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Writer's pictureNina Nedelkovski

HIFU – Just an Aesthetic Fad?

Featured in Beauty Biz Year 15, Issue 4.


HIFU - what is it? How does it work? And does it really reduce facial volume that causes premature ageing? HIFU (High Intensity Focused Ultrasound) fractionally and specifically traumatises tissue, whilst maintaining dermal integrity around each traumatised thermal zone, thereby expediting wound healing, increasing skin tightening and enhancing dermal remodelling results.


Fractional trauma is fast becoming the preferred method of controlled trauma, as it leads to consistent and predictable results. Keeping surrounding tissue intact and healthy, also enables higher cytokine activity, reduces downtime and risks of adverse events, such as PIHP. Further, there is zero incidence of infection, unlike fully ablative treatment options.

What is HIFU & How Does it Work?

HIFU was first used as an early stage cancer treatment in medicine, from there HIFU is now utilised in the aesthetic industry and has a wide array of treatment applications for both face and body. Treatment is extremely safe, has virtually no down time and provides comparable results to invasive surgery.


The inflammatory response that HIFU triggers, leads on to the other two stages of wound healing: proliferation and maturation or remodelling, causing fibroblast synthesis and jumpstarting neocollagenesis, followed by remodelling of the collagen fibres. The secondary effect HIFU is set in motion by heat - when tissue is exposed to substantial heat, noticeable skin tightening and contraction can be seen. HIFU waves bypass the epidermis and converge at specific depths, which then induce cellular vibrations within molecules, triggering friction leasing to thermal damage and denaturation of the proteins in collagen, at approximately 6070 degrees. Because HIFU can bypass certain depths, HIFU can reach depths that lasers and light based devices can’t and can do so safely on most Fitzpatrick types. By using very specific depths of penetration HIFU targets and address epidermal-dermal junction, the dermis, SMAS or the subcutaneous layer of the skin. Beams of intersecting ultrasound energy are delivered, which is focused by an ‘acoustic lens’ to bypass the epidermis and travel directly to the targeted depth. Below is a simple example of how some of the most common HIFU depths produce very different end points.


  • 1.5mm targets superficial dermis, (similar to needling), but without epidermal damage or disruption

  • 3.0mm targets connective tissue of deeper dermis (collagen zone)

  • 4.5mm targets SMAS layer – this deeper collagen structure; tightening and regeneration of this layer results in skin lifting and contouring of the jowls.

What is SMAS Anyway?

Do we Really Need to Prep for HIFU?

Are the Myths True?

How Should you Perform HIFU and Setting Client Expectations


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