The HIFU (High Intensity Focused Ultrasound) face lifting system was developed by Ulthera. Similar to the mechanism of creating heat from focusing light through a concave lens, the ultrasound energy is focused into a small area to cause thermocoagulation. Ultrasound focused onto a focal point or target area can cause micro thermal denaturalization similar to that in the dermis following fractional laser irradiation. This leads to collagenesis and wound contraction. The resultant outcome is lifting, which is difficult to achieve with previous devices.

 

 

Personally, I have a wealth of memories with this device as I was one of the first in Japan to purchase the device. During the clinical review of the device after the development phase, I heard that the manufacturer was starting their Asia regional review in Japan. I contacted Ulthera’s team stationed at Japanese research centers and universities to purchase their HIFU device and volunteered my participation in the clinical data collection. In Japan, doctors can purchase new medical devices under his own liability without the approval of the health authorities. I purchased the new HIFU device under the condition that I treat a certain number of patients using irradiation parameters and methods predefined by Ulthera and provide photographs of treated cases. I also purchased and installed at my practice Canfield’s specialized photography equipment which is used by Ulthera to record clinical images.

 

HIFU device in Korea.

 

When I first heard about the mechanism of action of this device, I immediately felt that it would bring innovative changes to the sagging skin. HIFU lived up to my expectations in practice and brought outstanding results. I could visually see the deeper layers including the SMAS tighten and give an overall lifting effect. The device that I purchased was one of the earlier models and has become discolored on the exterior but still works well.

 

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I was surprised to see the high level of enthusiasm among Korean doctors toward HIFU

 

HIFU was originally developed and used for treatment of transrectal prostate cancer. Therefore, I was already quite confident of its effect without having seen the device.

In the early days, the protocol was to irradiate over a single layer at a fixed focal length of the transducer. The neck area was to be avoided. However, as these methods rarely brought desired outcomes, I irradiated on multiple layers including the neck area based on my frequent consultations with Ulthera and shared opinions of specialists around the world. Then, I was able to achieve satisfying results.

The device was immediately marketed in Japan but its sales were stagnant. This was because the manufacturer promoted the device only to experienced cosmetic surgeons well-versed in facial anatomy due to the risk of neural paralysis and pain.

Sales began in Korea soon after. Around the time of the market launch, a workshop on the science of the device was held in December 2009. I was asked to give a talk on clinical experience and live demonstration.

The participants of the workshop were surprised to see the enthusiasm of Korean doctors for this new device. In Japan, a workshop for a single device rarely attracts such a large audience unless it is a part of a larger academic conference. After the workshops held in Seoul and Busan over consecutive days, a few Korean doctors visited my practice with many questions about Ulthera.

 

-To be continued-