Everything You Need to Know About Ultrasound For Cosmetic Procedures

In recent years, manufacturers began harnessing the power of ultrasound as a means to tighten skin, reduce fat, reshape the body, and reduce pigmentation.

Ultrasound, also known as sonography, has traditionally been used for medical imaging. Sonography involves sound frequencies higher than 20,000 Hz, or a higher sound frequency than what humans can pick up. These pulses of ultrasound are sent to the tissues using a probe, then the “sound” bounces back off the tissue.

Different types of tissues would reflect varying degrees of sound. These “sounds” are then recorded and displayed as an image on the screen, which the operator translates. There are different types of sonographic equipment for varying medical applications. Ultrasounds offer many advantages, from providing real-time imaging, portability, safety, and lower costs.

In dermatology, High Intensity Focused Ultrasound is applied for the treatment of solid benign tumors, like lipomas, and malignant tumors. In recent years, however, manufacturers began harnessing the power of ultrasound as a means to tighten skin, induce collagen synthesis, boost facial rejuvenation, reduce fat, reshape the body, and reduce the appearance of pigmentation.


Ultrasound waves are focused at precise points under the skin or fat, and produce micro thermal lesions on specific depths. Imagine something moving really fast focused at a particular point. This causes heat and the heat will, in turn, induce tissue changes. When the aim is to tighten the skin, specific transducers of a particular depth are used to target the dermis up to the fibro-muscular layer causing contraction of collagen, tissue coagulation followed by collagenases, while sparing the epidermis. What does this mean? This means no obvious marks or burns on the skin surface, or peeling. So, unlike needles, lasers, or other devices that bank on superficial tissue damage, you are free to get up and leave after the treatment.

Possible procedures

This is the basic principle of HIFU and it is known in the beauty and medical world by many names. You’ve probably heard about Ultraformer 3, Ulthera, Ulfit, ACTS, Liposonix, Ultrashape, or Scizer. These machines work under the same premise but are marketed with different purposes. Ultraformer and Ulthera, for example, are mostly used on the face and neck, while Ulfit, Scizer, and Liposonix are used for fat.

One advantage of HIFU is the ability to treat at different layers, from superficial to deep. You can treat skin, muscle, and fat by carefully choosing your transducer and energy settings. It is also ideal to combine with other energy devices like lasers, threads, and fillers after a certain point. It also gives treatment options for patients that can’t tolerate light, metal implants, or needles, and for those who do not wish for surgery downtime.

Patients immediately feel tight after each session but results may vary depending on the machine and the doctor’s protocol. Because it relies on wound healing and not immediate suspension (like threads), it will take time to see the results. This is between two to three months, so the changes are subtle but cumulative.

The downside and risks

The treatment isn’t painless, especially in the bony areas. Topical anesthetic creams help only up to a certain extent. Due to the depth the ultrasound beams are applied on, patients will feel it. Some people request sedation, but the pain is tolerable and worth it.

It might sound too good to be true: an hour of treatment resulting in tighter, younger, and smoother you? Well, remember it’s still a medical procedure. It does have its issues. There is still no standard protocol for this treatment. Initially, the results were inconsistent. At times, it produced no results at all. For a very costly procedure, this is a big problem.

Understanding anatomy

Understand that knowledge of anatomy is very important when it comes to this procedure. Nerves and blood vessels change in course throughout the face, coming from deep to superficial. Bruising can happen but is usually resolved in a week or so. The worst case is nerve damage, which looks like facial palsy. For the most part, this is not permanent but it does last longer than you would want it to (about a month). So patient selection, briefing, and parameters are crucial.

HIFU for fat reduction and reshaping involves transmitting temperatures between 65 to 70 degrees Celsius. This instantly causes fat tissue death. Macrophages eventually clear out the destroyed fat tissues and the heat from the HIFU also stimulate collagen production, which improves the treated area. Results can be seen and measured a month after the procedure. Scizer, for example, has really huge transducers designed for the abdomen. The beam goes 13 mm deep into the fat with energies going up to 60 joules.

The ones used on the face would normally be at 4.5 mm with energies of about 3 joules. That is a huge difference in power, so post procedure, patients tend to look bruised. The bruising is similar to getting a liposuction without the surgery. Lately, a number of studies have come out, expounding on the use of HIFU for pigmentation or in combination with other materials like Radiesse for stretch marks.

Seeking treatment

Fat reduction is great for people who are not obese. One would need at least an inch of fat via body caliper to be considered a good candidate. The treatment aims to destroy fat, not muscle. If you are the type of person who will demand immediate changes, then this might not be for you. There are results, but they occur over time.

A doctor’s consultation is needed for the procedure. The treatment isn’t safe for pregnant women. Patients must also disclose any injections or implants prior to the treatment.

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Windie Villarica
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