SMAS lifting Ulthera therapy

What Is SMAS Lifting and Why Does It Work Deeper Than Other Treatments?

SMAS lifting is a cosmetic procedure that provides a non-surgical facelift using a modern ultrasound device.

During a classic lifting procedure, the depth of impulse penetration is 1.5 mm, involving only the skin and the upper layer of fatty tissue. Ulthera lifting reaches much deeper layers — up to 4.5 mm. This helps improve muscle tone, stimulate the production of elastin and collagen, and achieve a rejuvenating effect.

Previously, similar procedures could only be performed through surgery. Today, age-related and expression wrinkles can be effectively reduced, facial contours can be reshaped and defined, and the overall condition of the skin can be improved using non-invasive technologies. At LeoDerm Medical Center, for example, this is achieved with the innovative Ulthera System.

What Is the SMAS Layer?

SMAS (Superficial Musculo-Aponeurotic System) is a superficial musculoaponeurotic system located beneath the skin and subcutaneous fat. It forms a kind of structural framework for the face, connecting the facial muscles to the skin and helping maintain well-defined facial contours.

With age, the SMAS structure weakens and stretches, contributing to tissue sagging, the appearance of jowls, a double chin, and less defined facial contours. During SMAS lifting, focused ultrasound targets a specific depth, triggering tissue contraction and stimulating the production of new collagen. As a result, the skin gradually becomes firmer and the facial contours become more defined.

Three Treatment Depths: 1.5 / 3.0 / 4.5 mm

One of the key features of Ulthera is its ability to target three different tissue depths. The doctor selects the appropriate depth based on the anatomy of the treatment area, tissue thickness, and desired result. Built-in ultrasound imaging helps visualize the tissue layers and direct the energy more precisely.

• 1.5 mm — superficial level.
  The treatment primarily targets the dermis. This depth is used to firm and tighten the skin, improve its elasticity, and correct fine lines and wrinkles, particularly in delicate areas.
• 3.0 mm — deep dermis and subcutaneous tissue.
  Ultrasound stimulates the remodeling of collagen fibers, promotes gradual skin tightening, and provides a moderate lifting effect. It is used to address age-related skin laxity and poorly defined facial contours.
• 4.5 mm — deep tissue level.
  In many areas of the face, this depth corresponds to the location of the superficial musculoaponeurotic system (SMAS). The treatment promotes tissue contraction and remodeling, helping improve facial contours, define the jawline, and reduce signs of ptosis.

Combining different treatment depths makes it possible to target not only the skin’s surface but also deeper supporting structures. At the same time, the doctor does not necessarily use all three transducers during every procedure — the treatment protocol is tailored to each individual patient.

Why To Choose Ulthera System?

Ultherapy is one of the first microfocused ultrasound systems to receive FDA clearance for non-invasive skin lifting. The Ulthera System is certified medical equipment with defined indications for use.

The key feature of Ulthera lifting is its non-invasive technology, performed without incisions or damage to the skin’s surface. Focused ultrasound triggers the processes of collagen and elastin synthesis. The ultrasound waves pass through the superficial layers of the skin, while the energy is focused at a specific depth, including the area of the musculoaponeurotic layer. At the treatment points, the tissues are heated and contract, triggering subsequent processes of regeneration and collagen remodeling.

The cosmetic doctor can adjust the depth to which the ultrasound penetrates beneath the skin. The heating is also controlled and precisely targeted — energy is delivered only to the planned treatment areas. At the focal points, the temperature may reach approximately 60–70°C. This temperature range promotes collagen fiber contraction and stimulates the formation of new collagen. The depth, degree, and intensity of treatment are determined by the doctor based on the anatomy of the selected area, the initial condition of the skin, and the desired treatment goals.

An important distinguishing feature of Ultherapy is its real-time ultrasound imaging technology. During the procedure, the doctor can see the tissues beneath the skin on the screen and control the level at which the energy will be focused. This makes it possible to account for the patient’s individual anatomy, ensure proper contact between the transducer and the skin, and plan the treatment of each area more precisely.

DeepSEE technology enables visualization of dermal and subcutaneous structures at depths of up to 8 mm. It allows the doctor to confirm the correct treatment depth and avoid directing energy toward bony structures. The on-screen SMAS/Fibrous Layer and Dermal Layer maps help distinguish between the dermal and fibrous layers and create a personalized treatment protocol based on the anatomy the specialist can see directly during the procedure.

Indications: Who Is SMAS Lifting Suitable For?

This type of lifting effectively addresses signs of skin aging. The procedure is prescribed by a doctor who takes into account the presence of both indications and contraindications.
Indications for the procedure include:

• deep expression lines and pronounced nasolabial folds;
• the appearance of a double chin;
• sagging cheeks and eyelids;
• facial puffiness;
• pronounced malar bags;
• premature skin aging;
• poorly defined facial contours;
• prevention of certain skin concerns, such as ptosis.

Specialists at LeoDerm Medical Center recommend Ulthera SMAS lifting in Lviv for clients who have contraindications to surgical procedures or for whom general anesthesia is not permitted.

How Is the Procedure Performed?

Before any cosmetic procedure, the doctor carefully examines the skin and cleanses it of makeup and impurities. The treatment areas are then marked with lines. The number of treatment lines is individual and is determined after the doctor’s consultation. Before the device is activated, the optimal depth of ultrasound penetration is selected.

How Is the Procedure Performed?

Before any cosmetic procedure, the doctor carefully examines the skin and cleanses it of makeup and impurities. The treatment areas are then marked with lines. The number of lines is individual and is determined after the doctor’s consultation. Before the device is activated, the optimal depth of ultrasound penetration is selected.

Which Treatment Protocol Should You Choose?

There is no single Ultherapy protocol that is suitable for every patient. The cosmetic doctor develops an individualized treatment plan based on the treatment area, the severity of age-related changes, the thickness of the skin and subcutaneous tissue, the location of the target structures, and the desired outcome.

Thanks to ultrasound imaging, the doctor can visualize the anatomical layers, control the depth at which energy is delivered, and adapt the treatment directly during the procedure.

Choosing a protocol based solely on age or a photograph is not appropriate. The final Ultherapy treatment plan is determined by the doctor after an in-person consultation, examination of the tissues, assessment of indications, and exclusion of contraindications.

Is the Procedure Painful and Is Anesthesia Required?

Skin tightening is performed using the high-quality Ulthera System ultrasound device. During the session, the patient does not experience pain, but may feel mild tingling, tightness, warmth, or brief discomfort. The intensity of these sensations depends on individual sensitivity. Anesthesia is not required for the procedure.

How Long Does a Session Take?

The duration of a single session depends on the complexity of the concerns being treated. On average, it takes 30–90 minutes.
After the Ulthera lifting procedure, a soothing cream is applied to the patient’s skin.

Results: When Will They Appear and How Long Will They Last?

Ultherapy provides gradual, natural-looking lifting without dramatically changing the facial features. The procedure helps make the skin firmer and more elastic, lift the eyebrows, improve the contours of the lower third of the face, and reduce tissue laxity under the chin and on the neck.

The extent of the results depends on the initial condition of the skin, the degree of ptosis, age, the body’s individual ability to produce collagen, and the properly selected treatment protocol. Ultherapy does not replicate the results of a surgical facelift, so it is best suited for correcting mild to moderate age-related changes.

Immediately After the Procedure

The first changes may be noticeable immediately after the session. Focused ultrasound causes an initial contraction of collagen fibers, which can make the tissues appear firmer and the contours somewhat more defined. However, this is not the final result: the main tissue remodeling takes place gradually. Reviews of Ulthera indicate that some patients notice an initial lifting effect immediately after the procedure.

Cumulative Effect — 2–6 Months

The main results develop over the following months. In response to the controlled ultrasound treatment, neocollagenesis is stimulated — the formation of new collagen and remodeling of existing fibers. The most noticeable lifting effect usually develops within 2–3 months, while the condition of the tissues may continue to improve for up to six months.

How Long Do the Results Last?

After a single Ultherapy session, the results on the face may last for up to a year or longer. The duration of the effect varies from person to person and depends on age, the condition of the tissues, lifestyle, the rate of natural aging, and skincare. The procedure stimulates the formation of new collagen but does not stop further age-related changes.

When Can the Procedure Be Repeated?

Ultherapy is generally performed as a single treatment, after which the full results are allowed to develop. There is no single mandatory interval for repeating the procedure; the doctor determines whether another session is appropriate on an individual basis, taking into account the results achieved, the condition of the tissues, and the rate at which age-related skin laxity returns.
Since the results may last for a year or longer, a repeat Ultherapy treatment is often considered a maintenance procedure once the effects begin to diminish.

Recovery and Restrictions After the Procedure

Ultherapy does not damage the skin’s surface, so a prolonged recovery period is generally not required. Patients can return to work and their usual activities immediately after the session. No special post-procedure care, dressings, or skin treatments are required.

Immediately after the procedure, redness may occur and usually disappears within a few hours. Mild swelling, tingling, sensitivity, or tenderness to the touch may also develop. Less commonly, bruising or temporary numbness may occur. Most of these reactions are mild and resolve on their own, although the recovery period may vary from person to person.

There are no strict universal restrictions after Ultherapy. However, during the first few days, it is advisable to treat the treated area gently and avoid rubbing or massaging it unless recommended by your doctor. Intensive cosmetic procedures, heat treatments, injections, or the use of active skincare products should be discussed with a specialist. Specific restrictions depend on the treatment area, procedure parameters, and the skin’s individual response.

If swelling, pain, changes in sensation, or other symptoms become more severe or persist longer than expected, you should contact the doctor who performed the procedure.

Contraindications to Ultherapy

Before the procedure, the doctor conducts a consultation, assesses the condition of the skin, any underlying medical conditions, existing implants, and medications the patient is taking, and follows the official Ulthera System instructions, which distinguish between direct and absolute contraindications.

Absolute Contraindications

Ultherapy is not performed in the presence of:

• open wounds or other damage in the treatment area;
• severe or cystic acne in the treatment area;
• active electronic implants, including a pacemaker or defibrillator;
• metal implants located directly in the treatment area.

Ultrasound energy must also not be directed at the eyes, eyelids, or areas within the orbital rim. During the procedure, the thyroid gland, trachea, major blood vessels, and nerves must be avoided.

Relative Contraindications

Relative contraindications include:

• pregnancy and breastfeeding;
• taking anticoagulants;
• blood clotting disorders;
• active systemic or local skin conditions that may impair healing;
• active herpes infection;
• autoimmune diseases;
• diabetes mellitus;
• epilepsy;
• Bell’s palsy;
• a tendency to develop keloid scars;
• the presence of dermal fillers, mechanical implants, or breast implants in the planned treatment area.

The presence of a relative contraindication does not always mean that the procedure is completely prohibited. The doctor assesses the potential risks and, if necessary, postpones the session, changes the treatment area, or recommends an alternative method.

Ulthera SMAS lifting in Lviv is available at LeoDerm Medical Center. We offer responsible and experienced specialists, high-quality service, modern equipment, and affordable Ulthera treatment prices. Welcome to our clinic for safe and effective rejuvenation!