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  • Writer's pictureBotany Skin Clinic

HIFU for skin tightening and lifting

Ulthera is a face-lift without the surgery. Skin can be tightened and lifted non-invasively with no downtime using focused ultrasound energy.

What are HIFU

HIFU is a device that uses focused ultrasound energy to lift and tighten the skin. HIFU, a blend of the words ‘HIFU’ and ‘therapy’ describes the treatment performed with the HIFU device. It is a safe non-surgical method to lift and tighten skin without any visible downtime.

How does it work?

Medically, ultrasound is used for a variety of reasons. The term ‘ultrasound’ is commonly associated with pregnancy scans. In these ultrasound scans, high-frequency sound waves are emitted by a handpiece, and the reflections of these soundwaves are recaptured to form an image. Conversely, HIFU focuses ultrasound waves to a specific point deep within the skin or beneath the skin. This heats and coagulates proteins that in turn stimulate new collagen formation and tightening or lifting of the skin. HIFU targets the foundational layers of the skin, including the deep dermis and the SMAS layer (or superficial muscular aponeurotic system, the layer that is tightened in face-lifts). This ‘deep heating’ leads to tightening of the skin. There is no visible downtime to HIFU treatment as the superficial layers of the skin are bypassed. All of the effects are deep within the skin or beneath it. It is akin to lithotripsy, a procedure that utilises focused ultrasound energy to break down kidney stones for excretion. The ultrasound energy reaches the target (the kidney stone) without disrupting the skin or other structures.

What can be treated?

Utilising the power of focused ultrasound, HIFU skin tightening can be used to lift and tighten the jawline, chin, brow, and neck with one treatment. It is not a replacement for a surgical face-lift. Instead, it provides an alternative for those who are looking for a non-invasive treatment to tighten skin and slow the facial ageing process.

In summary, the key benefits of HIFU include:

· Non-invasive nature

· No visible downtime

· Neocollagenesis – builds collagen

· Single treatment

Who can have HIFU and what areas can HIFU treat?

HIFU is suitable for most patients concerned about skin laxity. It is most common for those over the age of 35 seeking a lift or tightening, who are not wanting to have a surgical face-lift. It may also be sought by those looking to prevent skin laxity or to slow down the facial ageing process.

The results of HIFU cannot be compared to that of a surgical facelift. The results are not as dramatic or visible, and hence this procedure is only suited to those looking for subtle changes. It does not replace a surgical facelift. Instead, it provides a non-invasive alternative for those looking to subtly fight the progression of skin laxity.

HIFU works on mild to moderate skin laxity where the skin begins to feel and look less firm. Common areas to treat include loose cheek skin and jowls, sagging under the chin, loose skin on the neck, the forehead to lift lowered brows, and lines or wrinkles on the chest.

How does HIFU work?

The HIFU procedure stimulates collagen production by delivering focused ultrasound energy to the skin’s foundation layer, typically addressed in cosmetic surgery, without cutting or disrupting the surface of the skin.

HIFU utilises focused ultrasound waves in precise areas from the dermis down to subcutaneous tissue causing thermal coagulation points (TCPs). Thermal coagulation occurs when heat is generated at the site of the collagen, heating to temperatures of 60 – 70 degrees celsius. Intense vibrations are caused at a cellular level, the friction of this leads to heat formation at the localised site, thermal coagulation points. During a HIFU treatment, there are approximately 1600 thermal coagulation points precisely placed into well-defined areas and depths of the skin.

How does heat make my skin tighter?

As we age our collagen begins to loose it’s shape, much like our favourite pants that were once well fitted and now a little saggy around the buttocks and knees. As the shape of collagen begins to change, the foundations on which our skin is supported becomes uneven and lax, this allows for the skin to sag and wrinkles begin to form. When collagen is heated, between 60 and 70 Degrees Celcuis, multiple processes occur to the collagen fibres resulting in tighter and more lifted skin:

· The heat disrupts and breaks the bonds holding the collagen fibres in their shape, these are hydrogen bonds. This, like stretching and releasing a spring, allows the collagen fibres to contract, returning it to its original tight shape.

· A process called neocollagenesis occurs. This refers to the process of new collagen formation. The body registers the TCPs as an injury site which initiates the natural healing response. This response involves tissue repair and the creation of new collagen.

· Reorganisation and cross-linking of this new and existing collagen also occur at the TCP sites, giving the skin increased elasticity properties and greater resistance to physical stress to skin.

· Inflammation from the ultrasound heat triggers a secondary natural response, the release of a speciality cell that comes along to “mop up” any damaged tissue, this speciality cell is followed by fibroblasts. Fibroblasts are responsible for the creation of more collagen, replacing anything that is mopped up with new, tighter collagen.

The Ultrasound energy is delivered between 3mm and 4.5mm into the skin’s dermis, ensuring tightening through the deepest layers of the skin to provide long-lasting results. Unlike skin laser and surgical procedures, HIFU bypasses the upper layers of the skin to deliver the right amount of ultrasound energy at the right depths and the right temperature.

What does treatment involve?

Marking the face with grid lines to guide the treatment is the first step. The treatment handpiece is then systematically passed over the treatment areas. Each position is held for a few seconds to allow the handpiece to fire multiple focused ultrasound points along the skin in a linear fashion. Depending on the area treated, a different number of lines are fired. Usually, 800 lines are fired for a full-face treatment. Different levels of the skin are targeted with different handpieces to get tightening at different levels.

One of the main concerns with HIFU treatment for our patients is the level of discomfort. It can be a painful treatment for some, especially the deeper penetrating handpieces. Numbing cream is not effective for this procedure as it does not penetrate deeply enough to provide anaesthesia for the treatment.

Downtime, results and treatment time

How long before I see results?

Initial tightening of the skin can be seen immediately after treatment, much of this, however, is from the inflammation caused by the heat. True results appear over 2−3 months as the new collagen formation needs to mature. As maturation occurs collagen is realigned to provide a smooth and well-supported foundation for the skin’s surface.

While Ulthera cannot duplicate the results of a facelift, it’s a clinically proven non-invasive alternative for those not ready for surgery.

How long it takes

This will depend on how many area’s you are having treated. The practitioner will carefully mark out your face and systematically treat the desired areas. Commonly treatments take 1 hour in the clinic.

Will I need time off work?

After your treatment, you will be able to go back to your normal activities. Your skin might appear flushed at first, but the redness should disappear within a few hours. Some patients experience mild swelling of the treatment area or tingling or tenderness to the touch. These are mild and temporary effects. The first step on your HIFU journey is to book a consultation, your practitioner will address your concerns, assess your skin and determine if HIFU is right for you.

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