Abstract

Objectives: To present the unique clinical application of fractional high-intensity focused ultrasound (HIFU), which can be performed without anesthesia. Attendees will learn how dot- and pen-type cartridges at 1.5 mm and 2.0 mm depths effectively deliver thermal energy to the dermis, promoting collagen remodeling and skin tightening. The session will also provide comparative insights into differences between this approach and high-intensity parallel beam ultrasound devices in terms of pain, depth targeting, and treatment flexibility. Introduction: Skin laxity from collagen loss due to aging or excess skin after liposuction or rapid weight loss is a serious concern. Treatments like radiofrequency or thread lifts often lack effectiveness and longevity. While high-intensity parallel beam ultrasound targeting 1.5 mm shows tightening effects, pain and cost remain issues. Our clinic utilizes a fractional HIFU system designed to deliver controlled thermal energy precisely into the dermis using dot and pen-type cartridges (1.5 mm/2.0 mm), promoting collagen remodeling for skin tightening and rejuvenation. Materials / method: Patients aged 20 and older who visited our clinic between February and March 2025 were included. High-intensity focused ultrasound (HIFU) was performed on the full face and neck, delivering 400–1000 shots. Cartridges included 2.0 mm dot-type and 1.5 mm dot-type and pen-type transducers. Standardized facial photos were taken before, immediately after, and 2 and 4 weeks post-treatment using a smartphone camera and a 3D imaging system. Pain was evaluated immediately post-treatment using an 11-point numerical rating scale (NRS). Results: Four participants (mean age 43.6, median 44), all female, were included. VECTRA 3D showed skin laxity improvement immediately after treatment compared to baseline, with continued improvement at one month. All procedures were performed without anesthesia. The average pain score was 4.0 ± 2.3 on the NRS. No adverse effects such as burns or nodules were observed. One patient showed improvement in pre-existing acne. Conclusion: Our fractional HIFU is an effective treatment for skin tightening and rejuvenation, particularly for skin laxity caused by excess skin. Notably, it can be performed without anesthesia and utilizes an existing HIFU platform in a unique way to achieve dermal tightening effects. This approach offers a distinctive, minimally invasive option for patients seeking both efficacy and comfort in non-surgical skin laxity treatments.