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Ultrasound treatments: what are they and how do they work?

Known for effective face and body lifting and tightening, which of the latest ultrasound treatments do you need in your life?

Ultrasound imaging has been used in the medical sector since the 1940s; the procedure uses high frequency sound waves to image internal body structures.

There are two main categories of ultrasound – pregnancy and diagnostic – which are used to study unborn babies, abdominal and pelvic organs, the heart, and muscles and tendons.

Aesthetic medicine uses two types of ultrasound: high-intensity focused ultrasound (HIFU) and micro-focused ultrasound (MFU), which targets a specific skin layer.

Cosmetically, the energy source is used by practitioners to stimulate the deeper structures of the face and provide tightening for patients experiencing sagging or skin laxity.

It works by producing ultrasonic waves generated by a transducer. With the right choice of frequency, ultrasound waves of high intensity can become focused.

When absorbed in tissue at the right depth and temperature (the optimal temperature for stimulating collagen ranges between 60C and 70C), they can induce thermal injury to the tissue, thus prompting skin coagulation which is vital for skin firmness, and rejuvenation.

The technology is also used to increase collagen and elastin production, improve fine lines and wrinkles, and help practitioners to see more detail beneath the surface of the skin, including skin thickness, fat pads and blood vessels.

An interesting development has seen ultrasound becoming a useful tool for analysing dermal filler location and performance, and assisting in the management of complications. By visualising the filler, it enables dissolving filler known as Hyalase to be targeted in the relevant area, so that smaller doses can be used.

Before taking the plunge into the world of ultrasound, make sure you consult an experienced practitioner who will determine if you are a suitable candidate.

''Non-invasive skin tightening treatments that use ultrasound energy are now commonplace," says EV Expert Dr Osman Bashir Tahir. "Although many patients ask for the treatment that will get the best results, I explain that certain treatments are more effective than others for specific conditions. I evaluate a patient’s skin laxity and other features, along with considering their cosmetic goals, before recommending a specific treatment.”

Check out some of the most popular ultrasound treatments on the market…

High Intensity Focused Ultrasound (HIFU)

Original HIFU devices were used to lift and firm the neck, chin and brow and were widely adopted, despite the treatment being lengthy and more uncomfortable for the patient.

A non surgical HIFU treatment uses traditional dot technology and multiple high energy ultrasound waves to create heat between 1.5 and 4.5mm beneath the skin; this damages the skin cells, resulting in the body trying to repair them by producing collagen and elastin.

HIFU can also be used on the body for a collagen boost and skin tightening benefits. The treatment is reported to be mildly uncomfortable, which is why practitioners may apply a numbing cream and even offer painkillers to patients.

While swelling, numbness and redness are some of the temporary after effects, there is no downtime and HIFU is known to be safe and effective.


Ultherapy has been around for longer than HIFU – the FDA approved it in 2009 for non invasive skin tightening and lifting. When it launched in the UK, the treatment made the headlines as being one of the most ouchy aesthetic procedures on the market.

Things have moved on since then however, and the technology now features game-changing real-time visualisation so your practitioner can precisely see, through ultrasound imaging, the layers of tissue beneath the skin’s surface, allowing them to deliver the right amount of energy at the right depth and temperature for optimal collagen stimulation.

Suitable for most skin tones and types, including darker skin tones, Ultherapy is used for structural tightening and to counteract signs of ageing including sagging and wrinkles on the face, neck, chin and chest as well as a drooping brow.

Using micro-focused (MFU) ultrasound energy to cause focused and specific deep tissue heating without disturbing the skin’s surface, as a result, the tissues undergo remodelling which leads to new collagen formation, along with a lifting and tightening of the skin and deeper muscle layers.

Downtime can be up to 24 hours as mild tenderness, sensitivity and possible swelling may occur; results kick in around three months later.

Ultracel Q+

Said to be the world’s fastest HIFU for the face and body, Ultracel Q+ is a non-surgical contouring system that uses high intensity focused ultrasound to rejuvenate the skin on the arms, contour, lift and tighten the skin and promote collagen growth and elastin production.

HIFU is delivered deep down into the SMAS and the dermis; the SMAS is the area typically targeted in a surgical face lift. Unlike other HIFU treatments, it has fast ‘linear shot’ technology to break down and reduce stubborn pockets of fat and works three times faster (between three and 15 minutes a treatment), resulting in less discomfort.

It can also help to improve sagging, fine lines and wrinkles, jowls, dull skin, nasolabial folds, and fat under the chin and jawline, as well as other parts of the body.

There is zero downtime and the results continue to develop over the course of three months.


A new generation ultrasound device using feedback-controlled skin cooling for patient comfort, Sofwave covers a greater surface area during treatment with multiple ultrasound beams and targets the mid-dermis to deliver coagulative energy.

With tissue temperatures reaching a sweet spot of 60-70C thanks to Synchronous Ultrasound Parallel Beam Technology, studies have demonstrated improvements in fine lines and wrinkles following tissue coagulation of the mid dermis, which is located at a depth of 1.5mm on the face.

Said to be more comfortable than Ultherapy (alongside a decent slathering of numbing cream), Sofwave has been FDA-cleared for lifting of the eyebrow and submentum (chin) – because it works within the skin, the lift is impressive: 3-4mm on the eyebrow on average. It can also treat fine lines and wrinkles without injury to the epidermis.

“Sofwave was a clear winner for me when it came to choosing an ultrasound technology device for my clinics,” says Practitioner Sophie Shotter. “The incredible results, FDA clearance and the fact that it is far more comfortable than older technologies on the market, meant the decision was not a hard one.

“I was also concerned about fat loss for my patients – if they decide to graduate to a facelift, destroying fat in the face is not too conducive to having a good outcome. The results can be seen straight away (I tell my team to always do one side first so you can show them), with best results after six months. Having a comfortable technology that can lift the delicate eye area as well as the brow is an industry first.”

Look out for our review coming soon.

Osman Bashir Tahir, Aesthetic Plastic Surgery and Aesthetics

Dr Osman Bashir Tahir is a practising consultant Plastic, Reconstructive and Aesthetic surgeon. He is registered as...

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