High-intensity focused ultrasound (HIFU) is a relatively new treatment for skin tightening that can be considered as a noninvasive and painless replacement for facelifts. HIFU uses focused ultrasound energy to target the layers of skin just below the surface, its energy causes the tissue to heat up rapidly. Once the cells in the targeted area reach a certain temperature, it stimulates the cells to produce more collagen — a protein that provides structural support to the skin. The increase in collagen synthesis results in tighter and firmer skin.

HIFU was approved by the Food and Drug Administration (FDA) in 2009 for brow lifts and in 2014 to improve lines and wrinkles of the upper chest and neckline (décolletage). Various clinical trials have found HIFU to be safe and effective for facial lifting and improvement in wrinkles. People usually able to see results in a few months after treatment, without any relative risks. HIFU is also used for overall facial rejuvenation, lifting, tightening, and body contouring, and it has been found to be a very good treatment that could replace facelifts, especially in younger people who don’t want the risks and recovery time associated with a surgical facelift. HIFU usually would not work well for people with more severe cases of sagging skin.

HIFU may not be appropriate for everyone. This procedure works best on people older than 30 with mild-to-moderate skin laxity. People with a high degree of loose skin may need several treatments before seeing results. Older people with more severe skin laxity or very saggy skin on the neck are not good candidates and may require surgery. Contraindications for HIFU are people with infections and open skin lesions at the target area, severe or cystic acne, and metallic implants in the treatment area.

HIFU for the Face (Procedure)

  • There is no special preparation needed before having a HIFU treatment. Makeup and skincare products should be removed from the target area before treatment. One may experience mild discomfort during a HIFU procedure. Most people describe it as tiny electric pulses or a slight prickly sensation.
  • A dermatologist or technician first will clean the target area.
  • A topical anesthetic cream may be applied before 30 minutes of starting the procedure.
  • The dermatologist or technician then applies an ultrasound gel.
  • The HIFU device is placed over the skin.
  • A dermatologist will adjust the device to the right setting.
  • Ultrasound energy is then delivered to the target area in short pulses for roughly 30 to 45 minutes.
  • The device is removed after completion of treatment.

While the ultrasound energy is being applied, one may feel heat and tingling. Pain medication as prescribed by the doctor can be taken after the procedure if it is bothersome. Immediately after the procedure, one may experience mild redness or swelling, which will gradually subside over the next few hours. Rarely, some people may experience temporary numbness but this usually goes away after a few days. The patient is free to go home and resume normal daily activities immediately after the procedure.