The World of cosmetic dermatology is not limited to one magical treatment that can turn back the clock. Often, we need to work across multiple layers of the face to give our patients and adequate result.

Over reliance on one treatment such as Botox or fillers can often lead to a natural result.

One of my favorite treatments to achieve face lifting in a non-invasive fashion is high frequency ultrasound.


This treatment is designed to target tissues in a non-invasive or a minimally invasive manner. It is well tolerated and it does not alter the epidermal barrier function or physiology of skin.

Significant increase in the elasticity of skin are seen 12 weeks after a single treatment which reflects improvement in dermal tissue function due to an intrinsic tissue remodeling process.

This Technology was first created in 1972 by Frank Fry to destroy brain tumors. It has been used to destroy prostate cancer cells as well. It was only 30 years after used in medicine that it’s aesthetic and lifting properties were discovered.

These devices deploy Micro Focused ultrasound waves that, at certain energy levels, produce heat over 55ºC at the focal point, which leads to heat induced coagulation points in the target tissue. However, because the beams are so fine it does not cause any damage outside the tissue we are targeting. At different depths, this can bring about either a lifting effect or skin tightening, depending on the structure targeted in a non-invasive or minimally invasive manner.

Noninvasive facial treatment with intense micro focused ultrasound (MFU) started to be developed, such as Ulthera® System (Merz North America, Raleigh, NC), (DeepSee®; Merz North America, Raleigh, NC), followed by Doblo (Hironic®, Korea) , and Ultraformer (Cryomed®, Australia), .

As MFU is a focused ultrasound device, at certain energy levels, it produces heat over 55ºC at the focal point, which leads to thermal coagulation points (TCPs) in the target tissue. This creates a healing cascade, ending with neocollagenesis and neoelastogenesis.

This healing is regulated and described as an “orchestra playing” by Reinke and Song, which begins immediately after the first phase of the injury and lasts for 1 to 3 days.

This is the most important phase for the purpose of collagen stimulation. During this very early phase, mediators such as different growth factors lead to the production of new collagen and elastin, as well as new blood vessels within the extracellular matrix The second phase of proliferation lasts for 5-10 days under the control of regulating growth factors and other basic substances needed for wound healing.

These represent the basis for the new connective tissue matrix, serving to close tissue gaps and to restore the mechanical strength of the wound. Subsequently, there is synthesis of collagen increases and the third phase can last from 21 days to 1 year. The aging process involves more than just collagen and elastin restoration.

We must understand that there are different needs in terms of stimulation. Therefore, patient assessment and selection become a key point in understanding whether just one treatment such as Micro focused ultrasound is enough to induce collagen formation, or if other procedures that up-regulate mediators and cell migration are also needed during the first phases of healing started by MFU.


Cosmetic Dermatology and Aesthetic Medicine is not limited to a single treatment. Neither can a single treatment achieve optimum results.

Patients are strongly advised to consider combination therapies for achieving best non surgical facelift & non surgical lifting results, targeting different areas and layers of the face/hands etc. Please look at the Morpheus 8, Ultraformer 3 and Tixel sections of this website,

In addition, we recommend the use of Skin boosters such as Profhilo, Skinko E or Redensity 1 to keep your skin looking youthful.