Intense Focused Ultrasound: Evaluation of a New Treatment Modality for Precise Microcoagulation within the Skin

Abstract

Intense focused ultrasound can be used as a noninvasive method for spatially confined heating and coagulation within the skin or its underlying structures. These findings have a significant potential for the development of novel, noninvasive treatment devices in dermatology.

Ultrasound tightening of facial and neck skin: A rater-blinded prospective cohort study

“…For the 3-mm probe, the deepest point of the cone was approximately 3 mm from the skin surface; for the 4.5-mm/7-MHz probe it was 4 to 4.5 mm; and for the 4.5-mm/4-MHz probe it was approximately 4.5 mm. These results have been previously reported in various contexts: in vitro and in vivo porcine with bioacoustic simulations 7 ; cadaver skin 6,8 ; and treatand-resect human clinical studies. 5 Photographic setup.…”

“…Overall, selective coagulative change is effected within the focal region of the beam but other tissue proximal and distal to the focal region of the ultrasound field is preserved. [5][6][7][8][30][31][32][33][34] Notably, the intense ultrasound we investigated for skin tightening is different from ultrasound devices designed for lipolysis. The skin tightening ultrasound penetrates 4 to 5 mm into the facial skin and delivers focal, intense pulses (20-50 milliseconds long) that cause localized thermal injury (thermal coagulation zone ;1-mm 3 volume), and instigate the tissue repair cascade.…”

“…The pulse duration for each individual exposure ranged from 25 to 40 milliseconds. Prior work [5][6][7][8] in which the facial skin tissue was excised after exposure to the intense ultrasound device has shown that the zones of thermal coagulation are wedge shaped and are consistent in size and depth. In each case the epidermis was spared after ultrasound energy exposure.…”

Lasers and Optical Technologies in Facial Plastic Surgery

“…127,128 Radiofrequency has also been used in corrugator supercilii motor nerve ablation for the elimination of glabellar furrowing, 129 a condition that is commonly treated by surgery 130,131 or by botulinum toxin. 132 Other nonablative resurfacing technologies that have been studied include high-frequency focused ultrasound, 133 which has been used to specifically target and tighten the superficial musculoaponeurotic system in the face 134 or subcutaneous fat, 135 and intense pulsed light, which will be discussed below. Recently, plasma skin regeneration devices have been introduced to achieve resurfacing by selectively heating the dermal layer with plasma energy.…”

Non-Excisional Face and Neck Tightening Using a Novel Subdermal Radiofrequency Thermo-Coaugulative Device

“…Excisional facial surgery such as a face lift may provide a dramatic improvement, but concerns over the excisional nature of this "real surgery" and visible scarring significantly limit the popularity of the procedure, especially for Asians and other dark skin populations, who have a higher risk of post inflammatory hyper-pigmentation, wound hypertrophy and visibility of the scars. Non-invasive procedures, such as trans-epidermal radiofrequency, infrared tightening, or recently high frequency focused ultrasound, skin tightening devices have a greater acceptance, but, the aesthetic outcome is relatively modest in comparison to excisional plastic surgery [3][4][5][6].…”