My experience with HIFU (High-Intensity Focused Ultrasound)

The other week I dabbled with a facial treatment at New You Medispa  I've never tried before. If you read my last post, you may have noticed there was a trend in the treatments I have sort after since turning 30. Working in facial aesthetics has its pros and cons. Having a knowledge of the ageing process and the changes that occur to every level of the face at each decade and knowing the treatments that can help limit or the reduce the signs of ageing is no bad thing. Having easy access to a network of practitioners that can provide a number of those treatments is also wonderful. However, being able to detect the little signs that my face in changing with age that usually goes unnoticed until they become more significant can be torturous. It's unsurprising that according to Dr. Selina (of Dr. Selina Clinics) that BDD (body dimorphic disorder) is as high as 14% in the aesthetics practitioners community. These ageing changes bother me, for sure, as much as ripping the seam in the only pair of black denim jeans that stay wondrously black wash after wash. Annoying, but I don't spend all day thinking about it.  


The sad reality is that around the age of 25 as women, our collagen production starts to decline. This decline is steady through our 30's and 40's until menopause when it dramatically reduces. Collagen affects the laxity of the skin and the ability to 'snap back' leading to increased in sagging and the formation of folds and wrinkles. Unfortunately, this decline is inevitable and although there is no way to completely halt the decline and stop ageing there are certainly ways to prevent the drop in collagen production.  


There is an abundance of misinformation which regards to collagen production and the ways to fight the ageing process. One thing for sure is that collagen-containing creams are simply a waste of time. The collagen molecule is too large to be absorbed through the skin surface - therefore topicals simply sit on the skin surface. With regards to "collagen capsules" these most commonly come from animal sources like chicken bones - as collagen is a protein - like other proteins it has to be broken down to be absorbed and you'd have to pop a little of those pills for them to make a difference.  


So like with anything, I like to have some good hearty clinical evidence of a treatment efficiency before I invest. It's the classic combination of being a medical professional and a cynic. I want proof. It's why I don't bother with fads like activated charcoal - but you didn't hear that from me. Some clinical trials report clinical improvement in skin tightening results to be as high as 94% 1. However, speaking with Dr. Aneesha from Skyn Doctor clinics, I was aware before embarking on treatment that results can be very dependant on the individual practitioner.




So HIFU, what exactly is it?


The principle of HIFU is the use of high-frequency ultrasound beams at specified treatment sites to induce controlled cellular damage and volume reduction without damage to the skin layer. Though cellular damage seems counterintuitive to healthy skin, the damage actually stimulates the cells to produce more collagen. More collagen means tighter, smoother firmer skin with fewer wrinkles.  


The first dermatological use for HIFU was in 2008 before it gained FDA approval in 2009 for its use in brow lifting. Currently, the use for facial tightening is 'off-label' use - not unlike many things in aesthetic medicine.




That all sounds wonderful, but what I really want to know is…does it hurt?


Yes and no. As the technician passed the handpiece over my skin and fired the ultrasound beams, with each go, she asked me how the pain was. She started on low power and gradually increased the power (possibly encouraged by the words "crank it up" that left my mouth). It felt hot - not surprisingly as HIFU uses ultrasound energy to target layers of the skin, causing them to heat up rapidly. But the heat wasn't painful, the discomfort came more from the electric feeling that came from the handpiece. It felt like electric shocks were passing from it through to my jaw bone a bit like the game in the arcade you used to play that "electric shocked" you.  The metal retainer on the back of my front teeth felt like it was playing a high pitched tune. I have one filling in a lower right molar, and when the handpiece passed over it, pain shot through the tooth. Afterwards, I felt a combination of throbbing and numbness that passed in less than 10 minutes - I went to work that afternoon. As per aftercare instructions, I applied make up straight after and practically forgot I'd had the treatment. Three days later however I had my usually anti-wrinkle treatment (commonly known as botox), and I couldn't believe the pain. Usually, I rank it as a 2/10, but this time was an 8/10, and it wasn't the practitioner or the product. Then 7 days after treatment, I felt bruised. Not physically bruised, but my lower face was sore to touch. It was painful using a beauty blender but not unpleasant otherwise - which I was aware was to be expected. 


How long does the treatment take? 
 
 Ahead of my treatment appointment, I had attended a 15-minute consultation to allow the practitioner to assess my suitability for treatment. I was in the treatment room for an hour - the actual treatment component took around 30 minutes, but the practitioner took her time to explain the pros and cons of treatment and gain informed consent. Most courses of treatment comprise of three treatment sessions though on their advice, I've started with one with a follow-up of some radiofrequency 6 weeks after. 



How about the results?
 
 If this were in my aesthetics practice, I would class this an "unsexy" treatment. Lips, cheeks, jawline fillers; sexy treatments with immediate results. Jawline slimming toxin, profhilo; unsexy treatments - significant effects but results take several months to show. Which is understandable - I'd be placing the deposit on a machine tomorrow If it could grow me new collagen in a fortnight. But like with my other beloved facials including microdermabrasion and dermapen even If there's not an immediate 'sexy' result I feel like I'm doing some good for my skin in the long run. I took my skin for granted in my 20's, but I hope that won't be a regret of mine in my 40's. 

1. Clinical effectiveness of a high intensity focused ultrasound in skin lifting. Medical Laser dec 2014 K Joehopon et al