If you have looked into skin tightening, you have probably come across Ultherapy. It is the most widely known ultrasound treatment for sagging skin. The version we use, Ultherapy PRIME, is its latest generation. This article explains how it works: how deep the energy goes, which layers it targets, and why its real-time imaging matters.
Ultherapy heats the deep layers
Sagging starts below the surface, in the deeper layers of the face. Microfocused ultrasound, or MFU, focuses sound energy on a single point at a set depth below the skin and heats it. Both Ultherapy and Ultherapy PRIME work this way.
At that focal point the tissue briefly heats to above 60°C (about 140°F) and forms a tiny spot of coagulated tissue. The skin surface above it is left untouched (Fabi 2015, PMID 25709486). How deep that spot sits depends on the transducer: 1.5, 3.0, or 4.5 mm.
The 3.0 mm and 4.5 mm transducers do most of the work. They reach the superficial fat that sags with age, the fibrous septa running through it, and the SMAS, the layer a facelift tightens. Heated collagen contracts right away, and new collagen builds over the months that follow (Fabi 2015, PMID 25709486).
Real-time imaging guides the heat
Several focused ultrasound devices reach these layers, but only Ultherapy shows the tissue on a live ultrasound image while it treats. The others deliver energy to a preset depth with no view of what lies beneath the skin.
Ultherapy combines focused ultrasound with high-resolution ultrasound imaging. The pairing is known as MFU-V, short for microfocused ultrasound with visualization. On the image we can tell skin, fat, SMAS, muscle, and bone apart. That shows us which layer we are treating and lets us keep the energy away from bone and larger blood vessels (Fabi 2015, PMID 25709486).
It suits mild to moderate sagging
Focused ultrasound works for mild to moderate laxity of the skin and the soft tissue beneath it (Fabi 2015, PMID 25709486). When sagging is severe, a surgical lift is often the better choice.
For help choosing between devices, see Ultherapy, Sofwave, or Thermage: which skin tightening treatment is right for you?.
References
- Fabi SG (2015). Noninvasive skin tightening: focus on new ultrasound techniques. Clin Cosmet Investig Dermatol. PMID 25709486 (opens in new window).
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