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What is HIFU and why all the craze?

A HIFU stands for High-Intensity Focused Ultrasound. It has recently been growing in popularity due to the increased demand for achieving significant non-invasive skin lifting and tightening. The HIFU also helps with reducing the appearance of excess fats on areas such as the jowls, double chin and cheeks.

HIFU utilises ultrasound energy to tighten the skin and reduce unwanted facial fats in certain areas. Ultrasound is an energy modality that can be focused and penetrated deep into the skin layers to cause thermal (heat) coagulation.

The ultrasound used in HIFUs is similar to ultrasound scans in medical clinics or hospitals. However, instead of scanning a broad area, ultrasound energy in HIFU is focused and converged onto a small focal point deep in the skin.

This results in increased temperatures on the focal point, creating tissue coagulation to stimulate collagen production and targeted fat reduction. There is no damage to the surrounding skin or tissue except only at the focal point.

As a result, HIFUs are able to target deep skin layers to cause tightening and lift the face without needles or surgery. Here’s an important point to note: A HIFU takes about 10 weeks before results can be seen because time is needed for collagen production and tightening.

Where can I do the HIFU on?

  • Full facelift (overall tightening)
  • V-shape facelift
  • Double chin reduction
  • Jowl reduction (tightens and reduces saggy jowls)
  • Brow lift

Who is most suitable for a HIFU, HIFU vs Thermage

I usually choose my patients carefully according to face shapes and conditions. In general, HIFUs are more suitable for people with a heavier lower face, prominent jowls, or excess facial fats.

HIFU – or Ulthera as some know it as – has been compared with the popular Thermage. Thermage is more suitable for patients with more skin laxity, fine facial lines, and a thinner face.

Read what Dr Joanna has to say when it comes to choosing a HIFU or Thermage.

What are the differences between HIFUs?

Too often have I encountered a patient asking, ‘why is your HIFU more expensive than what my friend did?’. The reason for this is because there are different types of Ultrasound machines, which also mean different efficacies and results.

In Singapore, ultrasound procedure for lifting should be categorised into two groups; the HIFUs (only performed by doctors) and Microfractionated ultrasound (or microfocused ultrasound, which can be performed by therapists or spas).

Below is a comparison of Ultraformer vs a micro-fractionated ultrasound:

Ultraformer HIFU Microfractionated Ultrasound
Need only be done once every 12-18months. 4-6 treatments needed
Only performed by qualified doctors. Performed by therapists.
Achieve a temperature of up to 72 degrees under the skin due to focused energy. Achieve a temperature range of 38-50 degrees under the skin due to smaller heat concentration.
Penetrates deeper, up to 4.5mm under the skin to effectively target the SMAS layer which is responsible for a non-surgical facelift. Does not penetrate as deep as focused ultrasound HIFUs
Can be used to reduce excess fats. Cannot reduce excess fats.
Cost for a full face hifu: about $2000-$2500 Cost of each session: about $300-$600, depending on device.

So how do I choose which HIFU?

There are some HIFU brands that our doctors personally like. These brands are namely the Ultraformer, Ulthera, and Doublo-S.

The reason why our doctors feel that these brands are superior to other HIFUs / Microfractionated ultrasounds is due to the peak power and stability of the machines, which results in a higher energy output. This will, therefore, improve efficacy per treatment, and produce better results with just one treatment.

How should a HIFU procedure be, and why is it important to choose the right HIFU?

1. Done by Doctor vs Therapist

In Singapore, medical procedures are closely regulated and a MOH-approved HIFU should only be performed by a qualified doctor.

2. Number of Treatments

A good HIFU procedure for a facelift should only need to be done once every 12-18 months, depending on the individual. As for fat-melting procedures such as for jowls or double chin reduction, 1-2 procedures might be needed.

A micro-fractionated HIFU and various other HIFUs from certain brands may not omit the same amount of heat or energy as a traditional HIFU, and may require more sessions to achieve visible results.

3. Pain management

A good HIFU procedure should also NOT be ‘painless’. A HIFU a utilises a high amount of heat to partially damage collagen structure, allowing them to repair over time to become tighter and firmer.

Also, this heat reaches up to 72 degrees under the skin to damage fat cells and can be used to reduce double chins and chubby jowls.

Because of this heat, a HIFU procedure will be slightly uncomfortable as the procedure progresses, as the heat accumulates under the skin. For those who are concerned about the discomfort, I usually perform a nerve-block to reduce sensation.

A nerve-block is the injection of local anaesthesia to numb the face, like how a dentist will inject local anaesthesia to numb the gums before a tooth extraction. A nerve-block greatly reduces any possible pain, and also allows me to perform the HIFU at a strong power setting for optimum results.

With a micro-fractionated ultrasound procedure, the procedure is ‘painless’ as there is less heat generated and the energy is spread out under the skin, resulting in a less ideal outcome as compared to a normal HIFU. This might end up requiring many more treatments than a normal HIFU.

Common FAQs

How many sessions do I need?

Only 1 session is needed for a facelift. For double chin reduction, 1-2 treatments will be needed.

What can I expect from a HIFU?

  • A face-lift, especially for the lower face
  • Tighter skin
  • Reduction in jowls and laugh lines
  • Eyebrow lifting

Does it hurt?

A good HIFU will cause some discomfort due to the high energy and heat generated for good results. Numbing cream is needed and at Mizu, our doctors are trained to administer nerve blocks to reduce sensation on the face for those who have a lower pain threshold.

Does it really melt fat?

A good HIFU procedure, when done in a unique way, can be used to reduce fats on the face. Specific HIFUs are also used to reduce body fats.

Excess facial fats such as jowls, double chin, and chubby cheeks can be reduced with a HIFU.

Why Mizu Aesthetic?

At most clinics, skin tightening and facial lifts are standardised procedures.

We believe that facial rejuvenation needs to be individualised, from laser procedures to HIFU facelifts. A HIFU is no exception and detailed attention needs to be paid to different individuals.

At Mizu, Dr. YZ Tan has had the honour of being invited by Ultraformer manufacturer, Classys, to Seoul, Korea for a one-to-one discussion and training with renowned Seoul aesthetic doctor Dr Cho Chang-Hwan of Dongan Centre Clinic. This has allowed Dr. Tan to move away from standard protocols and develop his own techniques for individualised HIFU procedures with his team.

Our team of doctors were also invited to Seoul for the International Microaesthetic Surgery Anatomy Masterclass (IMSA) hands-on practicals, which helped them recognise the specific anatomy of the facial SMAS layer. This was crucial in helping us formulate our unique technique of facial tightening and lifting with the HIFU and other face lifting techniques.

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