Combining HIFU (high-intensity focused ultrasound) with thread lift is an effective way to address the sagging skin and changes in fat volume that occur with age. This article is a report on a live surgery for HIFU and also a thread lift for double chin. It explains in detail the mechanisms, indications, and process of each treatment, and considers the optimal lifting strategy.
- INDEX
- What is HIFU? Effects and Treatment
- Process of HIFU Treatment
- Approach to the Pain and the Efficacy of HIFU
- Duration of HIFU Results and Appropriate Treatment Intervals
- Controlling Fat Gain and Loss with HIFU
- Thread lift Procedure and Its Design
- Long-lasting Lifting Effect through Subcutaneous Detachment
- Maintenance and Long-term Care after Thread Lifting
What is HIFU? Effects and Treatment
Linear Mode of HIFU (high-intensity focused ultrasound) is a treatment that can lead the fat layers, which increases with age, to apoptosis in in stages.
HIFU is an excellent treatment, but over time, cells will try to return to their original state, so in order to maintain the effect, it is recommended to insert threads after HIFU treatment to promote collagen production and tighten the skin.
Process of HIFU Treatment
During the live surgery, we used Linear Mode, switching the depth from 4.5mm to 1.5mm at intervals of 0.5mm. We started at a depth of 4.5mm with an output of 0.4J. In the past, some treatments used stronger output, but now a treatment policy of repeatedly irradiating with low output is being taken, which has increased safety.
Approach to the Pain and the Efficacy of HIFU
The procedure is based on the concept of producing a lifting effect by stimulating fat contraction rather than by cauterizing the SMAS layer. This minimizes the pain associated with HIFU, which was previously said to be quite painful, and allows treatment to be carried out at an appropriate output. The ideal output for HIFU is a level that induces apoptosis with moderate stimulation, and if there is strong pain, it may indicate that necrosis is occurring.
Duration of HIFU Results and Appropriate Treatment Intervals
The recommended treatment interval for HIFU is 2 to 3 months, and if left untreated, the results will return, so it is important to tighten the skin afterwards. By combining the treatment with a skin tightening procedure, longer-lasting results can be expected. Since the excess skin will be left after reducing the amount of fat with HIFU, a procedure to tighten the surface is necessary.
Controlling Fat Gain and Loss with HIFU
For treatments to increase fat, HIFU is applied in Dot Mode at a depth of 6mm with an output of 0.1J, and then again at a depth of 9mm with the same output. This makes it possible to increase fat in specific areas while maintaining the overall balance. By combining HIFU irradiation on the appropriate layers with post-treatment tightening procedure, it is possible to achieve a more lasting lifting effect.
Thread lift Procedure and Its Design
There are two main methods to perform a thread lift under the chin. One is to insert the thread in a V-shape from the hard area called the mastoid and lift it up while pulling it from the back to the front. The other is called “Necklace Lift”, where a needle is inserted from the midline under the chin to both sides and pulled up to prevent a double chin. The Necklace Lift was performed at this live surgery.
The design prior to the procedure is crucial. Check the area where the double chin forms and decide where to pass through the threads. Be especially careful to pass the thread under the lower jawbone, because if the thread crosses the lower jawbone from top to bottom, it will pull the skin unnaturally. Anchoring point is set about 1.5 cm below the earlobe, near the anterior border of the sternocleidomastoid muscle. It is important to fix the thread to hard tissue to maintain the lifting effect.
Long-lasting Lifting Effect through Subcutaneous Detachment
An important step is to perform subcutaneous detachment. Using a blunt 18G needle, the skin and fat layer are slightly and gently detached to promote the skin fusion afterwards which in turn maintain the lifting effect. Without the detachment, the skin will not be firmly fixed over time.
Maintenance and Long-term Care after Thread Lifting
Once the threads have been anchored in place, the overall facial balance is adjusted and the procedure is complete. After the procedure, the patient is explained the importance of long-term maintenance. Thread lifting is not a permanent solution and requires regular care.
Today’s procedures involved a necklace lift to improve the patient’s double chin. It is important to provide appropriate care tailored to the patient’s condition while continuing to monitor their progress over the long term.
