Doctor's Answers (4)
The ageing process is not a straightforward one. Ageing takes place in the slow degeneration of various layers of our skin:
1. Facial bones shrink and lose volume
2. Muscles and ligaments that hold fat compartment in place become lax; these fat compartments shift downwards with gravity
3. Outer skin becomes thinner and wrinkly.
In order to reverse ageing with the aim of creating a more youthful complexion, there isn't a treatment that fits all. In many instances, a combination of treatments are exployed for optimal results.
HIFU, in short for High Intensity Focused Ultrasound, delivers focused ultrasound energy into the deeper planes of the face, namely the deep skin (dermis), superficial fat and muscle layer (SMAS layer – Superficial Muscular Aponeurotic System). The SMAS layer is the same site that is tightened in a surgical face lift. By stimulating focal contraction points (as shown in the image below), there is immediate collagen contraction, resulting in SMAS tightness. Delayed wound healing in the next 3-6 months will stimulate new collagen production for even greater results.
Other anti ageing treatments would include fillers, threadlift, botox and lasers.
In short, there isn't a most effective treatment per se. I would suggest getting professional opinion from a qualified doctor to decide which one is suitable for you.
Have a good day ahead!
Thank you for your question. There are many methods for firming the skin and they range from the non-invasive to the invasive surgical facelift.
In recent times, there has been quite a lot of attention given to ultrasound based tightening procedures to rejuvenate the face. Two of the common brands are HIFU and Ulthera. These are ideal for the younger patients as they cause skin tightening and provide a modest lift of the face. Personally, I have used both and I prefer the Ulthera as it provides a more definite lift with a long lasting result.
The HIFU is noted to be less painful and more sessions are required whilst some of the concerns of the Ulthera are that it can be more painful so we provide the patient with ample anaesthetic to numb the skin before the procedure to reduce the discomfort. There are also some radio frequency based devices which I have used but with limited success.
The Ultherapy aims to tighten the SMAS which is the same layer that we address during a surgical facelift. The ultrasound aims to cause contraction of the collagen at specific points which leads to lifting and firming of the face. New collagen is stimulated in the coming months and this causes the results to last. However, it is of course without doubt that the pull of these ultrasound based treatments are modest and cannot address significant skin laxity in the face or neck. In such cases a surgical facelift would be required. The other doctors have correctly mentioned that injectables such as botox and fillers can be done in combination to complement the Ulthera or HIFU to give a youthful, rejuvenated appearance.
Please seek an in-person consultation with a well trained plastic surgeon that is able to give you the full spectrum of options to address your problems. I hope this answers your question. Have a great week ahead and all the best!
Dr. Terence Goh
The information provided is purely for educational purposes and does not constitute medical advice or create any physician/patient relationship. Results may vary between individuals.
There are many methods for firming up loose or saggy skin. They range from completely non-invasive, to minimally invasive and lastly surgical face-lift.
Aesthetic clinics offer up to minimally invasive options for those who do not want surgery (due to scarring, anesthesia risks and stigma). These include:
1. Lasers or radiofrequency (usually more for upper skin layers)
2. Threadlifts (usually for fat sagging)
3. HIFU (tightens from deep ligamental areas to fat and even surface skin)
4. Botox (relaxes the depressor muscles on the face and neck to help with a gentle lift)
5. Fillers (replaces fat or bone loss areas, supports deep ligaments to provide a gentle lift)
As you can see, which method of lifting really depends on which condition or problem an individual has. It is common to combine some of the above solutions to provide synergy to the result. There is an article on DxD that touches on the various skin treatment devices available on the market which would be useful for more reading.
HIFU can target multiple layers of the aging tissues on the face and would definitely be one of the most precise and versatile skin tightening options available. It is still important for a proper consultation and assessment by an experienced doctor to see if it is suitable, if there are any other issues to address, or if there are any better options.
Hope this helps!
HIFU as a form of facial treatment employs the use of concentrated ultrasound energy to the face and neck by a handheld device. It is a non-invasive treatment that helps stimulates the cells, resulting in tissue rejuvenation and collagen production. The overall effect of the treatment is to promote tightening and lifting of the skin in these areas.
HIFU treatment can help stimulate tissue rejuvenation and collagen production – resulting in the tightening and lifting of saggy skin – and can also be used to break down fat deposits. In the hands of a skilled practitioner, this can produce results akin to facial sculpting (but without the need for surgery).
There are a number of indications for applying HIFU treatment for the face, which include the following…
-Fine lines and wrinkles
-Sagging skin along the cheeks and eyelids
-Skin that is thin and with a texture like crepe paper
-Drooping skin around the mouth area
As a skin rejuvenating procedure, HIFU can help women lift and tighten the neck, chin and brow, and improve lines and wrinkles on the chest. and even the tummy region.
There are no special preparations needed prior to the HIFU consultation and treatment. In the doctor’s office,I would will take the patient’s complete medical history and perform a thorough physical examination, especially the face and neck. With the exception of a diagnosed skin infection or existing skin problem that would require treatment at a later date, the HIFU procedure can be performed immediately after the consult.
Most HIFU treatments follow the same procedure outlined below…
Specially-trained nurses will perform a full facial cleansing and preparation for the patient.
The doctor applies ultrasound gel to the patient’s face and neck.
A hand HIFU device is glided over the patient’s skin. This delivers ultrasound energy to the skin, stimulating the skin cells to produce collagen and promote tissue healing, repair and rejuvenation.
Depending upon the patient’s skin condition, the physician adjusts the skin penetration depth setting of the hand piece As this procedure is being done, the patient may feel heat under the skin or a slight prickling. Each HIFU treatment lasts between 30 and 60 minutes depending upon the severity of the skin problem.
After Treatment, some patients have reported mild soreness, which typically resolves itself.
In the presence of these symptoms, the doctor may prescribe pain medications. Some physicians will also prescribe special facial creams to protect the skin from the UV rays of the sun and other harmful factors in the environment.
The patient does not need any downtime following HIFU treatment. She can immediately resume her daily activities. But again, she is required to apply sun protection creams to protect her skin.
To get the best results, it is advised to have HIFU treatments done for four to six weeks, followed by maintenance sessions at three to four month intervals.
Collagen production is expected to reach its optimum level at two to three months. It is during this period that a patient can already see her facial skin becoming younger-looking, healthier, softer, and supple.