HIFU In this study, we evaluated the clinical improvement, adverse effects, and patient satisfaction through the evaluation of clinical photographs and by using a questionnaire at 3 and 6 months after Ulthera treatment, in patients older than 30 years who desired facial lifting and wrinkle improvement.
HIFU Twenty patients with facial wrinkles and skin laxity were enrolled in the study. All patients were of Fitzpatrick skin types III and IV. Informed consent was obtained from all patients, consisting of 18 women and 2 men. The patients' ages ranged from 37 to 75 years (mean, 52.3 years).
HIFU They were treated with a HIFU tightening device (Ulthera system; Ulthera Inc., Mesa, AZ, USA) to the entire face, except for the nose and eyes, by using the following probes: 4 MHz, 4.5-mm focal depth; 7 MHz, 4.5-mm focal depth; and 7 MHz, 3.0-mm focal depth.
We used hand pieces that delivered energy at 7.5 MHz and focal depths of 3.0 and 4.5 mm. Topical lidocaine/prilocaine cream (EMLA cream; Astra Pharmaceutical Products Inc., Westborough, MA, USA) was applied under an occlusive dressing for 60 minutes.
In three patients, we used a nerve block of the supraorbital, supratrochlear, intraorbital, and mental nerves. After cleaning the face, a layer of ultrasound gel was applied to the skin. Each probe delivered a set of pulses in a linear array at 1-cm intervals. From 400 to 500 shots were delivered according to the size of the face.
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