Don’t jump to “how many lines”
Seeing your nasolabial folds, you might ask, “Can Ultherapy lift this line away?” I first look at how the line formed, and only then answer whether it can improve.
I separate two cases. In one, the fold area has sunk in because of volume loss. In the other, subcutaneous fat above the fold sags and forms a more visible line below it. Until these two are told apart, “having nasolabial folds” is not enough on its own to decide on Ultherapy.
Where it has sunk in, the point is putting volume back
If the main problem is hollowing, the direction is simple: the missing volume needs to be put back. In that case I don’t treat lifting as the answer to filling a hollow.
This judgment saves you money spent on the wrong treatment. First confirm that what really needs treating is the sunken part, then talk about restoring volume. Don’t use one HIFU session as a test to see whether it disappears. If the hollowing is not only at the fold but also under the cheekbones, how I split the areas is in can hollow cheeks have Ultherapy.
When the tissue above sags, it isn’t the line itself you look at
In the other case, subcutaneous fat above the fold sags and makes the boundary below look deeper. What needs judging then is how much the tissue above contributes, not just the position of the fold.
Once I confirm the sagging above involves the SMAS and subcutaneous fat, I consider Ultherapy. Where fat needs reducing, lipolysis (fat-dissolving) injections may be combined as well. The goal is to treat the tissue pressing down on the line, not to treat the groove as something a lift can fill. The treatment’s line count and cost only mean something once the direction is settled. If you have already had Ultherapy and other areas changed but the tissue above the fold still sags, see the localized-residual branch in when Ultherapy seems to have no effect.
