Featured Experts
Dr. Omer Ibrahim, a board-certified dermatologist in Chicago
Dr. Norman Rowe, a board-certified plastic surgeon in New York City
Dr. Lyle Leipziger, a board-certified plastic surgeon in Great Neck, New York
If you’ve never heard of an HIFU facial, take heart in knowing that you’re not alone. (It was an unfamiliar term even for our RealSelf veteran editors.) But it turns out that it’s actually not anything new at all—just the technical term for a very well-known treatment. Here’s what you need to know.
What is a HIFU facial?
HIFU stands for high-intensity focused ultrasound; an HIFU facial is simply another term for Ultherapy. “Ultherapy is the brand name, HIFU is the technology being used,” explains Dr. Omer Ibrahim, a board-certified dermatologist in Chicago. (Think of it as the equivalent of Kleenex and facial tissue.) HIFU delivers very small, very focused areas of thermal damage, he says, adding that it is also referred to as microfocused ultrasound, or MFU. While there are other HIFU devices available overseas, Ultherapy is the only one that’s FDA approved in the United States, says Dr. Ibrahim.
How does a HIFU facial work?
The concept behind any type of ultrasound-based device is the same: “The ultrasonic energy penetrates through the epidermis into the deeper dermal and subdermal layers of the skin. It creates heat, which damages and kills cells, ultimately triggering the production of new collagen,” explains Dr. Norman Rowe, a board-certified plastic surgeon in New York City. And more collagen translates to smoother, tighter skin.
What’s the difference between a HIFU facial and Sofwave?
It’s admittedly a bit confusing, because Sofwave also uses ultrasound energy and promises similar lifting and tightening benefits. But the difference lies in Ultherapy’s technology. “HIFU produces very targeted areas of thermal damage at specific depths in the skin—1.5, 3, and 4.5 millimeters,” explains Dr. Ibrahim. “Sofwave works differently, with high-intensity parallel-beam ultrasound. It’s still ultrasound energy, but it’s delivered at a singular depth of 1.5 millimeters. HIFU creates tiny, concentrated, pinpoints of heat, whereas Sofwave creates a more widespread, bulk heating underneath the skin,” he says. While there’ve not yet been any head-to-head studies comparing the two treatments, Dr. Ibrahim says that, anecdotally, results are comparable—and that Sofwave is noticeably less painful.
What kind of results can a HIFU facial deliver?
While this treatment can be performed on the full face and neck, Dr. Rowe says that it’s most effective when addressing fine lines and laxity around the perioral region and cheeks. “Because there’s more fat in these areas, the intensity can be dialed up, ultimately yielding better results,” he explains. Bonier areas (such as the forehead or around the eyes) can’t be treated as aggressively, since delivering heat too close to the bone becomes extremely painful, he notes. Regardless, results are anything but instantaneous. “People need to understand that this treatment is about gratification over time. In order for the collagen production and skin-tightening effects to take effect, it can take anywhere from three to six months,” says Dr. Lyle Leipziger, a board-certified plastic surgeon in Great Neck, New York.
Who is a good candidate?
“This treatment is by no means a magic bullet and it’s never going to yield the results of a facelift, so it’s imperative that people have realistic expectations,” cautions Dr. Leipziger. “It’s a good option for ‘tweeners’—the subset of patients who fall somewhere between needing something more than filler and not quite yet being candidates for a scalpel.” Dr. Rowe agrees, adding that it’s worth incorporating into a preventive routine. “HIFU is a good jumping-off point for someone in their 30s or even late 20s who wants to get ahead of the aging game—as well as for someone who really doesn’t want surgery and is willing to accept any type of improvement, even if it’s minimal,” he says.
What is a HIFU facial like?
Buyer beware: the term facial is a major misnomer. “This is not a relaxing, spa-type facial. It’s a full-on treatment that can really be painful,” warns Dr. Ibrahim. Topical numbing, oral Valium, nitrous oxide—you’re going to need some type of medication because Ultherapy is uncomfortable; Dr. Rowe notes that it’s often best reserved as an add-on treatment performed when people are under anesthesia for something else, such as a rhinoplasty. It takes anywhere from 30 minutes to an hour and is designed to be a one-and-done procedure, though it will need to be repeated every year or so if you want to maintain the results.
What are the side effects of a HIFU facial?
While the treatment itself doesn’t feel great, downtime is minimal. You’re completely bypassing the top layer of the skin, so there’s need to worry about lingering redness, peeling, or flaking. If anything, some minor swelling is the only potential side effect, and this should dissipate quickly, says Dr. Rowe. There is, however, the potential for a slightly more serious complication. HIFU can inadvertently penetrate too deeply, destroying fat cells and ultimately resulting in more skin laxity rather than less. This is why it’s imperative to see a provider who’s well trained and experienced in Ultherapy, cautions Dr. Ibrahim.
