Ultherapy – Skin Tightening Treatment

Among the growing range of non-surgical skin-tightening technologies, Ultherapy occupies a unique position. It is the only FDA-cleared non-invasive treatment specifically approved for lifting the skin on the brow, under the chin, and on the neck — and the only non-surgical device that delivers its energy directly to the SMAS layer, the same deep structural tissue that surgeons engage during a facelift. By using focused ultrasound to reach a depth no other non-invasive device can match, Ultherapy can produce meaningful lifting and tightening over the months following treatment, without incisions, anesthesia, or significant downtime.

Few facial plastic surgeons in New York are better positioned to evaluate and perform Ultherapy than Dr. Maurice Khosh. Dual board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology–Head and Neck Surgery, Dr. Khosh is a Fellow of the American College of Surgeons (FACS), a Clinical Assistant Professor at Columbia University, and the former Director of Facial Plastic Surgery Clinics at Columbia University Medical Center and St. Luke’s-Roosevelt Medical Center. The SMAS layer that Ultherapy targets is the same structural tissue Dr. Khosh has engaged thousands of times during his three decades of performing facelifts — meaning the anatomical landmarks Ultherapy depends on are not theoretical to him, but part of his everyday surgical practice. In 2023, he was an invited lecturer on non-surgical techniques at the Minimally Invasive ENT/Open Forum, reflecting his standing in the rapidly evolving field of non-surgical facial rejuvenation. Dr. Khosh has been recognized as a Castle Connolly Top Doctor every year since 2013, a Best Doctors in America honoree, and a recipient of the New York Magazine Best Doctor in Facial Plastic Surgery award.

How Ultherapy Works

Ultherapy uses high-intensity focused ultrasound (HIFU) to deliver thermal energy to precise depths beneath the skin’s surface — without damaging the overlying tissue. The device’s transducers focus ultrasound waves at converging focal points, similar to the way a magnifying glass concentrates sunlight at a single point without burning the surface it passes through. At its deepest setting, Ultherapy reaches the SMAS (superficial musculoaponeurotic system), the fibromuscular layer that forms the structural foundation of the face. The controlled thermal injury at this depth produces two distinct effects: immediate tissue contraction and tightening, followed by a months-long collagen and elastin remodeling response that continues to refine the result. Real-time ultrasound visualization built into the Ultherapy device allows the treating physician to see the targeted tissue layers before and during treatment — a precision advantage over competing HIFU devices that operate without visualization.

“Ultherapy is the only non-surgical device that engages the SMAS layer — the same structural foundation we work with during a facelift. Knowing exactly where that layer sits in each patient’s anatomy, and where the transducer should and shouldn’t be placed, is what allows the result to be lifting rather than just surface tightening.” — Dr. Maurice Khosh

Areas Ultherapy Can Treat

Ultherapy is FDA-cleared to lift and tighten specific areas of the face, neck, and chest. Common treatment zones include:

• Brow and Upper Face: Subtle elevation of the brow position for a more open, refreshed appearance
• Cheeks and Midface: Lifts descending tissue and refines the cheek contour
• Jawline and Jowls: Refines lower-face definition by addressing early jowl development
• Under the Chin (Submentum): Tightens the submental skin and improves neck-jaw transition
• Neck: Lifts and firms loose neck skin and softens horizontal neck lines
• Décolletage: Smooths fine lines and crepey texture on the chest

What to Expect During Treatment

A typical Ultherapy session at Dr. Khosh’s Park Avenue office takes between 30 and 90 minutes depending on the area being treated. After cleansing the skin and applying ultrasound gel, Dr. Khosh uses the Ultherapy applicator to deliver focused energy to the targeted depths, using the device’s built-in imaging to confirm proper placement throughout the procedure. Most patients describe brief sensations of warmth or tingling as each pulse is delivered. Because the treatment is non-invasive, there is no downtime — patients can return to work, social engagements, and normal activities immediately. Some patients experience mild redness, swelling, or tenderness for a day or two following treatment, which typically resolves without intervention.

Visible tightening is often noticeable immediately after treatment, but the most meaningful improvement develops gradually over the following two to six months as new collagen forms and the SMAS layer remodels. Results typically last one to two years, with maintenance treatments helping to preserve the lift over time.

Combining Ultherapy with Other Treatments

For patients seeking the most comprehensive non-surgical rejuvenation, Ultherapy is often paired with complementary treatments that address different aspects of facial aging. Combining Ultherapy with a thread lift, neuromodulators, hyaluronic acid fillers, or laser resurfacing allows the deep lifting effect of Ultherapy to work in concert with surface and volume refinement. Dr. Khosh evaluates each patient’s full facial profile during consultation and recommends a combined approach when it would produce a more balanced and longer-lasting outcome.

Why Patients Choose Dr. Khosh for Ultherapy

• SMAS Surgical Familiarity: Three decades operating on the same structural layer Ultherapy targets, from the perspective of a surgical facelift specialist
• Former Columbia Faculty Leadership: Past Director of Facial Plastic Surgery Clinics at Columbia University Medical Center and St. Luke’s-Roosevelt Medical Center
• Recognized Non-Surgical Authority: Invited lecturer on non-surgical facial techniques at the 2023 Minimally Invasive ENT/Open Forum
• Honest Candidacy Evaluation: Realistic conversation about what Ultherapy can deliver and when a more comprehensive approach would be appropriate
• Park Avenue Convenience: Private Upper East Side practice serving patients from across Manhattan and the tri-state area

Schedule Your Consultation in Manhattan

The right approach to non-surgical lifting depends on accurate evaluation of skin laxity, underlying anatomy, and the limits of what ultrasound technology can deliver. Dr. Khosh offers thorough consultations to determine whether Ultherapy — alone or in combination — will produce your desired result, or whether a different approach would be a better match. To schedule a consultation at Dr. Khosh’s Park Avenue office in New York City, call (212) 339-9988 or contact us online to request an appointment.