Which tightening system is the least painful and most effective?

I just turned 58, am above my average weight now and see beginning jowls and "marionette" lines that are driving me crazy. I did one Rejuv filler but my dermatologist has recommended Ultherapy. Now I am hearing that Thermage is equally effective, and less painful -- including by you. Can you offer me an Ultherapy vs. Thermage overall? In short, is Ultherapy more effective for the increased pain and cost? Please help. Thanks

Between Thermage and Ultherapy, in my opinion, they are equally effective when done well, but Ultherapy is much more painful.   The newer Exilis system is least painful of all three of them, and seems to be (limited data still) as effective or possibly even slightly more effective than the first two. 

But………. and this is key……….. no tightening system at age 58, is going to give you great results.    More info on these systems. 

Dr. I

Dr. Brandith Irwin, MD

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