Why the popular skin-tightening treatment is now gaining attention for a different method of use.

High-Intensity Focused Ultrasound (HIFU) once emerged as a revolutionary noninvasive technique for various cosmetic procedures, and since its initial clearance by the Food and Drug Administration (FDA) in 2009 for noninvasive brow and neck lifts, HIFU has garnered attention for its potential in tightening lax skin and promoting a ‘lifting’ effect for the lower to mid face.

Now, experts are focusing on the efficacy of the applications of HIFU with reducing waist circumference and localised fat reduction and simultaneous dermal remodelling.

The evidence

A study in 2017 reported the temperature changes of the porcine model during a HIFU treatment. They showed targeted subcutaneous fat to be around 70°C, whereas the skin surface temperature only went up to 33.1–35.6°C. Therefore, newly developed transducers, or hand-pieces, could effectively and safely deliver HIFU energy deeper into the skin and eventually show body sculpting effects, not only due to skin tightening, but also to the reduction of subcutaneous fat.

Amongst other recent studies in 2022 and 2023 documenting the efficacy of HIFU in inducing apoptosis (programmed cellular death) of adipocytes, this has brought forward safety and clinical indications for applications of HIFU on the mid and lower face for considerations of premature facial ageing, if not selected appropriately.

Selecting the right client

Achieving optimal outcomes with HIFU necessitates a nuanced approach. Factors such as skin thickness and composition play a pivotal role in determining treatment effectiveness and safety. Research highlights the impact of treatment parameters, including depth of penetration and energy settings, on both results and potential side effects.

Anatomical variations among individuals underscore the importance of customisation. The thickness of the skin varies, warranting careful consideration during treatment planning to minimise adverse effects.

As the understanding of HIFU’s potential deepens, the importance of personalised treatment plans becomes evident. Adapting the technique to individual patient profiles, including skin conditions and fat layer thickness, is essential for achieving desired outcomes while mitigating risks.

HIFU’s capabilities are expanding beyond its current applications, promising further advancements in noninvasive body sculpting.

Safety remains a paramount concern in cosmetic procedures. HIFU has showcased a strong safety profile compared to other methods like laser-based treatments. Clinical studies have reported minimal adverse events, emphasising the potential of HIFU for body sculpting.

However, in practice there have been instances of after-effects following the treatment, like unanticipated further reduction of fat, surface-level nodules, and damage to the underlying skin, potentially caused by variations in the thickness of the epidermis, dermis, and subcutaneous fat layer based on the specific anatomical area and the skin condition of the patient, emphasising on the role of careful patient selection.

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