Ulthera/Thermage, red light collagen therapy and fillers – how do I combine them?

Photo Rejuvenation (Red Light) in Conjunction with Ultherapy: Hi, Dr. Irwin. I stumbled across your site and am very impressed by what I see. I wanted to get your views on Photo Rejuvenation (Red Light Collagen Anti-Aging Therapy), particularly in conjunction with Ulthera. I am a 35 year old woman, and I have been using Ulthera on the face and neck since it came out. Before that I used Thermage. I get a treatment every 18 months (with lesser frequency on some body areas) with excellent results. I am interested in using Photo Rejuvenation as an adjunct maintenance treatment in between these treatments. Specifically, I wanted to get your views on whether I can use it shortly after an Ulthera treatment. I ask about compatibility because I am due for an Ulthera treatment on the face and neck shortly. The place I would go to for Photo Rejvenation uses a bed that treats the body and face at once. So, there would be a benefit to the body (which I treat less frequently with lasers) if I could do it shortly after Ulthera on the face. My concern, however, would be that the treatment would somehow diminish the effectiveness of Ulthera. I don't see that this would be the case. I can't see how this would interfere with Ulthera's collagen-building process and think it would only have a beneficial additive effect, but I wanted to get the views of a professional. I will additionally consult my doctor who does the Ulthera, but it's always good to seek a second opinion. Also, my secondary question is whether there is any research/evidence that the Photo Rejuvenation treatment degrades dermal fillers. I usually get some radiesse and restalyne shortly after my regular Ulthera treatments. I can't see that a mild treatment like Photo Rejuvenation that doesn't directly heat the structures under the skin would cause fillers to degrade more quickly but am not sure on that either. Thanks so much if you get a chance to answer these questions. -Jamie

Good questions! Let’s take them one by one and then in combination.

1) The Ulthera, in my opinion, works as well as Thermage but often requires more treatments and is more painful. But results are usually equivalent, as you have noticed, so as a preventive measure and to build collagen, this is a good option.


2) In my opinion, the red light collagen building devices, especially the beds, are probably not helpful over time (at least anything the eye can actually see). They use very low levels of energy. Also, red light is used at higher power (and with photoactivators) to destroy/treat skin cancers. It’s possible that chronic use of this wavelength over time may actually be destructive. There is not enough data yet on this and my recommendation is to avoid these cosmetically until more is known. Remember to be very skeptical about before and after photos.


Red light is not truly photorejuvenation (uses a spectrum of light between 515-1300 nm at higher power) which is time tested and proven. If you want true photorejuvenation, get a treatment with an IPL Photorejuvenation laser that is good quality.


3)  Generally fillers do not interact with superficial light/laser treatments. Thermage and Ulthera (radiofrequency) can sometimes penentrate deep enough depending on placement of the filler and the power used. Have the fillers done after the radio frequency treatment.


Hope this helps,  Dr. I


Find out more information from Dr. Irwin’s Guide to Thermage skin treatment.


Learn more information on Tips to Get a Great Laser Treatment.


Watch Dr. Irwin’s short video on Laser Treatments for Sagging Skin.


Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin, and I believe that consumers need and deserve a medically trained and unbiased skincare advocate.

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