acial skin quality has a prominent influence on the overall perception of an individual's appearance and is an important aspect of facial rejuvenation. 1,2 The overall perception of skin quality is affected by various attributes, such as skin firmness, skin surface evenness, skin tone evenness, skin glow, etc., many of which are interrelated. 1,2 A common aesthetic concern among Asian individuals is enlarged facial pores, which adversely impacts perceived skin surface evenness and affects overall skin quality. 1,2 One of the leading causes of enlarged pores is facial skin laxity. 3 Available treatments for enlarged pores include oral antiandrogens, topical creams, lasers, radiofrequency, ultrasound devices, etc. 4 Depending on the causative factors, a single or combined treatment approach may be necessary to address the concern. 4 Microfocused ultrasound with visualization (MFU-V; Ultherapy; Merz North America, Inc. Raleigh, N.C.) is widely regarded as the gold standard for nonsurgical lifting and tightening of lax skin. 5 MFU-V delivers microfocused ultrasound
Cosmetic
Ideas and InnovatIonsSummary: Facial skin quality profoundly influences an individual's perceived appearance and is an important aspect of facial rejuvenation. Facial pore enlargement is one of the most common concerns among Asian individuals that adversely impacts perceived skin surface evenness and affects overall skin quality. One of the major causes of enlarged pores is facial skin laxity. Microfocused ultrasound with visualization (MFU-V; Ultherapy; Merz North America, Inc., Raleigh, N.C.) is indicated for lifting and tightening of the face and neck, and improving the appearance of wrinkles on the décolletage. In addition, it is useful for addressing several aspects of facial rejuvenation, including facial pores, skin laxity, skin unevenness, etc., but there is limited literature on these applications. Thus, we present our proposed MFU-V treatment protocol for achieving a harmonious outcome for attractive skin, along with practical strategies for its application, illustrated in patients presenting with enlarged pores as their main concern. Drawing on our collective experience in using MFU-V for facial rejuvenation and the recently published skin quality framework that advocates addressing interrelated attributes of skin quality for optimal outcomes, we developed a treatment protocol for improving skin quality using MFU-V. This MFU-V treatment protocol reliably improves overall skin quality in patients presenting with enlarged pores, through MFU-V's effects on skin lifting and tightening, and consequent improvement in facial pores and skin texture. This treatment protocol can be readily used as part of a multimodal layering approach to yield successful outcomes in patients with various facial skin concerns.