What has changed in HIFU technology over the past 10 years? What should you pay attention to when choosing a device?

2022-01-10

Ultrasound has been one of the most indispensable technologies in the field of aesthetic medicine for many years. Let's talk about what's new in the HIFU technology market.

Valeria Vakarchuk , dermatovenerologist of the highest category, cosmetologist, medical director of NBC GROUP Ukraine, chief physician of Beauty & Medical “Place Under the Sun” (Odessa), specialist in ANTI-AGE therapy, preventive medicine, member of RUSIAM

One of the most effective and popular procedures using ultrasound in hardware medicine is HIFU, High Intensity Focused Ultrasound. This is due to the ideal correlation of the pronounced effect of the procedures with their relative safety, minimally invasiveness and accessibility for patients and doctors.

The lifting effect of the procedures is achieved due to the penetration of focused ultrasound energy into the deep structures of the skin, in particular, acting on SMAS.

How High Intensity Focused Ultrasound Works

In places where ultrasound is focused in the layers of the dermis, hypodermis and SMAS, heating points are created where thermocoagulation occurs. Focusing and activation of processes is carried out directly through a converter, or transducer - a sensor that generates and directs high-frequency pulses.

How does a transducer work?

The concave ceramic vibrates with high frequency ultrasonic pulses and generates ultrasonic waves.
Ultrasonic waves are focused towards the center.
The center of the accumulation of ultrasonic waves forms a thermal region.
The depth of penetration depends on the curvature of the lens and the frequency of the ultrasound.
The center of the thermal area has the highest heating temperature.

The heating points are located on the same line at a set depth: during the SMAS lifting procedure, the depth reaches 1.5, 3, 4.5 mm; for body procedures – 8, 13, 18 mm.

Thus, the great advantage of HIFU is that stimulation of neocollagenogenesis occurs without the impact of ultrasound on surrounding tissue. This explains the fairly rapid post-procedural rehabilitation period.

What should you be wary of when working with a HIFU device?

It is very important for a specialist to study the technology from all sides in order to be as objective as possible when advising his patient this or that procedure: there is no limit to perfection, even if the technology has been developing in the beauty industry market since the last century!

The main problem when working with HIFU devices is pain at the thermocoagulation points. They can irritate nerve endings and cause very unpleasant sensations. The anatomical features of the structures and the pain threshold are different in patients, so it is very difficult for a specialist to predict the pain of the procedure. It is also worth understanding that severe pain is not a sign of high effectiveness, so you need to monitor the patient’s condition during the procedure.

More complex complications from HIFU therapy are associated with thermal destruction of various blood vessels, nerve endings, muscle, and connective tissue.

**Possible complications of HIFU therapy**
Complication	Localization	Duration
Erythema	Mid face, neck	Few hours
Edema	Midface, around the lower jaw	3 - 72 hours
Hematoma	Midface, temples	2 days - 2 weeks
Painful Feel	Mid face	2 days - 2 weeks
A loss sensitivity	Eyebrows, mid-face, neck	2 days - 6 weeks
Muscular weakness	Eyebrows, midface, neck	2 days - 6 weeks
Damage facial nerve	loss of elasticity above the upper lip	2 weeks - 3 months

Complications from the HIFU procedure

HIFU is the method of choice in any tissue rejuvenation and lifting protocols

The SMAS device is one of the first to succumb to the aging process. Stretching and weakening of the true and false ligaments of the lower third of the face under the influence of gravitational forces leads to displacement, protrusion and atrophy of fat packets. Subsequently, the face looks tired and atonic.

Age-related changes in facial structures

One of the most effective methods to correct age-related changes in SMAS is HIFU technology.

Indications for HIFU therapy:

Presence of tissue ptosis.
Deformation and loss of clarity of the oval of the face.
The appearance of a double chin.
Drooping of the cheeks, eyebrows, corners of the lips and eyelids.
Descent of soft tissues under the chin.
Flabbiness of the neck area.
Improving skin quality, eliminating sagging in the face and body.
Correction of local fat deposits throughout the body.
Prevention of ptosis.

Benefits of using HIFU

Focused heating, penetration depth up to SMAS

The technology is capable of heating tissue to 65-75 degrees Celsius , forming an area of thermal coagulation in the layers of the dermis, hypodermis and at the SMAS level.

Differences in the operation of different hardware technologies; Top row from left to right: CO2 fractional laser (ablative), Fractional erbium glass laser (non-ablative), Infrared lifting, Monopolar RF, Microneedling RF; bottom row: HIFU

Impact on the supporting ligaments and also work with fatty tissues: displacement and increase in the volume of adipose tissue (orbital, malar fat, Bisha's fat pad)

True ligaments originate from the periosteum:

orbital (A);
orbitozygomatic (B);
zygomatic ligament – McGregor tissue (C);
mandibular (N).

False connectives—originate from SMAS:

parotid cutaneous (D);
platysmo-auricular (E);
masticatory cutaneous (F);
buccomaxillary ligament (G), true and false.

Anatomy and syntopy of the suspensory ligaments of the face

Reconstruction of collagen using thermal energy without damaging surrounding tissues

Instant reduction of collagen with the launch of neocollagenesis within 3 months .

Comfortable post-procedural results with an invisible recovery period

Natural, natural result
No overcorrection on the face
Fast recovery period
Lack of seasonality of the procedure
There is no downtime of the device
No visible marks of correction on the face

Ultrasound HIFU technologies: what's new?

Science in aesthetic medicine does not stand still, and patients have more and more opportunities to emphasize their beauty in the most effective and safe way.

As mentioned above, most complications from HIFU procedures are associated with the high intensity of energy, which is focused in the heating area. One of the latest developments of the South Korean company KORUST (KOREA Ultra Sound Technology) , specializing in the research, development and production of devices for HIFU technology, allows minimizing the risk of adverse consequences of SMAS face and body lifting procedures.

While other manufacturers of HIFU devices are chasing profits without actually changing anything in the devices for more than 10 years, the company, after analyzing the world experience in using HIFU and the existing problems of its use, invented a new device UTIMS-A3 .

HIFU device UTIMS-A3 , KORUST, South Korea

Advantages of the UTIMS-A3 device

1. CENTERLESS ™ technology

The essence of the technology is to isolate the center of the transducer (sensor), which avoids overheating of the tissue at the center of the heating point. When a thermal area is formed, there is no overheating of the tissues in its center.

The absolute advantage of CENTERLESS™ : Unlike other HIFU techniques, Centerless allows you to maintain the effectiveness of the procedure without reducing the parameters of the device, while reducing pain, and also reducing the risk of tissue overheating, leading to complications in the form of burns and scars.

Thanks to the development of technology , pain during HIFU therapy has been reduced by 50% , which makes it more popular with patients.

2. Large selection of sensors

There are nine types of transducers in total: three for the body and six for the face. This allows the creation of broad protocols, since aging involves many structures of the skin and the musculo-ligamentous apparatus. Variations in shape and power of the sensor allow the specialist to comfortably work on almost all areas of the body and face.

Sensor name	Sensor depth	Line length	Sensor Feature
C4D 4 MHz	4.5 mm	5-30 mm	The impact is carried out on SMAS in the middle and lower thirds of the face, décolleté.
C7D 7 MHz	4.5 mm	5-30 mm	The effect is carried out depending on the thickness of the skin on the SMAS or hypodermis in the upper, middle and lower thirds of the face.
C7M 7 MHz	3.0 mm	5-30 mm	The effect is carried out depending on the thickness of the skin on the hypodermis or deep layers of the dermis in the upper, middle and lower thirds of the face, in the neck and décolleté.
N7M Mini 7 MHz	3.0 mm	5-15 mm	The effect is carried out depending on the thickness of the skin on the hypodermis or deep layers of the dermis in anatomically difficult-to-reach areas, such as the periorbital and areas of projection of hard-to-reach ligaments.
C10S 10 MHz	1.5 mm	5-30 mm	The impact is carried out on the deep layers of the dermis in the upper, middle and lower thirds of the face, in the neck and décolleté.
N10S Mini 10 MHz	1.5 mm	5-15 mm	The impact is carried out on the deep layers of the dermis in anatomically difficult-to-reach areas, such as the periorbital and perioral.
C3F 3 MHz	18 mm	5-30 mm	The impact is carried out on the hypodermis with a fold thickness (pinch grip) of at least 36 mm.
C3N 3 MHz	13 mm	5-30 mm	The impact is carried out on the hypodermis with a fold thickness (pinch grip) of at least 26 mm.
C3N 3 MHz	8 mm	5-30 mm	The impact is carried out on the hypodermis with a fold thickness (pinch grip) of at least 16 mm.

Characteristics of transducers of UTIMS devices

The difference between sensors for the face and body

3. Impact line is 20% longer

The line length on the UTIMS device = 30 mm - this is 20% longer, in contrast to devices with a line length of 25 mm. Thus, one procedure requires 20% fewer lines than other devices .

And also many other advantages for the comfortable work of the specialist and high-quality results for the patient:

Universal handpiece with double-sided operation: suitable for left-handed and right-handed people
Low cost of the procedure: ensures high profitability
2 year warranty on the device HAS CE / Korea FDA CERTIFICATION: official warranty from the manufacturer
Possibility of renting the device from an exclusive distributor - NBC GROUP Ukraine .

Results of using the UTIMS-A3 device

Correction of the periorbital zone using the UTIMS-A3 device

Correction of facial contours, reduction of double chin, smoothing of facial expressions and reduction of deep wrinkles using the UTIMS-A3 device

Lifting the skin of the neck, correction of fat deposits on the abdomen, lateral surface of the back, increasing the tone of the skin of the thighs with the UTIMS-A3 device

Factors on which the results depend:

Number of lines;
Device parameters;
Scheme of work;
The severity of age-related changes, the type of aging;
Tissue fullness, tissue swelling;
Combination of protocols;
Cellular resource;
Correct information about the future result.

The UTIMS-A3 device is an indispensable assistant to an aesthetic medicine specialist in anti-age therapy. A carefully collected patient history, visualization studies and the content of the HIFU procedure technique are a guarantee of a bright lifting effect and minimization of adverse complications.

You can find out more information about new products in the field of HIFU ultrasound technology by watching the video recording of the lecture from Injection Congress 2021:

Possible complications of HIFU therapy