The micro-focused ultrasound face lift treatment is more and more popular in Hungary, but there’s a wide range of price and quality of treatment, and they don’t always correlate. Therefore, some factors should be clarified that affect whether the treatment will be worth the money. I won’t go into detailed technical descriptions of treatment, because these can be found on many web sites: what happens during treatment, on what principle it works, etc. You can check it out; the texts are roughly the same.
Epidermis, Upper dermis, Deep dermis, Hypodermis (connective tissue and fat tissue), SMAS Muscle tissue
I’ll focus instead on whether treatment will be efficient and impressive. This depends on two things:
- The competence of operation
- The device itself
Let me immediately make the point that there are several good HIFU devices on the Hungarian market. However, the treatment can be ineffective even with a good machine. Moreover, even a good machine can cause serious side effects (unfortunately, there are a number of examples). And, of course, with an ineffective device, there is little a competent operator can do, even when complying appropriately with the treatment protocol. Here’s what to look for and why.
Criteria for an appropriate treatment
Thorough and correct consultation.
Did you get information about cases in which treatment cannot be performed, and what should not be done two weeks before and after treatment? Many aesthetic treatments are not recommended two to three months before and after treatment. A competent operator does not undertake the treatment if, for example, the applicant underwent a Thermage treatment the previous week. But the question may emerge, when afterwards, within two or three months, a different type of treatment will be suggested: how do you know which treatment had the desired effect? I have seen many examples in which the treatment was not undertaken correctly in one place, so the client went to another salon in just two weeks or a month. For such a profound, expensive and new treatment, couldn’t we wait for two or three weeks in order to be in good hands?
Realistic promises.
While we are on the subject of getting the right information: Were you promised that the results would last for ten years? That skin would appear ten to fifteen years younger? With a good HIFU treatment, we can realistically rejuvenate five to seven years for a period of 1-2 years. The later the treatment is performed, the more treatments (up to 2 or 3, 3 to 6 months apart) may be recommended, and the shorter the effects may last. Precise and thorough information is important.
Accurate treatment planning.
Treatment cards should be used to assess how many shooting points can be applied, and the implementation of the treatment should be planned on a face map. This map should be drawn to the face prior to treatment. Anaesthesia is not recommended because it’s important to know if something hurts. If it does hurt, it means a nerve or a veinlet was hit and the parameters need adjusting. Should the operator omit the planning step, the treatment won’t be as accurate, thorough and safe. Be sure to ask who performs the treatments. A doctor or a certified health care provider is more likely to have the skill to plan and perform the treatment accurately.
Well-chosen treatment depth.
All HIFU devices have multiple heads, each head targeting different depths. If the tips are not properly used, the beneficial fat layer will be ablated and the face will be frighteningly drawn in. There are some regions where not all the heads should be used. If the operator does not know this, treatment can cause more harm than good.
Working at more depths.
If the operator uses only one treatment tip, you may get 50% satisfaction; at 2 depths you get 75%. In addition, the results continue to improve for a period of 6 months, compared to 3 months for one depth. As I said above, however, each region of the face is different. A good HIFU treatment works in 3 layers, but not all depths can be applied everywhere. Peoples’ skin thickness and nerve locations are unique. If the device has a live imaging unit, selection of the wrong tip and the depletion of beneficial fat can be avoided.
All three depths are not necessary, or even possible, at every session. At Revital, we carefully plan sessions to maximize results. If the client asks, the depth of 1.5 can be performed immediately, but a good treatment at 3 mm or 4.5 mm takes 2-2.5 hours to perform. Afterwards, clients won’t be able to stand the 1.5 mm treatment because of time or effort, so the result cannot be maximized. If we really want to achieve the best result, the last 1-1.5 hours at a depth of 1.5 mm we do at another time, so we can work thoroughly with higher energies. Thus, up to 1000-1200 impacts can be performed on one face. This is not possible within one session.
Working in more directions.
Did the operator go over the face in several directions with the treatment tip? Or did they just go in one direction with one head and then change the treatment tip immediately? This makes quite a difference for the results. By skimping, the operator may save on shot number or treatment time, or they may not be completely familiar with the correct procedure. Crossing in multiple directions may improve the result by 20-30%.
Working in the right direction.
If the operator does not move in the right direction, it also affects the result. There are videos on the net where the operator is moving from the outside to the inside or from the top to the bottom, pulling the muscles downwards. A strange technique.
The right energy level.
We may think, the more energy, the better. This is true to a certain level, but over a given Joule number, the coagulation points could protrude too far into the skin and cause longitudinal injury. The parameters must be customized. Who would think that the same energy level hurts a younger person more than an older person?
Choosing the correct shooting parameters.
Three decisions the operator makes most strongly affect the result: distance of shooting points, density of shooting lines and the number of shooting points. It is clinically proven that the result is better with more shots. If the operator shoots 300-400 impacts on a face, the results will be negligible, and satisfaction will be around 60%. If 700-800 impacts are shot, the results will appear sooner and more spectacularly. Performing 700-800 shots, the proportion of those who experience a significant change is 30%, and the satisfaction rate is around 90%. Look at the screen after the treatment and check how many shots the screen shows. If only 300-400 are shown after a full-face treatment, do not be surprised if you do not see results. You’ll be told that this is natural and months are needed for development. After a 700-800 impact shooting (if the machine is good) you may see an immediate result that will improve further. After a 300-400 impact facial treatment, there is no result, because it takes 3 months to develop. Some result is possibly achievable, of course, but much weaker than it could be.
What could be the reason? It is probably of economic nature (although it could be lack of qualification or simply laziness). Simply put: a shot entails expenses for the salon. The more impacts are performed, the more expensive the treatment is. A HIFU facial treatment for 40 000 HUF on a coupon site? It might be a non-profit organization, or we should start to suspect… The cost of an 800-shot facial treatment is far more than a treatment with fewer shots. When moving a good treatment tip, the impacts should be 2-3 mm apart. This means almost no movement when viewed from outside. This can be felt on the skin during treatment, and we can determine whether the operator is moving too fast.
A good HIFU device …
- Was not produced in China.
As the aesthetic application of this technology is still relatively fresh and complex, the Chinese have not been able to reproduce the production technology perfectly yet. Surely there will be good devices over time, but not now. Classifying HIFU technology is also not as easy as classifying cavitation or IPL machines, which is why the certificate of many Chinese machines are false. An impact may only occur every 4-5 pulses, and none of them evenly or at the right depth. Or at a good length. Let’s imagine that during the treatment only 100 out of the 400 shots gave off energy. And they did not even create coagulation points, which is also an important safety and efficiency factor. How does this compare to a 600-shot treatment with a good energy and depth? I’ve already answered the question of why a good HIFU treatment costs 6 times more than a bad one. That’s not even considering the fact that non-Chinese HIFU machines cost 6 times more than the Chinese ones. The cost of a good treatment is high, but reasonably high. If the back of the device doesn’t say Made in the USA, Korea or Italy, or there isn’t any CE-mark with a four-digit number and a silver sticker with a serial number and technical parameters, do not undergo the treatment. Of course, everyone can hire somebody to make a sticker and the back of the machine may not be viewable before the treatment, so let’s swing to the more tangible, concrete things.
- Has good technical parameters. Higher energy, better results. This is true, but only to a point. If the device is capable of delivering more than 3 J/cm2 (I saw a device with a written parameter of 100 Joules!), it can cause serious injury to the skin. It is also important to adjust the distance of the shot points, the energy level, and the shot length as finely as possible, so that the treatment can be fully customized to the face.
- Has an adequate, preferably medical certification. Today, every machine has a sticker claiming it’s a medical HIFU device. This is a huge deception because there are only two machines in Hungary with medical certification. Only medical machines have live ultrasound imaging; other machines have a normal CE certification and can even be used by a masseur. Their shot lines are inaccurate, as is their depth targeting.
- Has an ultrasound imaging unit. During treatment, the skin layers under the treatment head are continuously displayed, so the operator can observe and decide whether to use the deeper tip. Such an imaging unit makes the machine and the treatment rather expensive, but ensures the highest degree of safety and precision. Nobody should be fooled by the fact that creative Chinese device manufacturers have begun to install a screen that shows a video of a constantly changing ultrasound image during treatment. Such a machine is worse than one without any imaging screen.
- Comes with adequate training. Since anyone can legally use such a machine in Hungary today, it is essential that the manufacturer and distributor have provided theoretical and practical training. Is there a certificate on the wall? Where did the training take place? How long did it take? 2 days or 2 months? Does a doctor or a medical assistant perform the treatment, ensuring that they are equipped with anatomical knowledge and skilled at ultrasound imaging? Or is the operator a beautician or a masseur?
- Micro or macro? Micro-focusing shoots small amounts of energy while macro-focusing shoots large ones. HIFU macro-focusing is not allowed on the face. It is beneficial for the body, but dangerous for the face. If a salon claims to use macro-focusing for facial HIFU, they are either dangerously imprecise or proposing a dangerous procedure.
