High-Intensity Focused Ultrasound Treatment – General Information
High-intensity focused ultrasound (HIFU) is a relatively new cosmetic treatment for skin tightening that some consider a non-invasive and painless replacement for face lifts. It uses ultrasound energy to encourage the production of collagen, which results in firmer skin.
HIFU is most widely known for its use in treating tumours. The first reported use of HIFU for aesthetic use was in 2008. HIFU was then approved by the Food and Drug Administration (FDA) in 2009 for brow lifts. The device was also cleared by the FDA in 2014 to improve lines and wrinkles of the upper chest and neckline (décolletage).
HOW DOES IT WORK?
HIFU has the ability to target different tissue at programmable depths. We can target both the dermal and deeper subdermal connective tissue (eg. SMAS -superficial musculoaponeurotic system) to create small Thermal Injury Zones (TIZ).
These zones subsequently undergo neocollagenesis (formation of new collagen), collagen remodelling, tissue contraction and gradual lifting and tightening of the skin. [Ref 1]
Targeting the SMAS tissue is required for effective and long term skin tightening due to its durable holding property and less delayed relaxation [Ref 2]. The SMAS is the layer a surgeon would typically stretch as part of an invasive surgical face-lifting procedure.
HIFU is the only non-invasive treatment capable of targeting the SMAS layer. Other non-invasive skin tightening approaches, such as ablative laser treatments (eg. CO2 and Erbium:YAG lasers) and radiofrequency treatments (RF), cannot penetrate deep enough to reach the SMAS connective tissue and therefore can only stimulate neocollagenesis within the dermal tissue [Ref 2]
Reference 1.- Park H, Kim F, Kim L, Bo Y, J Ko, High Intensity Focused Ultrasound for the treatment of wrinkles and skin laxity in seven different facial areas. Ann Dermatol . 2015: 27, 6. 688-693.
Reference 2. – Har-Shai Y, Bodneer SR et al. Mechanical properties and microstructures of the superficial musculoaponeurotic system. Plast Reconstr Surg. 1996: 98. 59-70.
Several small clinical trials have found HIFU to be safe and effective for facial lifting and refining wrinkles. People were able to see results in a few months after treatment, without the risks associated with surgery.
HIFU won’t work as well for people with more severe cases of sagging skin.
HIFU uses focused ultrasound energy to target the layers of skin just below the surface. The ultrasound energy causes the tissue to heat up rapidly. Once the cells in the targeted area reach a certain temperature, they experience cellular damage. While this may seem counterintuitive, the damage actually stimulates the cells to produce more collagen — a protein that provides structure to the skin.
The increase in collagen results in tighter, firmer skin with fewer wrinkles. Since the high-frequency ultrasound beams are focused on a specific tissue site below the skin’s surface, there’s no damage to the upper layers of the skin and adjacent issue.
HIFU may not be appropriate for everyone. In general, the procedure works best on people older than 30 with mild-to-moderate skin laxity. People with photo-damaged skin or a high degree of loose skin may need several treatments before seeing results.
Older people with more extensive photo-aging, severe skin laxity, or very saggy skin on the neck aren’t good candidates and may need surgery. HIFU isn’t recommended for people with infections and open skin lesions at the target area, severe or cystic acne, and metallic implants in the treatment area.
HIFU has many aesthetic benefits, including:
-wrinkle reduction
-tightening sagging skin on the neck (sometimes called turkey neck)
-enhancing jawline / jowl definition
-tightening of the décolletage
-smoothing the skin
Study results are promising. A 2017 study involving 32 Korean people showed that HIFU significantly improved skin elasticity of the cheeks, lower abdomen, and thighs after 12 weeks. In a larger study of 93 people, 66 percent of those treated with HIFU perceived an improvement in the appearance of their face and neck after 90 days.[Ref 1]
You may experience slight discomfort during an HIFU procedure. Some people describe it as tiny electric pulses or a light prickly sensation. If you’re worried about pain, your practitioner may suggest taking acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen , prior to treatment.
Immediately after the treatment, you may experience mild redness or swelling, which will gradually recede over the next few hours.
There’s no special preparation needed before having an HIFU procedure. You should remove all makeup and skin care products from the target area before treatment.
Here’s what to expect at your appointment:
1. Practitioner first cleans the target area.
2. Practitioner then applies an ultrasound gel.
3. The HIFU device is placed against the skin.
4. Ultrasound energy is then delivered to the target area in short pulses for roughly 20 to 30 minutes.
4. The device is removed.
While the ultrasound energy is being applied, you might feel heat and tingling. You can take a pain medication if it’s bothersome. You’re free to go home and resume your normal daily activities right away after the procedure.
HIFU is considered very safe if performed by a trained and qualified professional.
After the treatment you’re able to resume your normal activities immediately after. Some light redness or swelling may occur, but it should subside quickly. A light tingling sensation of the treated area may persist for a few weeks. Rarely, you may experience temporary numbness or bruising, but these side effects usually go away after a few days.
High-intensity focused ultrasound (HIFU) uses ultrasound waves to stimulate collagen and elastin production in order to create a more youthful appearance.
Most people see full results three months after their final treatment. Of course, HIFU isn’t a miracle cure for aging. The procedure is best suited for patients with mild-to-moderate skin laxity, and you may need to have the procedure repeated in one to two years as the natural aging process takes over.