摘要

Objectives: In cases where protruding under-eye fat is caused by aging, treatments such as transconjunctival fat removal or transcutaneous infraorbital fat (IOF) removal can be employed. In some cases, fat repositioning or fat grafting may also be necessary. For non-surgical methods, lipolysis can be induced using PPC(Phosphatidyl Cholic Acid) injections to target under-eye fat, or fillers and threads can be inserted into the tear trough to make the protruding fat less noticeable. In this report, our purpose is to evaluate the safety and effectiveness of HIFU-assisted infraorbital fat (IOF) removal. Introduction: HIFU is a device that concentrates ultrasound energy on a specific area, inducing fat cell apoptosis. When using the typical energy level of 0.6J, it is known to activate fat cell death or the autophagy system through the P53-dependent pathway. We report three successful clinical cases where HIFU was used to induce fat cell apoptosis for aesthetic purposes on under-eye fat. Materials / method: Before the procedure, the lower eyelid fat thickness of all patients was measured using Diagnostic Ultrasound. All patients underwent infra-orbital nerve block and zygomaticofacial nerve block using 2% lidocaine. The HIFU treatment was performed 20 minutes after the local anesthetic injection. All patients underwent the procedure using the HIFU in 9.0mm (Dot, 2MHz) and 4.5mm (Dot, 4MHz) depths. Energy of 0.6J was applied per shot, A total of 100 shots (9.0mm: 50 shots, 4.5mm: 50 shots) was applied to the fat under each eye.The patients underwent three treatment sessions at one-month intervals. Results: The average age of patients were 48 years. Three months after the procedure, all patients reported 100% subjective satisfaction. Post-procedure swelling under the eyes typically lasted about 7 days, and no significant complications were reported. The average time required for the procedure was approximately 10 minutes, and no specific medications were prescribed post-treatment. The post-procedural changes in infraorbital fat were excellent. Conclusion: As a result, infraorbital fat (IOF) removal using HIFU proved to be a safe and effective method. Moreover, non-surgical HIFU-assisted IOF removal offers shorter downtime and simultaneous infraorbital skin tightening compared with surgical IOF removal.