Clinical Effectiveness of a High-Intensity Focused Ultrasound in Skin Lifting

Background and Objectives

Skin laxity is a common complaint of patients who request a skin rejuvenation procedure. In this study, the clinical effectiveness of high intensity focused ultrasound (HIFU) for the treatment of facial laxity.

Introduction

Skin laxity is a common problem of older people, for which they request skin rejuvenation procedures. Until recently, several traditional procedures such as laser ablation, dermabrasion, and chemical peels were the most common treatment options for skin laxity. However, they have various adverse side effects including pigment change, scarring, and infection. High-intensity focused ultrasound (HIFU) has been used for the treatment of benign and malignant tumors for several years. Recently, new machines developed which use HIFU technology for skin lifting. HIFU induces vibration at the molecular level, which generates thermal energy and eventually forms a thermal coagulation zone in the superficial muscular aponeurotic system (SMAS). It is different from other procedures in that the thermal lesion is found in the deep dermal tissue.

Materials and Methods

Nineteen Korean women and one Korean man with wrinkles and skin laxity enrolled in this study. They were from 28 to 60 years-of-age (mean 42.5 ± 7.5 years). Diagnoses were the results of clinical findings. After explaining the purpose and protocol of the study to all the patients, they gave written informed consent to participate in the study, as well as allowed for the use of their photographs for clinical purposes. Topical anesthesia cream applied before starting treatment. a cooling pack also applied after the treatment session. Therefore, Patients were treated with HIFU (DOUBLOTM, HIRONIC, SUNGNAM, South Korea) using a D4 cartridge (4 MHz, 4.5 mm probe) at 1.2 J/cm2 , 200-300 shots and then, additionally treated using a M7 cartridge (7 MHz, 3.0 mm probe) 0.45 J/cm2 , 100-150 shots.

Multiple passes made while avoiding stacking of the pulses, with the desired endpoint being mild erythema of the whole face. Feel the orbital rim by touch and operate to the extent that the M7 cartridge does not exceed the orbital rim. The operation should proceed in a fan-shape with eyeball as the center, and the number of operation shot should be between 20 and 40 lines. as a result we targeted a split face examination (Fig. 3);we treated the left side of the patient’s face.

Results

The results revealed that 16 of the 17 subjects (94%) had clinical improvement post-treatment. In a split-face study, the treated site showed excellent improvement compared to the control site. Reports show no side effects.

Among the 20 patients, 17 patients completed the study successfully. three individuals lost to follow-up.as a follow, Sixteen of the 17 subjects showed clinical improvement 3 months post-treatment. Their average 5-point scale score was 3.6 (mean 3.6 ± 1.1). Two patients (12%) were assessed as having noticeable improvement, 3 patients (18%) as having fair improvement, 7 patients (41%) as having good improvement, and 4 patients (24%) as having excellent improvement at the 3-month follow up visit. One subject (6%) reported to show little or no improvement. One subject representing excellent improvement in skin laxity is in Fig. 1, and outstanding result in periorbital area in Fig. 2. In a split face study, the treated site showed excellent improvement compared to the control site (Fig. 3).

Conclusion

In conclusion, HIFU is a useful non-ablative method for skin lifting in Asian patients.

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