What is HIFU treatment? HIFU treatment is a non-surgical treatment that uses high intensity focused ultrasound to deliver energy to selected depths beneath the skin, creating controlled thermal stimulation within the targeted tissue while leaving the surface of the skin intact. It is used to address mild to moderate laxity and loss of definition.
That is the short answer. What is HIFU treatment in practice, though, and how does it differ from the other non-surgical options being marketed alongside it? This article explains how the technology works, what it is used for, what a session actually involves, what recovery looks like, and who it may not suit.
How does HIFU work?
Focused ultrasound works on a similar principle to light passing through a magnifying glass. Ultrasound energy travels through the surface of the skin without affecting it and converges at a precise depth below, where the concentrated energy raises the temperature of a very small volume of tissue.
That controlled thermal stimulation causes collagen fibres within the treated zone to contract, and it initiates the body’s natural collagen remodelling response over the weeks that follow. Because the energy is focused rather than spread across the surface, no incision is made and nothing is removed.
Newer platforms, including the Ultraformer MPT used at our clinic, deliver micro and macro focused ultrasound, usually shortened to MMFU. Micro focused ultrasound creates small, precise points of thermal stimulation. Macro focused ultrasound treats a broader area at a different depth. Having both available means the treatment can be adapted to the tissue in front of the practitioner rather than applied uniformly across every face.
Treatment depths and cartridges
A focused ultrasound platform uses interchangeable cartridges, and each cartridge is built to deliver its energy at a specific depth. The depth selected determines which layer of tissue responds, ranging from the more superficial layers of the dermis through to the deeper supporting tissue beneath.
In practice this means a single session may use several cartridges across different parts of the face. Your practitioner selects the combination based on the area being treated, your anatomy and the concern you have come in about.
What is HIFU treatment used for?
What is HIFU treatment generally used for? Focused ultrasound is used where the concern is laxity and loss of definition rather than surface texture or pigmentation. Concerns commonly assessed for this kind of treatment include:
- Mild to moderate skin laxity
- Reduced definition through the lower face and jawline
- Jowling
- Fullness underneath the chin, known as the submental area
- Fine lines and a general loss of firmness
- Laxity through the neck
- Contouring of selected body areas
It is worth being clear about the limits. Focused ultrasound is suited to mild and moderate laxity. It does not remove excess skin, and where laxity is more advanced a different approach, or a combination of approaches, is usually more appropriate.
What happens during a HIFU treatment
A treatment begins with assessment rather than with the device. Your practitioner looks at your facial structure, the degree and pattern of laxity, the quality of your skin and what you are hoping to change, then decides whether focused ultrasound is a reasonable option for you at all.
If it is, the area is cleansed and ultrasound gel is applied. The handpiece is placed against the skin and energy is delivered along mapped lines across the treatment area. Most people describe the sensation as warmth, tingling and brief pulses of energy, sometimes with a deeper aching sensation over bony areas such as the jawline. A full face and neck treatment commonly takes between 30 and 60 minutes, though this varies with the areas included.
Normal Mode and MP Mode
Modern platforms offer more than one way of delivering the same energy. Normal Mode creates individual focused thermal points and is generally used where precision and lifting are the priority. MP Mode, short for micro-pulsed mode, distributes energy differently across the treatment area and allows the practitioner to adjust delivery to the tissue and the concern being addressed.
The two are not competing options. Your practitioner may use both within a single session, in different areas and at different depths, as part of an individual treatment plan.
Recovery and aftercare
Most people return to their usual activities immediately after a focused ultrasound treatment. That is not the same as there being nothing to recover from. Skin often looks slightly pink and feels warm for a few hours, and mild tenderness, sensitivity to touch or a bruised feeling along the jawline is common. This typically settles on its own over several days, occasionally over a couple of weeks.
Less commonly, small areas of numbness or altered sensation occur in the treated area and resolve over the weeks following. Swelling and small areas of bruising are also possible.
Sensible aftercare is straightforward: protect the treated area from sun, keep your skincare simple for a few days, and avoid deliberate heat such as saunas, hot yoga and very hot showers for a day or two. Your practitioner will give you aftercare specific to the areas treated and to your skin.
HIFU side effects, risks and who it is not suitable for
Every energy-based treatment carries risk, and focused ultrasound is no exception. Reported effects include redness, swelling, tenderness, bruising and temporary numbness or tingling. Less commonly, temporary irritation of a nerve can cause weakness in a small area of the face, and where energy is applied in an area with very little tissue beneath the skin, small irregularities in contour are possible.
Focused ultrasound may not be appropriate where skin laxity is significant enough that a surgical approach would be more suitable, or for people with very lean faces and minimal facial volume, where reducing volume further is not the goal. Other considerations apply depending on your medical history and what else is going on in the treatment area, which is one of the reasons assessment comes before treatment.
This is not a complete list and it is not a substitute for assessment. Careful patient selection is what separates a good outcome from a disappointing one, and it is the reason a consultation comes first.
Does HIFU work, and when do HIFU results show?
Asking what is HIFU treatment capable of is a fairer question than asking whether it works. Focused ultrasound is an established non-surgical modality for laxity and definition and is used widely for that purpose. Outcomes, however, vary considerably between individuals, and honest expectations matter more here than with almost any other treatment.
Some people notice an initial feeling of firmness or tightening soon after their treatment. The more meaningful change, where it occurs, develops progressively over roughly eight to twelve weeks as collagen remodelling takes place, and it can continue to develop beyond that. Degree of laxity, age, skin condition, the settings used and individual biology all influence the response, and not everyone responds to the same extent.
How focused ultrasound compares with other approaches
Compared with other focused ultrasound devices. Several platforms use focused ultrasound, including Ultherapy and the Ultraformer range. They differ in the depths available, the delivery modes offered and whether real-time imaging is used during treatment. The more meaningful variable is usually the assessment behind the treatment and the settings chosen, rather than the name on the machine.
Compared with radiofrequency. Radiofrequency devices heat a volume of tissue more diffusely, while focused ultrasound concentrates energy at specific points and depths. They are often used for overlapping concerns and are sometimes used together within a treatment plan.
Compared with surgery. A facelift repositions and removes tissue. Focused ultrasound does neither, and it cannot reproduce the degree of change surgery achieves. It is better understood as an option for people with mild to moderate laxity who are not seeking surgery.
You can read more about HIFU treatments at our Perth clinic, and about why the neck often shows skin ageing first.
Frequently asked questions
Does HIFU hurt?
Comfort varies between individuals and with the area and depth being treated. You may feel warmth, tingling and brief pulses of energy, and areas over bone such as the jawline are often felt more strongly than others. Most people describe it as tolerable rather than comfortable. Your practitioner will adjust the treatment to the area and to what you can reasonably tolerate, and it is worth asking what to expect before you begin.
How long do HIFU results last?
This varies with age, skin condition, the intensity of the treatment and the fact that skin continues to age afterwards. Some people find the effect remains noticeable for around twelve months, while for others it is a shorter or a longer period. Maintenance treatments are commonly discussed as part of an ongoing plan rather than as a one-off.
How many treatments will I need?
That depends on the degree of laxity, the area being treated and what you are hoping to achieve. Some people are satisfied after a single treatment. Others benefit from additional sessions followed by maintenance. A treatment plan is set out after assessment rather than decided in advance.
Can focused ultrasound be combined with other treatments?
Yes. Depending on your concerns it may form part of a broader plan alongside other skin, laser and energy-based treatments such as skin needling. Order and timing matter, so the sequence is planned at consultation. Some treatment options can only be discussed during a consultation with a registered health practitioner.
Will focused ultrasound make my face look too thin?
Not necessarily. Depths and delivery modes are selected according to the goal, whether that is tightening and lifting the skin, improving definition, or addressing unwanted fullness. Facial anatomy is assessed before treatment so that volume is preserved where it matters. People with very lean faces and minimal facial volume may not be suitable candidates.
Is focused ultrasound a replacement for a facelift?
No. It is a non-surgical treatment and it cannot reproduce the degree of lifting achieved with surgery. It is generally considered by people wanting to address mild to moderate laxity, firmness and facial definition without surgery.
Book a consultation
If laxity through the lower face, jawline or neck is something you have been thinking about, the useful first step is an assessment rather than a treatment. At Everything Skin by Dr Salon in Perth, a consultation covers your facial structure, the degree and pattern of laxity, your skin, your history and what is realistic for you, including whether focused ultrasound is the right approach at all or whether something else would serve you better. If you have been researching what is HIFU treatment able to do for your own concern, that is the question a consultation is designed to answer.
Important information
This information is general in nature and is not medical advice. It is not a substitute for a consultation with a registered health practitioner. Outcomes vary between individuals and no result is guaranteed. Some treatment options can only be discussed during a consultation with a registered health practitioner. All procedures carry risks, which will be explained to you during your consultation. Always seek advice from a qualified health practitioner about your individual circumstances.
