Non-Surgical Skin Tightening (Ultherapy / Exilis Ultra / Morpheus8)

Golden Triangle Plastic Surgery and Medical Spa offers three complementary non-surgical skin tightening technologies at Dr. Roy David's San Diego practice. Exilis Ultra ($200/session) uses combined radiofrequency and ultrasound energy. Ultherapy ($600–$3,300) delivers focused ultrasound to the SMAS layer for brow and facial lifting. Morpheus8 ($1,200–$1,700) combines RF microneedling with adipose tissue remodelling for deeper skin tightening and contouring — suitable for both face and body.

The non-surgical skin tightening programme at Ora Plastic Surgery San Diego (Golden Triangle Plastic Surgery and Medical Spa) encompasses three energy-based devices — Exilis Ultra, Ultherapy, and Morpheus8 — each operating through a distinct biophysical mechanism and targeting a different depth and tissue layer, allowing the practice to tailor recommendations to each patient's anatomy and treatment goals. Exilis Ultra combines monopolar radiofrequency and ultrasound energy in a single applicator, simultaneously heating the deep dermis and subcutaneous tissue while using real-time thermal feedback to maintain controlled target temperatures. The RF component drives collagen contraction and remodelling in the reticular dermis, while the ultrasound component provides deeper tissue penetration for subdermal tightening. Sessions are typically comfortable and require no anaesthesia, priced at $200 per session at the San Diego practice — making it an accessible maintenance treatment between more intensive procedures. Ultherapy uses micro-focused ultrasound with visualisation (MFU-V) to deliver focused acoustic energy to precise tissue depths — including the SMAS layer at 4.5 mm, the deep reticular dermis at 3 mm, and the superficial dermis at 1.5 mm — without affecting intervening tissue. The SMAS-depth targeting is particularly relevant in a facial plastic surgery practice context, as the SMAS is the same layer addressed surgically during facelift procedures. Focused ultrasound at the SMAS level induces thermal coagulation points that trigger a wound-healing response and new collagen synthesis over two to three months, resulting in gradual skin lifting and tightening of the brow, lower face, and neck. Priced at $600–$3,300 at the practice depending on the number of treatment lines and anatomical zones addressed, Ultherapy is often recommended as a maintenance treatment between facelift procedures or for patients who are not yet surgical candidates. Morpheus8 is a fractional RF microneedling device that combines the dermal channel creation of microneedling with deep radiofrequency energy delivery — needles penetrate to 8 mm and emit bipolar RF at the tip, heating deep dermis and subdermal fat simultaneously. This deeper thermal effect, in addition to the superficial collagen induction, allows Morpheus8 to address early skin laxity, surface texture irregularities, and subdermal fat remodelling in a single treatment. At $1,200–$1,700 per session at the San Diego practice, it is positioned for patients seeking more substantive structural improvement than surface-level devices can deliver. All three devices are offered within a surgical practice environment where physician oversight of treatment planning and technique ensures that device settings, depth parameters, and anatomical targeting are appropriate to each patient's skin type, laxity, and goals.