Use of Ultrasound in Face and Neck Rejuvenation

Aim and Background: To review the current state of ultrasound energy-based devices and their role in facial and neck rejuvenation. Historical Aspects: High-frequency ultrasound (HIFU) paved the way for the micro-focused and parallel beam ultrasound technology in aesthetics. Anatomy: Facial and cervical aging reflect multilayered structural changes, as well as reduced collagen production and increased collagen breakdown at the histologic level, resulting in rhytids and skin laxity. Technology: Micro-focused ultrasound with visualization (MFU-V) is adapted from HIFU, using significantly less ultrasound energy and visualization to precisely target the deep dermis and superficial musculoaponeurotic system (SMAS) at depths ranging from 1.5 to 4.5 mm; synchronous ultrasound parallel beam (SUPERB) technology uses parallel transducers to deliver energy at a precise depth of 1.5 mm to target the mid-dermis. Patient Selection: Ultrasonic facial rejuvenation is ideal for those with mild to moderate skin laxity who desire incremental tightening and textural improvement without surgery. Techniques: MFU-V can be performed at different tissue depths based on the transducer tip, with various combination protocols described; SUPERB technology delivers energy at a fixed depth. Postoperative Care: Self-limited erythema and edema, sun protection. Current and Future Development: The intersection of ultrasonic devices and regenerative medicine is promising. Conclusion and Clinical Relevance: MFU-V and SUPERB are ideal noninvasive options for patients with mild to moderate skin laxity.