High-intensity focused ultrasound (HIFU) therapy is a relatively recent option for skin tightening. It employs focused ultrasound energy to stimulate collagen production, which helps create firmer, more resilient skin.
HIFU is most commonly associated with tumor treatment. The first cosmetic application of HIFU was reported in . Today, many view it as a noninvasive, minimally uncomfortable alternative to surgical facelifts.
The Food and Drug Administration (FDA) cleared HIFU in 2009 for brow lifts. The device received further FDA clearance in 2014 for improving lines and wrinkles of the upper chest and décolletage.
A number of small clinical trials have demonstrated HIFU’s safety and effectiveness for facial lifting and wrinkle improvement. Patients often notice results within a few months after treatment, without the risks linked to surgical procedures.
Although the procedure is also used for broader facial rejuvenation, lifting, tightening, and body contouring, these applications are considered “off-label,” which means the FDA has not formally approved HIFU for those uses.
More research is needed to clarify which patients benefit most from HIFU. So far, it appears to be a promising substitute for facelifts, particularly for younger individuals who prefer to avoid surgical risks and downtime.
HIFU is less effective for people with more pronounced sagging skin.
HIFU facial
HIFU directs focused ultrasound energy at layers of skin just beneath the surface. The ultrasound energy causes rapid heating of the targeted tissue.
When the cells in the treated zone reach a specific temperature, they experience controlled cellular injury. Although this might seem counterproductive, that injury triggers the cells to ramp up collagen production — the protein that provides structural support to the skin.
The boosted collagen leads to firmer skin with fewer wrinkles. Because the high-frequency ultrasound beams are concentrated on a precise tissue depth beneath the skin, the outer layers and nearby tissues remain unharmed.
HIFU may not be suitable for everyone. Generally, it works best for people over 30 who have mild-to-moderate skin laxity.
Individuals with skin that’s been heavily damaged by sun exposure or those with significant skin looseness may require multiple sessions to notice improvement.
Older patients with advanced photo-aging, severe laxity, or markedly sagging neck skin are typically poor candidates and may need surgical intervention.
HIFU is not advised for people who have infections or open wounds at the treatment site, severe or cystic acne, or metallic implants in the area to be treated.
Benefits of high-intensity focused ultrasound
Per the American Society for Aesthetic Plastic Surgery (ASAPS), HIFU and other nonsurgical facelift alternatives have become markedly more popular in recent years. The total number of such procedures rose 64.8 percent between 2012 and 2017.
HIFU offers several cosmetic advantages, including:
- reduction of wrinkles
- tightening of sagging neck skin (often called “turkey neck”)
- lifting of cheeks, brows, and eyelids
- improvement of jawline definition
- tightening of the décolletage
- smoother skin texture
Research findings are encouraging. A involving 32 Korean participants showed that HIFU significantly enhanced skin elasticity of the cheeks, lower abdomen, and thighs after 12 weeks.
In a larger study of 93 participants, 66 percent of those treated with HIFU reported improvements in the appearance of their face and neck after 90 days.
HIFU vs. facelift
HIFU involves far fewer risks and expenses than a surgical facelift, but its effects may not be as long-lasting and repeat treatments could be required. Below is a summary of key differences between the two approaches:
Invasive? Cost Recovery Time Risks Efficacy Long-term effects
HIFU — Noninvasive; no incisions. Average cost: $1,707. Recovery: none. Risks: mild redness and swelling. In one , 94% of participants reported improved skin lifting at a 3-month follow-up. The same found that visible improvement lasted at least 6 months. Additional HIFU sessions will likely be needed as aging continues.
Surgical facelift — Invasive surgery requiring incisions and sutures. Average cost: $7,562. Recovery: 2–4 weeks. Risks: anesthesia complications, bleeding, infection, blood clots, pain or scarring, and possible hair loss at incision sites. In one , 97.8% of patients rated their improvement as very good or beyond expectations after one year. Results tend to be long-lasting; in one , 68.5% of people described very good or better results an average of 12.6 years postprocedure.
HIFU for face cost
ASAPS reports the average price for a nonsurgical skin-tightening treatment in 2017 was $1,707. This contrasts sharply with the average surgical facelift cost of $7,562.
Final costs depend on the treatment area, your location, and how many sessions are necessary to reach your goals.
Contact a local HIFU provider for a price estimate. Health insurance typically does not cover HIFU cosmetic procedures.
What does HIFU feel like?
You may feel mild discomfort during HIFU. Some describe sensations like tiny electric zaps or a light prickling.
If you’re concerned about pain, your clinician might recommend taking acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil) before the session.
Right after treatment, mild redness or swelling may appear but usually fades within a few hours.
HIFU for face procedure
No special preparation is usually required before HIFU. Remove all makeup and skincare products from the area to be treated.
Typical steps during an appointment include:
- The physician or technician cleans the target area.
- A topical anesthetic cream may be applied beforehand.
- An ultrasound gel is spread over the skin.
- The HIFU device is positioned against the skin.
- Using an ultrasound viewer, the clinician sets the device to the appropriate settings.
- Ultrasound energy is delivered in short pulses to the targeted area for about 30 to 90 minutes.
- The device is removed.
If more sessions are indicated, you will schedule follow-up treatments.
During energy delivery, you might feel warmth and tingling. Pain medication can be taken if needed.
You can go home immediately and resume normal activities after the appointment.
HIFU treatment for face side effects
When performed by a trained, qualified provider, HIFU is considered very safe.
A major advantage is the immediate return to daily life after leaving the clinic. Slight redness or swelling can occur but usually resolves quickly. A mild tingling in the treated area may last a few weeks.
Rarely, temporary numbness or bruising may occur, but these side effects typically resolve within days.
Before and after
The takeaway
HIFU is regarded as a safe, effective, noninvasive option for tightening facial skin.
Its benefits compared with surgical facelifts are considerable: no incisions, no scars, and no mandatory downtime. HIFU is also substantially less costly than a surgical facelift.
Most patients observe full effects after their final session.
If you want a quick, minimally uncomfortable, noninvasive choice, HIFU is an excellent alternative to surgery.
However, HIFU is not a cure-all for aging. It works best for those with mild-to-moderate skin laxity, and repeat treatments may be necessary every one to two years as aging progresses.
For older individuals with significant skin sagging and deep wrinkles, HIFU may not fully correct these issues.
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