Treating the face with HIFU therapy (High Intensity Focused Ultrasounds)

Unfortunately, sagging skin on the face is an unavoidable process that starts very early (sometimes from age 20) due to gravity and also endogenic factors (genetics, hormones, etc.) and exogenic factors (weight fluctuations, smoking, stress, sun exposure, dehydration, etc.).

Modern medicine is rapidly evolving due to the increasing demand for non-invasive (i.e. non-surgical) skin sagging treatments.

To address this, aesthetic medicine offers a wide range of complementary treatments that are even more effective when carried out sooner rather than later – i.e. to tackle the early signs of skin sagging – and when these treatments are combined.

Though surgery is undeniably more effective, especially complex operations such as cervicofacial lifts (very invasive), aesthetic medicine offers a number of solutions, which may or may not be combined. They include:

Filler product injections, such as hyaluronic acid and/or calcium hydroxyapatite (Radiesse) into so-called “lifting” areas such as the cheekbones, tear trough, oval of the face . These treatments allow us to harmonise the facial contours by restoring any lost volumes to make the face look softer and more rested, while avoiding any excesses.
Tensor threads (permanent or absorbable) for a mechanical lifting action to complement filler injections. This technique is not currently available in our practice, as it was deemed too invasive for the durability of the results.
Fractional and non-fractional lasers to treat the skin’s surface and give it a plumper, more even and more radiant appearance, as opposed to firming it up.
In our practice, we have a Hollywood Spectra laser (Q-Switched). Our laser specialists select the most suitable laser treatment after analysing the patient’s skin in a free consultation.
HIFU: High Intensity Focused Ultrasounds
This is a complementary technique, often combined with injections, that is offered as part of a treatment plan for skin sagging, though only on thicker skin.
HIFU act upon the different layers of the skin and on the adipose layer (fat). These electroacoustic waves stimulate collagen and elastin synthesis (to retract and tighten the skin), and also destroy some of the fat cells to slim down the treated area.

HIFU, a recent technology?

Using focused ultrasounds is nothing new, but the modern machines are much more powerful and effective than the earlier ones.

A lot of studies have been carried out for this medical device, and it has obtained the highest FDA (Food and Drug Administration) standard, which proves its safety and efficacy.

HIFU, for which patients?

We can use ultrasounds to treat all phototypes, i.e. all skin colours, and at any time of year, since the electroacoustic waves do not interfere with skin pigmentation (melanin), unlike lasers.

HIFU, how do they work?

Les ultrasons de haute intensité émettent des ondes acoustiques au travers des tissus traités en un point bien précis, induisant une ultra courte émission de chaleur intense (+ de 65°C) sans endommager les tissus avoisinants.

Comme expliqué plus haut, il y aura une action sur toute l’épaisseur de la peau, à différents niveaux :

4,5 à 6 mm: action hypodermique sur les muscles et la graisse profonde
3 mm: derme moyen : action sur les fibroblastes : synthèse de collagène et élastine
1,5 mm: derme superficiel : action sur la qualité de la peau apparente

Ainsi, pour une même zone traitée, le médecin spécialiste utilisera différentes pièces à main, pour agir sur les différentes profondeurs, toujours des couches profondes vers les couches plus superficielles.

HIFU, what happens during a session?

Like for all aesthetic medicine procedures, the initial step is a medical diagnosis that enables Dr James Schinazi’s associate to set the right indications and identify any possible counterindications (pregnancy, breastfeeding, thin and/or too saggy skin).
The doctor marks out the treatment area using a skin-marker pencil and applies a contact gel to enable the HIFU to diffuse properly.
The different layers of the skin are then treated using the 4.5mm, 3mm and 1.5mm handpieces. The treatment is almost pain-free. The patient may feel a prickling sensation, but it is quite bearable.
Depending on the surface to treat, each session will take between 30 minutes and 1 hour.

HIFU do not lead to any additional volumes in the face over the long term.

No downtime is required, and the patient can get back to their daily life immediately after treatment.

Some redness and/or swelling may appear in the days following treatment, but this is temporary. Some patients also notice some skin sensitivity in the body areas that have been in contact with the handpiece.

All of these known side-effects are temporary* and not everyone will experience them.

HIFU, for what indications?

Early to moderate skin sagging, especially in the oval of the face
Sagging in the forehead and eyebrows
Sagging in the neck and décolleté
Reducing malar pouches
Reducing a double chin
Moderate skin sagging in the abdomen, arms and knees

All of these indications require a prior medical examination with the specialist in order to ensure that this treatment will have a real effect on the patient’s sagging skin.

HIFU, what protocol is used?

The first results are visible at the end of the session, but progressively improve over 2 months as the collagen synthesis and draining of the fat cells happens over 2 to 3 months.

We generally recommend having 2 to 3 sessions per zone, spaced 2 months apart on average, for results that last 1 to 2 years.

HIFU treatments can be followed by hyaluronic acid injections, either immediately or after a given time, in order to restore the volumes lost over time, particularly in the cheekbones and tear trough, in order to make the face look more shapely, younger and softer.

HIFU, how much does it cost?

Like any aesthetic medicine procedure performed in our practice, our specialist doctors first draw up a quote. This is free of charge and in no way commits the patient to having the treatments suggested.

The fee charged for a HIFU session depends on the size of the area to treat and therefore the treatment time. In general, each session costs between 400 and 800 euros.

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FAQ — Your questions about HIFU therapy

What is HIFU and how does it work?
HIFU (High-Intensity Focused Ultrasound) emits acoustic waves that create intense heat (over 65°C) at a precise point, without damaging neighbouring tissues. These waves stimulate collagen and elastin production and destroy some fat cells, acting at several depths: 4.5-6 mm (muscles and deep fat), 3 mm (mid dermis, fibroblasts) and 1.5 mm (superficial dermis, skin quality).

What are the indications and who can be treated?
HIFU treats mild to moderate skin laxity, notably of the oval of the face, forehead, eyebrows, neck and décolleté, as well as malar bags and double chin (it can also be used on the abdomen, arms and knees). All skin types can be treated, in any season, as there is no interference with melanin, unlike lasers.

How does a session go and are there any after-effects?
After a medical diagnosis, the practitioner marks out the area and applies ultrasound gel before treating the different depths with dedicated handpieces. The treatment is almost painless (bearable tingling) and lasts 30 minutes to 1 hour depending on the surface. There is no downtime; temporary redness or swelling may appear in the following days.

What is the protocol and how much does it cost?
The first results appear at the end of the session and improve over 2 months. 2 to 3 sessions per area, 2 months apart, are generally recommended, for an effect lasting about 1 to 2 years. The treatment can be complemented by hyaluronic acid injections to restore volume. Prices start at 450 euros per session.