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Medical HIFU is a very popular treatment as a “non-invasive lift.
Recently, HIFU is available at various facilities, but many people find it “ineffective” or “less effective,” and there is increasing interest in medical HIFU.
Further, the patient actually undergoing HIFU treatment needs to be informed and careful. Because the face has many nerve pathways, and irradiation to the wrong location could lead to a serious accident.
We asked Dr. Hiroko Sugino, who regularly performs lifting treatment with HIFU, to give us a demo of the actual procedure. She explains the actual process along with points to be noted when using medical HIFU.
In particular, please note her attention to areas that are particularly hard to treat, such as around the jaw and eyes.
- INDEX
Dot and linear treatment of the right half of the face
Cartridge setting: dot 4.5mm/0.8J
Proceeding to the lower jaw, cheeks, outer corner of the eyes, under the chin, and forehead.
Mandible
Avoid procedures on the inferior border of the mandible. The mandibular rim branch of the facial nerve comes up from this area.
It is effective to target the area where the SMAS is located.
Always visually check the hard-to-see area under the chin by observing it. Support the chin with your hand if it is not stable.
Cartridge setting: dot 3.0mm/0.7J
cheeks
Target fibrous tissue in the adipose layer. Avoid irradiation around the infraorbital foramen due to the infraorbital nerve.
Special attention is needed when irradiating around the eyes. Irradiate only the outer part of the eye area.
No irradiation inside the marionette line with 4.5 and 3.0 mm cartridges to avoid the miter nerve.
Beneath the chin
Lateral submandibular area is most prone to burns and edema. Pay attention to skin color, etc. Note also the greater auricular nerve.
Forehead
Avoid the area near the base of the eyebrow due to the supraglenoid and supraorbital nerves. Ensure to check for any numbness.
Cartridge setting: dot 1.5mm/0.5J
Linear, like RF, delivers heat to the entire skin. Linear does not “burn” a single point like dots, allowing it to be irradiated to areas with infraorbital nerves.
Tightening is achieved by applying heat from the dermal layer to the subcutaneous tissue.
Cartridge setting: Linear 4.5mm/0.6J
It is aimed at fat loss. Linear HIFU is also expected to have a fat-loss effect. Since the fat is coming down to the lower border of the mandible, the key is to irradiate it while lifting it up.
Irradiate mainly the jowl and beneath the chin. Up to this point, the skin should be quite red. Carefully ask the patient if it is not too hot.
Treatment of the right eye area (forehead and corner of the eye)
Extreme care should be taken when treating the area around the eye to avoid irradiation of the following areas
【Areas to avoid irradiation】
- Eyebrows
- Upper eyelids and eye area
- Areas of facial nerve temporal branch running beyond bony prominence of outer edge of frontalis muscle
Cartridge setting: Linear 2.0mm/0.5J
Forehead
If the forehead is strongly curved or uneven, not adhering the probe closely may cause burns. Make sure the probe is in close contact.
Corner of the eye
Upper eyelid skin is carefully irradiated only in bony areas. Eyebrows can be elevated with gauze to increase the area of irradiation.
Dot and linear treatment of the left half of the face
Left side. Same notes as on the right side.
She has more sagging than on the right side, so the joules are slightly increased on the left side.
The area with ligaments is irradiated well, but the zygomatic area can be painful, so it is important to monitor the patient carefully.
As with the right side, irradiation is proceeded from the lower jaw, cheek, lower eyelid, and forehead.
Linear is done in the same way.
Left eye area (forehead and corner of the eye)
Irradiate the forehead and the corner of the eye with the same steps as the right side.
As with the right side, avoid irradiating the following area below:
【Areas to avoid irradiation】
- Eyebrows
- Upper eyelids and eye area
- Areas of facial nerve temporal branch running beyond bony prominence of outer edge of frontalis muscle
Accidents have also occurred in medical laser hair removal where eyebrows have been lost due to mis-irradiation. Great care must be taken to eliminate potential accidents.
The changes in treated areas before/ immediately after the treatment
When measured with a dedicated device, the face is confirmed to have been lifted.
Conclusion(Lastly)
With the increase in cosmetic awareness, more patients are expected to wish to get facelifts. Jeisys Medical Japan regularly invites doctors to give lectures in order to ensure that patients can undergo the procedure in comfort. Please join us for our webinars.
