HIFU: Am I suitable, and which type of HIFU should I choose?


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 focuses and penetrates deep into the skin layers, causing 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 focuses and converges onto a small focal point 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. Best results are at 12 weeks, as collagen production and tightening takes time.

Where can I do the HIFU on?

  • Full face lift (overall tightening)
  • V-shape face lift
  • Double chin reduction
  • Jowl reduction (tightens and reduces saggy
  • jowls)
  • Brow lift
  • Neck 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 our doctor has to say when it comes to choosing a HIFU or Thermage.

What are the differences between the type of HIFUs?

Too often have I encountered a patient asking, ‘why is your type of 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 procedures for lifting should be categorised into two types. HIFUs done by doctors (focused ultrasound), and HIFUs performed by therapists (fractionated ultrasound). 

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 face lift.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-$2500Cost of each session: about $300-$600, depending on device.

So how do I choose a proper type of HIFU?

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

There are two reasons why we feel that these brands are superior: 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?


Done by Doctor vs Therapist
Proper HIFU machines are registered medical devices in Singapore and are only done by licensed doctors.


Number of  Treatments

A proper HIFU face lift procedure is repeated once every 12-18 months. As for fat-melting procedures such as for jowls or double chin reduction, 1-2 sessions might be needed.

A micro-fractionated HIFU or a unbranded HIFU may not omit the same amount of heat or energy as a proper type of HIFU, and may require more sessions to achieve visible results.


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.

A fractionated ultrasound procedure is ‘painless’, as less heat is generated and energy is spread out. This results in a less ideal outcome as compared to a normal HIFU. It also ends up requiring many more treatments than a normal HIFU.

Common FAQs

A face lift only requires a single session with a proper type of HIFU. For double chin reduction, 1-2 treatments may be needed.
  • A face-lift, especially for the lower face
  • Tighter skin
  • Reduction in jowls and laugh lines
  • Eyebrow lifting
A good HIFU will cause some discomfort due to the high energy and heat generated for good results. Numbing cream is always applied prior to procedure. At Mizu, our doctors also administer nerve blocks to reduce sensation on the face for those who have a lower pain threshold.

A proper HIFU procedure can reduce fats on the face / body when done properly with the right handpieces.


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

We believe that facial rejuvenation and anti-aging procedures need to be individualised. A HIFU is no exception, and we pay detailed attention to everyone’s unique needs.

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

We were also invited to Seoul for the International Microaesthetic Surgery Anatomy Masterclass (IMSA) hands-on practicals. This helped our doctors 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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