What's the difference between PRP and PRF?

Both come from your own blood and both deliver concentrated platelets to tissue. The difference is in how they're processed. PRP uses a higher-speed centrifuge spin and an anticoagulant, which yields a liquid platelet-rich plasma that releases growth factors quickly after injection. PRF uses a slower spin without anticoagulant, which lets a soft fibrin matrix form. That matrix holds the platelets in place and releases growth factors gradually over 7 to 10 days. PRP is often used where rapid signaling is the goal. PRF is often preferred when sustained release matters, such as scalp work for hair loss or under-eye remodeling.

How much does PRP or PRF therapy cost at Greenwich MD?

Pricing for a single session is discussed at the consultation. The recommended starting protocol for most facial and scalp indications is a series of 3 sessions spaced 4 to 6 weeks apart. After the initial series, maintenance is typically 1 to 2 sessions per year for face, or every 4 to 6 months for scalp. If PRP or PRF is layered with other regenerative treatments such as PDGF therapy, skinboosters, or RF microneedling, combination pricing is reviewed openly at the consultation. There are no hidden fees.

How many sessions do I need to see results?

Most patients complete an initial series of 3 sessions before judging final results. Visible change typically begins around the 4 to 6 week mark, with continued improvement over 3 to 6 months as new collagen builds and (for scalp work) follicular activity progresses. Some patients see meaningful change after the first or second session, but the standard recommendation is to complete the full series before assessing the protocol's effect.

Is the procedure painful?

Most patients describe the discomfort as mild. The blood draw is similar to a routine lab. The injections themselves are performed with very fine needles, and topical numbing is applied beforehand for sensitive areas like the under-eye or scalp. Some patients also opt for a vibration tool or cold compress during injection. Discomfort during the actual injection is brief, and there's no lingering pain afterward.

How long is the recovery?

Downtime is minimal. You can return to most normal activities the same day. Mild redness, swelling, or pinpoint bruising at injection sites is common for 24 to 48 hours. Strenuous exercise, sun exposure, and heat (saunas, hot yoga) are best avoided for 24 to 48 hours after treatment. Makeup can typically be applied the next morning. For scalp treatments, washing the hair is usually delayed by 24 hours.

Can PRP or PRF be combined with other treatments?

Yes. Combinations are common at Greenwich MD and often deliver stronger results than any single treatment alone. The most frequent pairings are PRP/PRF with PDGF therapy, with skinboosters, with Genius RF microneedling, or with standard microneedling. Combination protocols are designed at the consultation based on your indication and goals.

PRP and PRF use your own blood, so there's no risk of allergic reaction or rejection. Safety considerations relate to the injection itself (rare bruising or temporary swelling) and to the underlying patient profile. Active blood disorders, certain anticoagulant medications, active infection at the treatment site, and active malignancy may be contraindications. These are reviewed at the consultation.

How long do PRP and PRF results last?

Results vary by indication and by individual response. For facial skin quality work, most patients sustain results with 1 to 2 maintenance sessions per year after the initial series. For scalp and hair density work, maintenance is typically every 4 to 6 months because hair cycling is continuous and the regenerative signal needs to be refreshed more often. Combining PRP or PRF with other modalities (PDGF, RF microneedling) often extends the durability of results.

Laser Light, Radiofrequency and Ultrasound Treatments

Ultherapy

Name: Ultherapy
Creator: Dr. Susana Querido

Ultherapy at Greenwich MD: the only FDA-cleared microfocused ultrasound treatment available at our Stamford, CT practice for non-surgical lifting at the SMAS layer, delivered personally by Dr. Susana Querido, a triple board-certified physician who selects every transducer depth and line count based on your individual anatomy. Related: Complete Guide to Aesthetic Lasers and Energy-Based Treatments →

Medically reviewed by Susana Querido, MD, Triple Board-Certified in Family Medicine, Aesthetic Medicine, and Anti-Aging & Regenerative Medicine. Medical Director, Greenwich MD.

What Is Ultherapy?

Ultherapy is the only FDA-cleared microfocused ultrasound (MFU) treatment that delivers energy to the SMAS layer beneath the skin. The SMAS, or superficial musculoaponeurotic system, sits approximately 4.5mm below the skin surface on the face and is the structural foundation that surgical facelifts tighten mechanically. Ultherapy reaches this layer non-invasively by focusing high-intensity ultrasound waves to precise focal points, generating controlled thermal coagulation zones without damaging the overlying skin.

The Ultherapy system, manufactured by Merz Pharma, uses three distinct transducer depths: 1.5mm targeting the superficial dermis, 3.0mm targeting the deep dermis, and 4.5mm targeting the SMAS layer directly. Each depth serves a different collagen-stimulating purpose, and a complete treatment typically employs all three in sequence depending on the area being treated. The built-in ultrasound imaging feature allows the treating provider to visualize tissue layers in real time before and during energy delivery, confirming correct placement at every pass. This combination of imaging and precision depth targeting is what distinguishes Ultherapy from other energy-based lifting devices on the market.

Quick Facts About Ultherapy

FDA Status: FDA-cleared for non-invasive lifting of the brow, submental area, neck, and improvement of lines and wrinkles on the decolletage.
Treatment Areas: Brow, jawline, submental (under chin), neck, and decolletage.
Sessions Required: Most patients benefit from a single full treatment session, with repeat sessions recommended every 12 to 18 months to maintain results as natural aging continues.
Session Length: Full face and neck treatments typically require 60 to 90 minutes in-office.
Downtime: Minimal. Most patients experience 0 to 3 days of mild redness, tenderness, or swelling. Bruising is possible but uncommon.
Results Timeline: Subtle changes may be noticeable at 4 weeks. Visible lifting and tightening typically emerge between 8 and 12 weeks. Peak results occur at approximately 24 weeks as collagen remodeling completes.
Cost Range: Treatments at Greenwich MD range from approximately (quoted at consultation) to (quoted at consultation) depending on the areas treated and the line count required.
Best Candidates: Patients in their 40s to 60s presenting with mild to moderate skin laxity and adequate residual collagen reserve to respond to ultrasound stimulation.

How Ultherapy Works

Ultherapy produces lifting and tightening through a four-stage biological process that begins during treatment and continues for up to six months afterward. Understanding each stage helps set accurate expectations for what the treatment does and when results become visible.

Stage 1, Ultrasound Visualization: Before any energy is delivered, the provider uses the built-in imaging system to view tissue layers in real time, confirming the correct depth and identifying anatomical landmarks that must be avoided.
Stage 2, Energy Delivery at Three Depths: Focused ultrasound pulses are placed at 1.5mm, 3.0mm, and 4.5mm depths in sequential passes across the treatment area, creating a grid of thermal coagulation points at each tissue level.
Stage 3, Controlled Thermal Injury at the SMAS: At the 4.5mm depth, focal heating reaches the SMAS layer, creating micro-coagulation zones that trigger the body’s wound-healing response at the structural foundation of the face.
Stage 4, Collagen Remodeling: Over 12 to 26 weeks, the body replaces thermally disrupted tissue with new, organized collagen fibers, gradually tightening and lifting treated areas from within.

The result is not an immediate dramatic change but a progressive, natural-looking improvement that mirrors how the tissue actually heals and rebuilds itself.

Dr. Susana Querido, Your Ultherapy Provider

Dr. Susana Querido is triple board certified in Family Medicine, Aesthetic Medicine, and Anti-Aging and Regenerative Medicine. At Greenwich MD in Stamford, CT, she has built a practice model in which physician-level judgment governs every energy-based treatment. Ultherapy is never delegated to non-physician staff at this practice. Dr. Querido performs the consultation, designs the treatment map, operates the device, and adjusts energy delivery in real time based on patient feedback and tissue response.

Her approach to Ultherapy is individualized at the level of line counts and transducer selection, not applied from a generic protocol. She assesses each patient’s degree of laxity, skin thickness, and anatomical structure before determining which depths and how many lines are appropriate. “I treat Ultherapy the way I treat every procedure here, as a medical intervention that requires anatomy, not just a device following a template,” Dr. Querido has said of her approach. For patients in Stamford, CT seeking lifting results they can trust, that physician-administered standard matters.

Treatment Areas and Combinations

Ultherapy treats the brow, jawline, neck, submental area, and decolletage as standalone targets, but its most compelling outcomes often occur when it is combined strategically with complementary modalities. Because Ultherapy addresses structural foundation at the SMAS layer, it creates an ideal platform for treatments that work at more superficial levels. Dr. Querido at Greenwich MD designs combination protocols that layer depth, stimulation type, and biological mechanism to compound results in ways that no single device can achieve alone.

Ultherapy + RF Microneedling

Pairing Ultherapy with Genius RF Microneedling creates a full-depth collagen induction strategy that addresses both structural laxity and surface quality. Ultherapy lifts from the SMAS layer at 4.5mm depth, while Genius RF Microneedling delivers fractional radiofrequency energy through insulated microneedles at 1.5mm to 3.5mm into the dermis, stimulating dermal collagen and elastin at the mid-tissue level. The two devices work at different depths and through different mechanisms, radiofrequency versus focused ultrasound, so their effects do not overlap but compound. Patients who combine these treatments typically see more significant skin tightening, pore refinement, and texture improvement than either treatment produces independently. Dr. Querido sequences these treatments based on each patient’s priorities and healing capacity.

Ultherapy + Biostimulators

Combining Ultherapy with biostimulators such as Sculptra or Radiesse addresses two distinct aspects of facial aging simultaneously. Ultherapy restores structural lift at the SMAS layer by stimulating collagen from below, while biostimulators replace lost facial volume and trigger collagen production throughout the dermis and subcutaneous tissue. As the face ages it loses both support and volume, and treating only one without addressing the other produces incomplete results. This combination is particularly well suited to patients in their late 40s to 60s who present with both early jowling and mid-face volume deflation, where lifting alone would leave hollowing unaddressed.

Ultherapy + Dermal Fillers

Ultherapy and dermal fillers serve complementary but distinct functions in facial rejuvenation. Ultherapy tightens the structural foundation, lifting tissue that has descended with gravitational aging, while dermal fillers restore targeted volume in areas such as the cheeks, temples, and jawline that have deflated over time. When placed after Ultherapy, fillers work with tissue that has been repositioned rather than tissue that continues to descend, which can improve filler longevity and reduce the volume needed. Dr. Querido at Greenwich MD sequences these treatments carefully, typically allowing Ultherapy’s lifting effect to begin before introducing fillers, so that volume is added to a better-supported structural framework.

Ultherapy + Skinboosters

Combining Ultherapy with skinboosters pairs deep structural lifting with surface-level hydration and quality improvement. Ultherapy addresses laxity at the SMAS and dermis, but it does not directly improve skin hydration, radiance, or fine surface texture. Skinboosters, delivered as intradermal microinjections of hyaluronic acid or polynucleotides, restore moisture retention and skin luminosity at the most superficial level. Patients who combine the two treatments often describe their skin as not only lifted and tighter but also more radiant and even in tone. This pairing is particularly popular among patients in their 40s and 50s who want comprehensive rejuvenation without appearing treated or overdone.

Treatment Protocol

Every Ultherapy treatment at Greenwich MD follows a structured protocol designed for precision, comfort, and consistent outcomes. Dr. Querido oversees each step directly.

Consultation and Candidacy Assessment: Dr. Querido evaluates skin laxity, tissue thickness, and anatomical structure to determine whether Ultherapy is appropriate and which areas will be treated.
Anatomy Markup: Treatment zones are mapped on the face and neck with anatomical landmarks identified to protect key structures during energy delivery.
Ultrasound Visualization: Before energy is placed, the imaging function confirms tissue layer depth and transducer positioning at each treatment site.
Energy Delivery in Passes: Sequential passes are made at 4.5mm, 3.0mm, and 1.5mm depths as indicated for each zone, with line counts tailored to the individual treatment plan.
Comfort Management: Ultherapy involves real discomfort as energy reaches the SMAS layer. Dr. Querido is direct about this. Pre-medication with oral analgesics or anti-inflammatories is available and routinely offered.
Post-Treatment Cooling and Aftercare: Mild cooling is applied after treatment and patients receive specific aftercare instructions including sun protection and product guidance.

Is Ultherapy Right for You?

Ultherapy produces its best outcomes in a specific patient profile, and Dr. Querido at Greenwich MD is candid about candidacy rather than recommending the treatment to every patient who asks about it. Understanding who benefits most, and who is unlikely to benefit, is part of the medical standard she applies to every consultation.

The ideal Ultherapy candidate is typically between their early 40s and mid-60s, presenting with mild to moderate skin laxity, meaning visible but not severe descent of the brow, jawline, or neck tissue. Critically, they must have adequate residual collagen in their skin to respond to ultrasound stimulation. Patients with severely thin, sun-damaged, or collagen-depleted skin may not mount a sufficient healing response to produce visible lifting, and Dr. Querido will say so directly rather than proceed with a treatment unlikely to deliver value.

Contraindications include: Open wounds or active skin infections in the treatment area.
Cystic acne or severe inflammatory skin conditions overlying treatment zones.
Significant metal implants, pacemakers, or electrical devices near the treatment area.
History of nerve disorders affecting the face.
Pregnancy or active breastfeeding.
Severe skin laxity better addressed through surgical intervention.
Prior use of certain dermal fillers in specific anatomical zones, evaluated case by case.

Patients who are not strong Ultherapy candidates will be presented with alternative pathways at Greenwich MD. The goal is always the right treatment for the individual, not the highest-revenue procedure available.

What to Expect from Your Ultherapy Treatment

Knowing what happens during and after your Ultherapy visit at Greenwich MD helps you prepare practically and set accurate expectations for your results. Dr. Querido walks every patient through this timeline at consultation, and it is repeated on the day of treatment.

Arrival and Preparation: You arrive with clean skin, free of makeup and heavy skincare products. If pre-medication has been recommended, it is taken approximately 45 minutes before treatment begins.
Consultation Review and Markup: Dr. Querido reviews your treatment plan, confirms the areas to be treated, and maps anatomy directly on your skin before the device is applied.
Energy Delivery: Treatment takes 60 to 90 minutes depending on the area count and line density. You will feel warmth and a deep, intermittent aching sensation as energy reaches the SMAS layer. This is expected and indicates correct depth placement.
Immediate Post-Treatment: Mild redness and tenderness are normal and typically resolve within a few hours to three days. There is no visible lifting immediately after treatment.
4 Weeks: Some patients notice subtle initial changes in skin firmness as early collagen formation begins.
12 Weeks: Visible tightening and lifting become apparent in most patients as collagen remodeling progresses.
24 Weeks: Peak results are reached. The full extent of lifting and tightening is visible at this point, and maintenance planning with Dr. Querido can be discussed at a follow-up visit.

Results vary based on individual biology, degree of laxity, and collagen reserve, and Dr. Querido discusses realistic outcome ranges specific to each patient during consultation.

Schedule Your Consultation

To learn whether PRP, PRF, or a combination protocol is the right regenerative treatment for your skin or scalp concerns, schedule a consultation with Dr. Susana Querido at Greenwich MD in Stamford. The consultation is the place to confirm fit, review your goals, and walk through the protocol and pricing in full.