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Focused Ultrasound Skin Tightening

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Focused Ultrasound Skin Tightening

Ultrasound was useful in two ways for tightening of facial and neck skin.

Depending on the frequency and focusing, ultrasound energy can target any structure in the body. In dermatology, its use has been studied primarily for melting fat, but skin tightening might be possible as well. In this industry-sponsored, rater-blinded, prospective study, 35 subjects underwent a single focused ultrasound treatment of the face and neck.

Treatment was delivered via a focused ultrasound device that lays down rows of small thermal coagulation zones (approximate size, 0.5–0.75 mm by 1.0–1.5 mm), spaced about 1.5 mm apart and deposited at a proximity of about 4 mm from the skin surface, depending on the probe used. The rows were placed 3–5 mm apart. Real-time diagnostic ultrasound was used first to determine skin thickness and to guide the choice of probe to target the deep dermis and superficial fat of the face and neck. Three experienced clinicians unaware of treatment state analyzed eyebrow lift using standardized photography.

At 90 days after treatment, 86% of patients were judged to have clinically significant eyebrow elevation. Mean eyebrow lift at 90 days was 1.7 mm. All subjects developed trace to slight edema and erythema that resolved within 1 week. Two subjects developed raised white streaks on the neck when treated with the 3-mm probe. High-potency topical corticosteroids completely resolved the problem within 1 week. No other adverse events were seen. A 4.5-mm probe was used for all subsequent treatments without side effects.

Comment: Focused ultrasound apparently produces significant skin tightening. The duration of the effect remains to be seen. Although eyebrow elevation was the only quantified effect, other areas should respond as well. The real-time diagnostic ultrasound component of the process should permit optimal targeting of dermis, fat, or fascia, depending on the desired therapeutic result, while avoiding important structures, such as nerves.

— George J. Hruza, MD

Published in Journal Watch Dermatology March 19, 2010


Alam M et al. Ultrasound tightening of facial and neck skin: A rater-blinded prospective cohort study. J Am Acad Dermatol 2010 Feb; 62:262.

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By the lack of responses to this I would guess that most people do not see the implications of this study. As you age and your skin loses tension your scars will worsen. At 38 your scars will look worse than they do at 18.

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