Recently, minimally invasive treatments for skin laxity have diversified, expanding options to include device-based therapies, thread lifts, and combinations thereof. This webinar presents findings from two case studies using ULTRAcel [zi:], verifying the synergistic effects achievable by performing HIFU prior to thread lift procedures. Although the number of cases is limited, clinically interesting findings were obtained, such as reduced reversion (revert to its pre-thread lift state) and sustained lifting effects. This content serves as a reference for future treatment planning.
- INDEX
Background for Evaluating Combined HIFU and Thread Lift Treatment (00:56-)
The combination of minimally invasive treatments is already practiced in many clinics, but few physicians have clear answers regarding the indications and timing for combining HIFU and thread lifts. Whether facial volume loss is present is a key factor in this treatment choice. When fat volume is low, restoring volume should be prioritized first. When skin is thick or fat volume is high, using energy-based devices before thread procedures may clarify the target area and potentially enhance efficacy. Therefore, this study examined the degree of reverting to the pre-thread lift state when threads were inserted after HIFU tightened the subcutaneous support tissue. HIFU creates linear thermal coagulation points, inducing collagen contraction and regeneration. Thread lifts, on the other hand, utilize ligaments and septa between compartments to anchor lax tissue. Theoretically, combining these two treatments offers high complementarity.
Treatment Design and Progress of Two Cases (03:40-)
The subjects were two women in their 50s. First, ULTRAcel [zi:] was used to deliver 1,000 lines (Dot + Linear) across the entire face. One month later, a thread lift using APTOS Visage Excellence HA was performed. Treatment effects were evaluated over time using standard photographs and 3D LifeViz.
Case 1 presented with moderate skin laxity and prominent jowls as the primary concerns. Facial contour tightening was observed immediately after HIFU treatment, with further lifting effect increase observed one month later. Maximum effect was achieved immediately after thread lift, followed by slight reversion over the next month; however, the level maintained remained comparable to that achieved with HIFU alone. Volume analysis also confirmed reduced downward sloping of the right jowl and moderate mid-face volume enhancement, resulting in very high patient satisfaction.
Case 2 was characterized by more pronounced skin laxity, thin skin, and soft fat. HIFU treatment resulted in mid-cheek augmentation and lateral lifting. The lifting effect was clearly visible immediately after the thread lift and remained relatively stable over the following one and two months. The nasolabial folds and jowls also consistently showed a reduction in volume, leading to high patient satisfaction.
How HIFU Helped Reduce Reversion (14:42–)
A particularly noteworthy point in these cases is the extent to which “reversion” occurred after thread placement. Generally, when only thread lifts are performed, significant lifting occurs immediately after treatment, but the effect often halves after one month and then persists for 3 to 6 months. In this combined treatment case, Case 1 showed some degree of reversion, but Case 2 maintained clear lifting effects 1 to 2 months after the procedure. This suggests that the strength of the ligaments and septa supported by the threads may have been improved by the pre-operative HIFU, enhancing the fixation force.
Conclusion and Future Prospects (18:34- )
These two cases suggest that performing HIFU preoperatively may help reduce reverting to the pre-thread lift state to some extent and potentially enhance the longevity of the lifting effect. While HIFU alone can provide some improvement in skin laxity, the subsequent thread lift clearly defines facial contours and enables optimization of results, including facial volume adjustment.
