing severe, just a slightly younger, more lifted look,” says a 59-year-old Webster Groves woman. Not wanting to undergo surgery, she turned to Dr. Kenneth Rotskoff at the Ultherapy Center of St. Louis.

Ultherapy is a noninvasive cosmetic procedure that uses ultrasound to deliver energy exactly 4.5 millimeters below the skin’s surface. Without damaging the skin, the deeper tissue layer is heated, causing it to contract and stimulating new collagen formation. “This is same level of tissue we operate on when doing a facelift,” Rotskoff says. “When patients are finished in an hour or so, they can go home, put on makeup and go out.”

In fact, the particular patient interviewed for this article says she went to lunch with her daughter after her ultherapy treatment. “I don’t like to go to doctors or dentists, but this wasn’t bad at all,” she says, noting that after a local anesthetic was administered, “All you feel is something moving across your skin.”

Rotskoff notes that the anesthetic eliminates pain during the procedure, and patients may feel their muscles are slightly tender to the touch for a day or two. “We’re creating a heat injury to the tissue, so that the injured collagen is absorbed by the body and repaired. New collagen is created over the course of two to four months; and after it’s made, it organizes itself and contracts to give lifting of the skin,” Rotskoff says.

Two months after the procedure, Rotskoff’s patient reports a noticeable improvement. “I think I look better,” she says. “And I should continue to look even better for the next couple of months.”

Ultherapy is not a permanent anecdote to natural aging, but Rotskoff notes that some patients add Botox and fillers to the procedure to create an even more dramatic result. “People need to have realistic expectations,” he says. “This is not the equivalent of a surgical facelift. But it can give you probably 50 percent of a surgical result.”

And that suits this patient just fine. “If I still feel pleased over time, I’d consider doing it again,” she says. “I want to look as good as I can—but no knives.”

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