High Intensity Focussed Ultrasound (HIFU)

Let’s start at the beginning. HIFU stands for High-Intensity Focused Ultrasound, and to really understand how it works, it helps to first know a bit about ultrasound itself.

1. Ultrasound Basics:
   Ultrasound is simply sound — but sound at a pitch that's way too high for the human ear to hear. Humans can hear sounds from around 20 Hz up to about 20,000 Hz. That’s our audible range. Anything higher than 20,000 Hz is technically called ultrasound. Now, compare that to the sound frequencies we use in HIFU treatments — they’re typically around 4,000,000 Hz to 7,000,000 Hz! That’s about 200 to 350 times higher than what even the sharpest human ear could detect. At these frequencies, ultrasound waves behave very differently from the sound waves we're familiar with: they can pass through tissues and focus energy deep beneath the surface without cutting or damaging the skin above.
2. Focussed Ultrasound:
   What makes HIFU special is the word “focussed.” Think of it like using a magnifying glass to focus sunlight onto a single spot — you can feel the heat concentrate at that point. HIFU works the same way, except instead of light, it focuses ultrasound waves. A specialized transducer acts like the lens, concentrating the ultrasound energy onto a precise point deep in the tissue. This focused energy produces localized heating exactly where we want it, without heating the skin's surface.
3. So what is HIFU in a nutshell?
   It’s a device that delivers high-energy ultrasound waves, tightly focused to a very specific spot underneath the skin. At that tiny focal point, the ultrasound energy gets absorbed and turned into heat. That heat can do three really useful things:

• (1) It can kill fat cells, helping to slim down areas like under the chin or the jowls.
• (2) It can heat muscle tissues, causing them to contract and tighten.
• (3) It can stimulate collagen production by heating the dermis, leading to firmer, younger-looking skin.

And importantly, HIFU isn’t just some theoretical idea — it’s officially recognized by the U.S. FDA for producing a brow lift in patients with mild to moderate skin laxity (Fitzpatrick et al., 2017).

A true brow lift has always been hard to achieve without surgery. Traditional brow lift surgery can be surprisingly invasive, involving large incisions, general anesthesia, significant downtime, and sometimes noticeable changes in facial expression. That’s why it's such a big deal that we now have a non-invasive method like HIFU that can produce an actual lift — no scalpels needed.

Here’s how it works:
The HIFU device focuses its energy deep into the frontalis muscle — that's the broad, flat muscle in your forehead responsible for raising your eyebrows. By precisely heating the frontalis muscle with HIFU energy, we stimulate it to contract and heal in a shortened, tightened state. If you’ve ever torn a hamstring and felt the muscle cramp and scar into a tighter form afterward, you already know this principle in action. Controlled heat injury encourages the muscle to rebuild itself — but in a lifted position.

Clinical studies show that just one HIFU treatment can produce a brow lift ranging from 0.5 mm to 1.7 mm (Alster & Tanzi, 2012). That might not sound like a lot, but in the delicate balance of facial aesthetics, even a 1 mm lift can make your eyes look more open, your forehead smoother, and your whole face more refreshed. 

And importantly: more treatments can typically yield even better results over time. Virtually any degree of lift achieved so safely and easily is considered outstanding value compared to traditional surgical options.

When it comes to jowl reduction, you’ve got several options — but HIFU often comes out on top:

1. Lose weight:
   Sure, losing weight can help reduce jowls, but it’s not a guarantee. Facial fat distribution is stubborn and genetically driven.
2. Liposuction:
   This surgical option removes fat, but it’s invasive, expensive, and can sometimes create lumpy or uneven results.
3. Cryolipolysis (CoolSculpting):
   This freezes fat cells to destroy them. It can work — but it carries a small risk (around 0.5–1%) of paradoxical adipose hyperplasia, where the fat actually gets bigger after treatment (Ingargiola et al., 2015).
4. Facelift Surgery:
   Effective for tightening skin — but again, costly, invasive, risky, and unless the surgeon specifically removes fat (not just tightens the skin), the jowls might come right back.
5. Lipodissolve (fat-dissolving injections):
   These injections can work well, and I’ve personally performed them for many years. However, they usually involve a few days of significant swelling, bruising, and pain — not exactly a walk in the park.
6. HIFU:
   Now here’s where HIFU shines. It’s non-invasive, reasonably comfortable, causes only minor swelling, rare bruising, and recovery is quick and easy. It doesn’t involve surgery, freezing, or injections.

Bottom line?
In terms of effectiveness combined with comfort and safety — HIFU wins.

A lot of advertisements promote HIFU as a “non-surgical facelift.” And while HIFU does firm the skin a bit (more on that in a moment), I think the real magic — the part you really notice — is the reduction of submental fat.
When we look at before-and-after profile photos, the striking improvement often comes from the loss of fat under the chin. That slimming effect alone can make the entire lower face and jawline look lifted and younger.

Several clinical studies confirm that HIFU significantly reduces subcutaneous fat thickness under the chin (Kennedy et al., 2015), improving the neck and jawline contour dramatically — all without surgery.

It’s not just under the chin!
HIFU can also reduce fat deposits in other areas — for example, around the nasolabial folds (the deep lines from the nose to the mouth) and even elsewhere on the body.
If you're concerned about localized stubborn fat, HIFU can often be tailored to target exactly where you need help. 

Finally, another powerful aspect of HIFU is its ability to firm the skin.

When we focus HIFU energy at a depth of about 1.5 mm, we’re aiming it right into the deep dermis — the layer of skin rich in collagen and elastin fibers. By heating this layer to the optimal temperature (typically 60–70°C), we trigger neocollagenesis — the production of brand-new collagen (Alster & Tanzi, 2012).
Multiple published studies show significant improvements in skin firmness, elasticity, and texture after HIFU treatments focused at these depths.

In simpler terms: HIFU helps your skin become stronger, tighter, and more resilient — all without cutting, stitching, or peeling. It works with your body’s natural healing processes to gradually rebuild a firmer, more youthful look over the following 3–6 months.