Speaker 1 (00:07):
You're listening to The La Jolla Cosmetic Podcast.

Monique Ramsey (00:14):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And today we're going to talk about a non-invasive way to lift and tighten the skin and it's called Ultherapy. And we have Anh Bridgewater with us today and she is one of our Ultherapy experts at the center. And so welcome Anh, to the podcast.

Anh Bridgewater (00:38):
Hi Monique. Thank you for welcoming me this morning.

Monique Ramsey (00:40):
This is really exciting because Corey Dylan, who's on BIG FM, 100.7, she just had the treatment a few days ago. So we're going to be talking to her and we have another episode about that, that we're going to record today. But two days ago she had her treatment. And so we thought, let's talk about, for people to understand what is Ultherapy, what it does and who kind of is a candidate. So tell us, what does Ultherapy do and maybe what does it do best?

Anh Bridgewater (01:10):
Yeah, so Ultherapy is a non-invasive, non-surgical way to tighten and lift skin and tissues. Essentially, it's microfocused ultrasound that's actually focused towards these tissue layers that we can actually visualize while we're doing the treatment. And it allows the practitioner to have a really detailed way of tailoring the treatment towards the patient.

Monique Ramsey (01:36):
Where can it be used?

Anh Bridgewater (01:38):
Ultherapy is FDA-cleared for the brow, neck, under the chin and the décolletage. Although there are some off-label areas that are very popular as well, such as the abdomen, arms, elbows and knees.

Monique Ramsey (01:52):
Ooh, knees, elbows, this is fascinating. So if your knees are saggy, you could maybe do some Ultherapy then?

Anh Bridgewater (01:59):
Absolutely. Pretty much anywhere that you need some skin tightening. That's your priority area, absolutely.

Monique Ramsey (02:06):
Okay. So most people I would think then they're kind of thinking about doing their face or their... I guess maybe it depends on age, right? So maybe if you're a lot younger, you don't need your whole face done or your face and neck.

Anh Bridgewater (02:19):
Yeah.

Monique Ramsey (02:20):
What would your advice be?

Anh Bridgewater (02:23):
That's a really hard question to answer because everyone ages differently at a different rate, depending on your genetics and UV exposure and how you take care of your body and your skin inside and out. And so I wouldn't say someone younger doesn't necessarily need like a full face treatment and really the epitome of aesthetics is that really we're trying to maintain and prevent. So ideally someone in even their early '30s, mid '30s can start doing Ultherapy, can do it yearly, or even like every couple of years just to maintain the tightening and the lifting effect of your skin.

Monique Ramsey (02:55):
Oh, that makes sense. So more preventative in some ways, if you're a little younger, then let's say you're 55 and you're like, okay, your skin is more lax. And so it's going to tighten up maybe the laxity of the skin you have, but if you're younger, maybe you don't have the same amount of laxity, but you're going to be preventing-

Anh Bridgewater (03:16):
Absolutely.

Monique Ramsey (03:17):
Or holding it off for a little while longer.

Anh Bridgewater (03:18):
Exactly.

Monique Ramsey (03:20):
So now what kind of results can people expect?

Anh Bridgewater (03:24):
So the only, I would say downside to Ultherapy is just that it's a waiting game. It takes about three to six months for you to see some of the results, but most your results won't start until around that four to six month mark. As your body continues to stimulate that collagen and tighten up the skin. It does take time for it to work, unfortunately. So it's not one of those things where it's like Botox or filler where you get that instant gratification. And so it does take time, but it's really great as like a background foundation, right? Because you always need that tightening lifting effect you really can't get with Botox and fillers. And while that's working in the background, you would continue your other non-surgical treatments in the office.

Monique Ramsey (04:01):
That's helpful. And the reason for the result, having to wait a few minutes is that's how long your body takes to build the collagen?

Anh Bridgewater (04:09):
Exactly. So it doesn't happen overnight, unfortunately. I would say for the majority of patients, a lot of patients are looking for something really natural where they don't want anyone to know that something had happened or they had done something. And so I would say for the majority of my patients, that's actually a good thing because they don't look drastically different than they did the day before or the week before. And it's always kind of working in the background. So, your body's always kind of lifting and getting a little bit more tight each day and each month.

Monique Ramsey (04:37):
And let me ask you just a random question. You've got these powders out there, collagen added to your coffee and do you think that helps? Like if you've got Ultherapy working in the background, could you throw some collagen scoops into your coffee and have that help? Is there any proof that works?

Anh Bridgewater (04:53):
Yeah. I get asked this question all the time, honestly. So over the counter products like collagen protein powders are not FDA regulated. And so you don't really know what kind of collagen, what it was extracted from, the quality of it. And so it will vary from collagen product to collagen product. In general, I tell my patients like sure, if it kind of gets you into that motivating drive to continue to take care of yourself, sure. I don't think it hurts at the very least it's protein.

Monique Ramsey (05:23):
Okay.

Anh Bridgewater (05:23):
Extra nutrition for your body. But I don't think that it's one of those things that you must invest in for your anti-aging purposes, but I don't think it hurts. And again, you can't say all this collagen, go to my skin. It's going to be kind of distributed throughout your body.

Monique Ramsey (05:40):
Oh, that's true. You're not telling it where to go.

Anh Bridgewater (05:42):
Exactly.

Monique Ramsey (05:44):
So you said results sort of take about three to six months and if you had a treatment today, then you know, I'm going to go home and there really is no downtime, but then what's the next step of when you might see that person?

Anh Bridgewater (06:00):
So typically for my patients, I would like to put them on a... Depending on their personal goals, but anywhere from a year to a couple of year treatment plan with the Ultherapy. And again, this would depend on their natural aging process.

Monique Ramsey (06:14):
Oh, okay. You just go home and wait for that college-

Anh Bridgewater (06:17):
And wait.

Monique Ramsey (06:17):
Do its thing.

Anh Bridgewater (06:19):
Exactly.

Monique Ramsey (06:21):
Now I was talking to someone recently, they're in their mid '50s and talking about, "oh yeah, I really want to do that, my neck is driving me crazy". And now, would you say that it's a good idea that's the only place you would treat or would you recommend, I know everybody's different, but do you recommend sort of like treat a bigger area, have it more natural or what's the suggestion?

Anh Bridgewater (06:47):
A lot of times patients will come in with a specific area that bothers them the most. And I do like to address their primary concern. So depending on the patient, what I would suggest is we start with the neck, see how you feel about it. If you like it, we can continue to do other areas in the future.

Monique Ramsey (07:06):
Now, could you delay a facelift by having Ultherapy?

Anh Bridgewater (07:11):
That's a great question. Honestly, if people are set on having a facelift, they're going to get a facelift regardless, right? I think that the two are completely separate. You can't use Ultherapy to delay forever. Perhaps you could delay for a little bit, but if eventually you're going to do a facelift, you still do the facelifts. But you would still have to maintain afterwards with Ultherapy. You can still do non-surgical treatments to maintain the results that you had invested into, which is your big surgery, right?

Monique Ramsey (07:39):
Yeah. And I think that's a really great point that you bring up is that this isn't just for people who haven't had facial surgery, this is a great thing to help maintain the results. So if you had a facelift five years ago, this would be like a perfect way to keep that result beautiful. Because Ultherapy is treating different layers of tissue, but not muscle, right. And a facelift is really going to tighten muscles, is that correct?

Anh Bridgewater (08:03):
It's going to actually treat the same layers as a surgery would, so the SMAS layer. So it's going to tighten that layer as well. And that's the layer that we actually look for to tighten when we're doing Ultherapy.

Monique Ramsey (08:14):
Oh, so you are going that deep, that's kind of cool. All right. So you said it's technology that's ultrasound, right? So can you explain, sort of, how does that work? Because most of us hear ultrasound and we're like, "oh, that's how I saw my baby in my tummy".

Anh Bridgewater (08:31):
I know.

Monique Ramsey (08:31):
How does that work to then do what it's going to do with this treatment?

Anh Bridgewater (08:36):
So ultrasound essentially sound waves that depending on the density of the tissue and what it's visualizing will bounce back differently. It is commonly used in medicine to visualize during pregnancy, even like kidney stones, things like that. But in this sense, the technology is a little bit different because these ultrasound waves are now microfocused. So they focus into tiny balls of energy and that energy is essentially directed straight into a particular layer that the practitioner is trying to essentially treat and tighten.

Monique Ramsey (09:06):
Okay. So it's heat in a way?

Anh Bridgewater (09:10):
Yeah. So we'll heat up the tissue.

Monique Ramsey (09:12):
Heats up the tissue. Now, who is a good candidate for Ultherapy? And then let's talk about who is not a good candidate.

Anh Bridgewater (09:20):
I would say most people will be a good candidate given realistic expectations. It's not surgery, it's not going to dramatically tighten and lift the skin. Again, it's great for a mile to moderate laxity, anything that's really more on the severe side or more to severe. And they're looking for something really dramatic, then probably surgery would be a better route. And then I would talk about, we can maintain your results after your surgery with Ultherapy once a year.

Monique Ramsey (09:53):
Can you do your eyes with Ultherapy? Can you go around the eyes or?

Anh Bridgewater (09:57):
Yeah, absolutely. So Ultherapy is FDA proof around the eye area. So you can really tighten the skin around there. And a lot of times that's a primary concern for a lot of patients. You know, as you get a little bit older, this skin on top of the eyelid starts to kind of drop down towards your eyes. And that bothers a lot of people and definitely can tighten the skin there a little bit.

Monique Ramsey (10:17):
Interesting. Is there pain involved? Does it hurt or is it discomfort or how would you describe it?

Anh Bridgewater (10:25):
Pain and discomfort is one of those things that are so subjective. I tell patients this all the time, it's very hard to tell how someone will respond to the treatment. In general, I would say it is uncomfortable. It's not going to be one of those treatments where you'll just breeze through. And for that reason we offer, here at LGC, we offer modalities to keep our patients comfortable. Either with medications, if they decide to bring on a driver that can take them home afterwards, or we can even use PRO-NOX, which is laughing gas, similar to what you would get at a dental office. Sometimes people in labor will use this and it's in your system for about five minutes and it leaves your system. But basically, it kind of takes you so that you kind of transcend that pain a little bit so it doesn't bother you as much. And we also use topical numbing as well, some people that's all they need. And so it really varies depending on the individual and we do what we need to do during the treatment to keep our patients as comfortable as possible.

Monique Ramsey (11:25):
And about how long does the treatment last or does it depend on the area? Let's say we're going to do our full face and our neck. About how long would that take?

Anh Bridgewater (11:34):
I would say about an hour and a half to two hours, again, depending on the pace of the treatment. But in general, it is a little bit more of an involved treatment. It does take some time because you're hitting all of that tissue and all those layers that we're trying to target multiple times.

Monique Ramsey (11:54):
Interesting, okay. So have you ever had PRO-NOX?

Anh Bridgewater (11:58):
I have.

Monique Ramsey (12:00):
And how would you describe it?

Anh Bridgewater (12:02):
I think it varies depending on the person. I just feel really light and I'm in a happy place. And so a lot of things just don't bother me. I just kind of look past it.

Monique Ramsey (12:13):
I love that. And do you use, just since we're talking about it, do people use PRO-NOX for other treatments at La Jolla Cosmetic?

Anh Bridgewater (12:19):
Oh, absolutely. Yes. We're pretty much for any of our treatments. PRO-NOX is always an option for you to add on. If you decide that you need something a little bit more than what we're able to, just than just topical.

Monique Ramsey (12:34):
Would somebody use it if they were having even fillers, if they're really stressed about it?

Anh Bridgewater (12:38):
Oh my gosh, yes.

Monique Ramsey (12:39):
Really?

Anh Bridgewater (12:41):
Absolutely. You can use it for fillers, for Botox, for any laser treatments, even laser hair removal, even cool sculpting.

Monique Ramsey (12:48):
Oh really? Interesting, okay. Now, what are alternatives to Ultherapy?

Anh Bridgewater (12:54):
There's a lot of devices out there on the market that are meant to lift and tighten the skin non-surgically. One that comes to mind is radio frequency, that's also commonly used to tighten the skin. But really, when it comes to non-surgical skin tightening, Ultherapy has got to be the gold standard just because it can really be customized to the patient. You see exactly what layers of the tissue you're hitting and the process is very visible versus just, you're kind of assuming that everyone has the same anatomy, which is not true. And so it can really be tailored to that specific patient. So really it's got to be the gold standard.

Monique Ramsey (13:35):
And so say the patient says, "Okay, well I'm not really ready for Ultherapy right now". What else do you have at La Jolla Cosmetic?

Anh Bridgewater (13:43):
We can always do like PDO threads to help stimulate some collagen there. But I tell my patients typically that will require a series of treatment versus the Ultherapy you're kind of one and done for the next year to two years. It really depends on their availability. And I mean, for most people they don't want to keep coming back and going back and forth. And then Ultherapy really is one of those treatments where there's really minimal downtime. So I would say it is a great procedure for the majority of people.

Monique Ramsey (14:16):
And would something like laser or microneedling, I guess those are more superficial?

Anh Bridgewater (14:23):
Yeah. So laser is great too, but it will also treat more of those superficial like sun spots and redness, which Ultherapy wouldn't be able to treat, right? So that's kind of something else. But when it comes to just skin tightening Ultherapy's going to trump, the laser is for skin tightening. Microneedling is great, but again, it's really similar to PDO threads where you have to do like a series. And it's not going to be able to quite tighten and lift as much as Ultherapy would. It's great for someone who's starting out a little bit younger and is looking again to maintain and doesn't mind coming in multiple times. But if you want something a little bit more big guns for nonsurgical, it's got to be Ultherapy.

Monique Ramsey (15:06):
And like you said, it's an investment a little bit more than maybe coming in for microneedling, but we have multiple financing companies that we work with. So a, you can join the GLAMfam, which would then, that gives you 15% off, right off the top, which is great. And then you can also then say, "okay, now I'm going to pay that at no interest over six months or whatever". So there's a lot of different options to be able to then use the big guns and get that foundation and enjoy it for the next couple years. Like you say, you're creating a treatment plan with them. Let's say, here's your goal, how are we going to get there over the next year or the next two years? And what are the things that we need to do then knowing that there's financing available to help make that a reality, I think is a good thing to keep in mind.

Anh Bridgewater (15:59):
Totally.

Monique Ramsey (16:00):
So we've got all our pricing on our website with Ultherapy, because we're very transparent about our prices. We want to give you a range of what you might be looking at, but when they have a consult with you, do you do your consults in the office or do you do it by Zoom?

Anh Bridgewater (16:16):
Both, depending on the patient's availability. It's great with technology nowadays because we can always meet on Zoom. It makes it a lot more convenient for my patients, but a lot of times they also want to meet me in person. We do both, either or whatever works for our patients.

Monique Ramsey (16:30):
And then come up with a treatment plan. And then is there anything you ask them to do or not do prior to having the treatment?

Anh Bridgewater (16:38):
Yeah. I usually recommend my patients to stop any sort of active skin care. So your retinoids, your AHA, BHAs, anything that's exfoliating for about five to seven days or about a week. And they would have to discontinue that for about a week after their treatment as well. And also just avoiding excessive sun exposure because although the side effects with Ultherapy is very unlikely. We just want to minimize any sort of potential side effect from excessive sun exposure with any sort of treatment that heats up tissue and causes some inflammatory response. But I mean, in general, people should always be wearing sunscreen whether or not they're getting a treatment done, right?

Monique Ramsey (17:20):
Okay. And then I don't know if we touched on who's not a candidate. So if you are thinking of having this done, but you are pregnant, I'm assuming you're not a candidate. Is there anybody else who's sort of like you're saying, mm-mm (negative), not going to happen.

Anh Bridgewater (17:36):
Right. So if you're pregnant, if you're breastfeeding, unfortunately you would not be able to do Ultherapy just because it hasn't been studied in that particular population. You absolutely can do it after you're done breastfeeding. People who have any sort of implantable devices on their face, we can kind of avoid those areas. Say if they have a chin implant or something. And even just open wounds on the skin, people with severe cystic acne would not be, unfortunately, a good candidate or any sort of infection on the face.

Monique Ramsey (18:09):
And what if you have, not that this is a huge population, but what if you have like a pacemaker or some other implantable device?

Anh Bridgewater (18:16):
Yeah. Then you would not be a good candidate for this procedure, unfortunately. And anyone who just wants really dramatic results, this would not be the type of treatment I would recommend.

Monique Ramsey (18:29):
So managing expectations is important.

Anh Bridgewater (18:32):
Exactly.

Monique Ramsey (18:32):
And that's why it's good to have before and after pictures to look at when you're having your consultation to see, okay, here's where this person started, here's where they ended up to kind of know what's the range. Because like you say, it's not a facelift, but at the same time, there's no downtime, there's no scars and it's natural. And it's over time. Nobody's going to go, "Ooh, what happened to you"?

Anh Bridgewater (18:57):
Exactly.

Monique Ramsey (18:57):
Next week. They're just going to go, "Wow, you look great". Which is what we all want. So today we want to ask you all for a special favor, if you love our podcast. And if you've learned something from it, or if it's helped you make a decision, tell your friends, we would love to have our audience grow over time. And you can write a review on the show on Apple Podcasts or Good Pods or wherever you're listening. We love reviews, we want to hear from you. And if you have ideas for future episodes which you'd like to learn about, we would love to know that too. So if you need any questions about scheduling, financing reviews, photos, check the show notes for links, and we'll also have links to before and after pictures.

Monique Ramsey (19:41):
And then stay tuned for the episode with Corey Dylan from BIG FM, 100.7 to hear about her experience. And we're also filming that experience. So she'll be able to talk to you about what to expect from her own point of view from being a patient and going through the procedure. Thanks, Anh, I appreciate you coming in early this morning and talking to us about Ultherapy and we will see you again on the next episode.

Anh Bridgewater (20:09):
Great, thank you. It was a pleasure as always.

Speaker 1 (20:16):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla Cosmetic is located just off the I-5 San Diego Freeway in the XIMED building on the Scripps Memorial Hospital Campus. To learn more, go to ljcsc.com or follow the team on Instagram @ljcsc. The La Jolla Cosmetic Podcast is a production of The Axis. the axis.io.