When looking into nonsurgical lifting in Seoul, which layer is treated with what kind of heat comes before the device name. HIFU (focused ultrasound) places small thermal points at a set depth, while radiofrequency cools the surface and heats the dermis more broadly. Even when they are grouped under the same search term, the device and sites that contact the skin today diverge.
3-line summary
1. Nonsurgical lifting is a group in which heat gathers at different sites, as with HIFU and radiofrequency.
2. After a single treatment, many studies looked at tightening on physician scores at three months, and scores from those treated were lower. This collection was conducted without manufacturer funding.
3. Disclose a pacemaker, open wounds, severe acne, and metal at the treatment site before the appointment, and compare follow-up photographs at the same angle.
Heat gathers at different sites
HIFU focuses ultrasound at a point to leave small thermal spots. During treatment, the skin and the layers beneath it are viewed on a screen, and bone is avoided. Sites in U.S. marketing documents are lifting the brow, lax tissue of the submental area and neck, and décolleté wrinkles.
Radiofrequency heats the dermis broadly while cooling the surface. Sites in marketing documents are wrinkles including the periocular area and eyelids. The eye, eyelid, and orbital rim are listed in HIFU instructions as sites not to receive energy, so when the periocular area is treated, the devices themselves diverge from the start.
Even when it is presented as HIFU, the official name of the device used today may differ. Summaries that pool a single treatment include devices from more than one company. A comparison of energy paths is in the Ulthera vs Thermage comparison guide.
Pulling tissue with threads is reviewed separately because recovery differs from heat-based procedures. Thread type and material are covered in the thread lifting guide.
| What to check today | HIFU | Radiofrequency |
|---|---|---|
| Sites in marketing documents | Brow, submental area, neck, décolleté wrinkles | Wrinkles including the periocular area and eyelids |
| Sensation during treatment | Point-by-point stimulation, moderate pain | Heat sensation, mild or moderate pain |
| Hollow cheeks | Mark the deep-layer plan | Facial fat volume change appears in the literature, so mark hollow sites |
| What the instructions prohibit | Open wounds, severe acne, metal, pacemaker | Pacemaker, extensive dental metal |
After a single treatment, when to compare photographs
Material on HIFU given once for mild to moderate laxity was collected. Depths may also be divided across several layers in one session. The last follow-up time point covered is 1 year, and the response was summarized as reduced when laxity was very large. Even after topical anesthesia or analgesics, pain remained moderate.
A multicenter periocular radiofrequency study looked at photographs through six months after a single treatment. In an abstract that pooled radiofrequency without regard to device type, facial fat volume change was observed along with elasticity and skin texture. If hollow cheeks are a concern, see the hollow cheeks and lifting guide first.
| Time point | What is observed |
|---|---|
| During treatment | Point stimulation or heat sensation |
| Hours to days | Redness, swelling |
| Two days to 2 weeks | The interval in which tenderness is described as settling |
| Three months | Time point at which the HIFU collection gathered physician scores |
| Six months | Time point at which the periocular radiofrequency study looked at photographs |
| 1 year | Last time point covered by the HIFU collection |
※ Time points in the table are the days studies looked at photographs, or the course described in the instructions for use.
Same-day reactions and what to disclose before the appointment
HIFU instructions list discomfort at the moment energy is delivered, redness within hours, swelling within 3 to 72 hours, and tenderness from two days to 2 weeks. Rarely, they describe a course in which sensory change and muscle weakness settle within 2 to 6 weeks, and grouped cases of burns when the treatment head was tilted or gel had pooled with incorrect technique.
Radiofrequency instructions list mild or moderate pain during treatment as a common reaction. Redness lasting hours and swelling within five days are typical, and they separately list the possibility of burns, blisters, and scarring. Fat atrophy was reported in radiofrequency follow-up, and an abstract that pooled radiofrequency in general included one punched-out wound on the neck.
Both instructions prohibit use when an implanted electronic device such as a pacemaker or defibrillator is present. For HIFU, open wounds, severe acne, and metal implants at the treatment site are also contraindications. Pregnancy and lactation are excluded from the populations evaluated in both instructions. For radiofrequency, heat can concentrate over extensive dental metal, so the instructions note placing dry cotton inside the cheek. Disclose filler location following the filler, botulinum toxin, and lifting history consultation guide, and see treatment safety information for general management of adverse reactions. For aftercare, see lifting aftercare.
Questions to ask as written in a Seoul consultation
Rather than a ranking of device intensity, writing down lax sites on today's face separately from hollow sites speeds planning. Check the items below, then ask them as written in the consultation room.
- □ What is the official name of the device used today. If HIFU, is it Ulthera or another focused ultrasound
- □ Which of the brow, submental area, neck, and periocular area will be treated, and is depth set after looking at skin thickness
- □ Will already hollow-looking cheeks be avoided, and how is fat volume change viewed
- □ Have a pacemaker, metal, open wounds, severe acne, and filler location been disclosed before the appointment
- □ Is the next appointment reviewed after comparing three-month photographs at the same angle
- □ Have you asked whether to overlap both energies on the same day, or to leave an interval
Frequently asked questions
Q1. Does it hurt?
Even after topical anesthesia or analgesics, HIFU pain remained moderate. Radiofrequency brings a heat sensation during treatment, and the instructions list this as a common reaction.
Q2. How many sessions?
The material that measured tightening is a single session. Whether to treat again after several months is decided after comparing three-month photographs at the same angle.
Q3. How long does it last?
The last time point covered by the HIFU collection is 1 year, and the periocular radiofrequency study looked at photographs through six months. Those dates are when observation stopped.
Q4. Can they be done together?
When deep laxity and surface elasticity are looked at together, they are reviewed with an interval. Filler sites, whether to proceed on the same day, and a schedule in which swelling and tenderness overlap are decided after looking at the tissue.
Q5. Who should postpone the appointment?
Disclose an implanted electronic device such as a pacemaker, open wounds, severe acne, or metal at the treatment site, and pregnancy or lactation, before the appointment. If laxity is very large or the cheeks are already hollow, the target layer is sorted again.
Results, duration, and suitability vary with individual skin condition, age, and lifestyle, and the same outcome cannot be guaranteed.
Procedures may cause temporary redness or swelling, and contraindications may apply, so please confirm these during your consultation.
This article is general information and does not replace individual medical care. Please confirm diagnosis and treatment suited to your condition during a consultation.
Sources
- U.S. FDA: Ulthera System 510(k) summary
- U.S. FDA: Thermage FLX 510(k) summary
- Ulthera instructions for use
- Thermage CPT technical user manual
- Contini M et al. (2023), Int J Environ Res Public Health: A Systematic Review of the Efficacy of Microfocused Ultrasound for Facial Skin Tightening (PMID 36674277)
- Austin GK et al. (2022), Lasers Surg Med: Evaluating the effectiveness and safety of radiofrequency for face and neck rejuvenation: A systematic review (PMID 34923652)
- Fitzpatrick R et al. (2003), Lasers Surg Med: Multicenter study of noninvasive radiofrequency for periorbital tissue tightening (PMID 14571447)
- de Felipe I et al. (2007), J Cosmet Dermatol: Adverse reactions after nonablative radiofrequency: follow-up of 290 patients (PMID 17760693)
Related reading
- Ulthera treatment guide
- Thermage radiofrequency treatment guide
- Ulthera and Thermage energy comparison
- Facial sagging, Ulthera and thread lifting selection
- Hollow cheeks and lifting guide
- Filler, botulinum toxin, and lifting history consultation
- Lifting aftercare
- Thread lifting duration guide
- Treatment safety and adverse-effects information
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