The face is one of the parts of the body most affected by the passage of time. Facial aging is due to so many reasons including loss of elasticity of the epidermis, volume that goes down as age advances, spots and other imperfections that appear on the skin.
The desire to look young and fresh at all times has led to the development of various medical and surgical methods. Facelift is one of the most widely used procedures for women and men to bring the appearance of the face (and beyond) back in time. Certainly it is an effective surgery, but it also has factors that make it unsuitable for everyone, for example, the relatively long postoperative recovery, the potential complications of surgery, and the price not affordable for everyone. In addition, it should also be considered that a facelift may not even be enough on its own to rejuvenate a person’s face.
There are also viable alternatives to the face lift that can be considered when such invasive surgery is not possible or not desired. Alternative methods, both medical and surgical, that are used very frequently are:
- Lipofilling (injection of adipose tissue from one’s own body).
- Hyaluronic acid-based fillers .
- Chemical Peels.
- Ablative Laser Resurfacing.
The last two treatments listed are very minimally invasive compared to all the others, but it should be pointed out that they are not able to give results comparable to Surgical Lifting in terms of skin lifting and retensioning.
The efficacy of noninvasive methods is lower because they cannot reach deeply, but only affect the superficial layers of the epidermis. To achieve really important results, it is necessary to work on the SMAS, or Superficial Muscular Aponeurotic System.
In order to achieve effective deep action while eliminating adverse effects on the surface layers, the method called HIFU was devised.
Ultrasound for the face: what is HIFU
HIFU stands for High-Intensity Focused Ultrasound.
The treatment harnesses acoustic ultrasound energy that precisely heats deep skin tissues and stimulates inflammation in them, generating collagen remodeling and skin contraction.
The final effects that are achieved are:
- Facial tissues regaining texture.
- Cheekbones and cheeks lifted and retensioned.
- Improved mandibular profile.
- Less slack neck.
How HIFU treatment works
As a first step, photographs should be taken of the patient’s face and then the areas to be treated should be delineated. The areas generally are those of the cheeks, the eye area, the forehead, and the submandibular region.
Depending on the skin thickness of the areas to be treated, the most suitable handpieces are selected: a handpiece with a depth of 4.5 mm will be used for regions where the skin is thicker (example: cheeks), moving on to employing handpieces that reach a shallower depth (3.0mm and 1.5 mm) where the skin is thinner or when a second pass must be made on a part already treated with the handpiece of greater depth.
This is done by applying a common ultrasound gel to the skin to promote heat flow and dissipation from the superficial layers, after which the HIFU handpiece can begin to channel energy to the deep layers. When the pulse is finished, the handpiece is advanced about 3mm within the area to be treated, and the administration is repeated until the entire area and all areas affected by the treatment are completed.
The patient experiences no or little pain in the treated areas, although it may be more uncomfortable in those with dental implants. It is important to know that it is never necessary to administer painkillers or anesthetics, because in most cases the sensation can be alleviated until it disappears by interposing between the cheek and the gum a cylinder of absorbent cotton such as that used in dental clinics.
The treatment takes about 40 minutes to complete (in the case of a full-face).
A slight sensation of warmth may be experienced and redness may sometimes occur, which, however, resolves spontaneously. Some patients experience jaw soreness that disappears within 24-36 hours.
Normally only one treatment is needed to achieve a good result. If the patient has significant skin laxity, increased skin thickness, and reduced retraction capacity, it may be necessary to perform a second treatment 60-90 days later.
Patients need to be properly informed so that they know that results will be achieved progressively and will not be immediately visible (we recommend waiting at least 30 days before evaluating the treatment), but will have a good duration over time (12 months and beyond).
Nonsurgical face lift: a case history of the new treatment
From November 2017 to April 2018, 52 patients (50 women, 2 men) aged 35 to 69 years (mean 52 years) underwent HIFU treatment. Patients with concomitant systemic or local diseases, pregnant or lactating, older than 69 years of age, and/or excessive skin laxity were excluded.
The 4.5- and 3.0-mm handpieces were most frequently used (about 80 percent), while the 1.5-mm handpiece was reserved for treating more delicate areas (such as the eye area) or in the case of patients with very thin skin, in order to concentrate the effect to the desired depth.
The power used averaged 1.5 mJ, and each patient received about 310 spots (350 in the case of full-face treatment).
After 40 to 60 days, patients were reviewed to evaluate the results both clinically and photographically, as well as through the subject’s own self-assessment. In 30%, a second treatment was performed, in the same manner as the first, and subsequent reevaluation occurred after an additional 40-60 days.
Aesthetic results of HIFU
Good or very good results, which matched or exceeded expectations, were found in 79% of patients (representing 41 patients).
Only 15 percent (8 patients) found the HIFU treatment satisfactory (improving but not as much as expected), while a small portion of the group surveyed, 5 percent (3 patients), were dissatisfied (they did not feel the expected result was achieved). Since the 3 patients in the last group were among the first to perform the treatment, it is possible that they were included because of a misjudgment of skin laxity, which led to improvements that were not evident to them.
Why choose High-Intensity Focused Ultrasound treatment
HIFU treatment is a viable alternative to surgery and also to less invasive medical treatments. The results are better than the latter and it has a lower risk of side effects while being equally free of pre- and post-operative setbacks.
The ability to act in depth while respecting the integrity of the superficial layers of the skin also allows treatment to be performed in any season of the year. In fact, the phototype or degree of skin tanning is not relevant, just as there are no possible complications with sun exposure following HIFU treatment.
As mentioned earlier, achieving the result after 1 or maximum 2 treatments is an additional advantage in terms of effectiveness and cost reduction for the patient. However, it is important to wait at least a month before evaluating the effects of the treatment, but the wait will be amply repaid by the long lasting final result.
To try the innovative ultrasonic facial treatment trust our department of cosmetic surgery and medicine in Castel Maggiore, Bologna Our team of private physicians will assist you in this innovative non-surgical face lift!
