What is HIFU? Everything you need to know about the viral aesthetic treatment

hifu treatment review
The 'sound wave' aesthetic treatment going viralCosmopolitan/Getty Images

For as long as I can remember, I’ve been obsessed with cleansing and serums, treatments, and tools. As a beauty writer, I kind of see my skin as a bit of an advertisement: evidence that when it comes to skincare, I know what I’m talking about. I’ve been a slow, almost non-adopter of injectables, dabbling every now and then, but when it comes to non-invasive high-tech treatments like ultrasound and radio frequency, I am all in. The results, let me tell you, are astounding.

It was with this enthusiasm that a few months back I arrived at the black lacquered door of Dr Ariel Haus’ dermatology clinic, having read up about Focus Dual. The treatment uses a combination of Radiofrequency via micro-needling, and High-Intensity Focused Ultrasound, or HIFU. It’s the 'HIFU' element that piqued my interest. It’s all over TikTok, with more than 275 million views and influencers such as Sarah Ashcroft raving about its ability to contour and tighten.

Now that I’m in my 30s, I've been on what I've dubbed my “journey of health”, becoming laser-focused on what I eat while ramping up my exercise. Guys, my Apple Watch’s step count has never had it so good. But, as my body has changed, I’ve become more aware of wanting to minimise changes to my skin. Collagen production starts to tail off the older we get and significant weight loss can actually age someone's appearance fast.

“Loss of facial volume becomes more prominent as we age, especially in the mid and lower face area,” Dr Haus tells Cosmopolitan UK. “This can result in a hollowed appearance and while it’s most prominent from your 40s onwards, gradual volume loss can start occurring as early as your late 20s or early 30s.” And does weight loss impact that? “It may lead to a decrease in skin elasticity,” he says. “The skin becomes less firm and less able to snap back into place, particularly around the jawline and chin.”

So, what is HIFU treatment?

A lot of treatments (aesthetic or otherwise) use ultrasound – but here’s the thing, not all ultrasound is the same. You might think back to a previous gynae appointment and assume that ultrasound is something that penetrates the skin painlessly to have a look at what’s going on beneath the surface. That’s just one type of ultrasound. In aesthetic treatments, ultrasound is doing something entirely different. It penetrates the skin to heat the cells, causing localised damage, which then prompts the skin to heal and produce more collagen. Enter: plump-looking skin.

So, that’s ultrasound, but then there is HIFU. Still with me? “HIFU stimulates collagen production further,” exclaims Dr Haus. “It targets the deepest layer of the skin, which causes contractions that tighten and lift. This is all done whilst avoiding damage to other areas. When it comes to treating sagging skin with unparalleled results, HIFU is truly a gold standard treatment.”

HIFU is so effective that it’s earned the “lunchtime facelift” moniker among its fans. As Dr Haus tells me, the deepest layer of the skin (the SMAS, or slightly more of a mouthful, the Superficial Musculoaponeurotic System) was previously only accessible by surgical knife. And while HIFU’s results aren’t quite up there with an actual facelift, they are impressive and tend to be more natural-looking.

The treatment begins first with a layer of conductive gel smoothed over your face and neck, before the HIFU handheld device is moved over the skin in a grid-like pattern, delivering little bursts of heat as it goes. The heat starts out quite mild, but builds in intensity until it peaks at a sharp pinch. It’s not pleasant, but it’s *so* quick and never uncomfortable for more than a couple of seconds at a time.

Can anyone get a HIFU treatment?

In short, yes – anyone can have HIFU. But not everyone needs it. This kind of skin-tightening treatment is going to give the best results to people who have started to notice the signs of ageing, or are approaching the age when they’re likely to appear. The results are not instant, as collagen takes around 12 weeks to generate, but when I underwent the treatment, I did see a noticeable result around my jawline just two weeks after my first appointment.

From my experience, I found success having HIFU in combination with radiofrequency and microneedling, as not only did I see a new, tauter structure develop before my eyes, but the texture and tone of my skin overall saw a massive improvement. I’ve had two treatments now, and I intend to go back for more in the future.

Is there downtime for HIFU treatment?

Second only to, “What are the results?” the questions I am asked most about HIFU is “Does it hurt?” and “What’s the downtime?”.

To answer the first question; yep, it hurts a bit. Whether you have HIFU as part of a combined treatment like Focus Dual, or as a standalone treatment, it’s spicy. Most clinics will offer you an oral painkiller beforehand, and then spend 30-45 minutes numbing your face with a topical gel. It’s uncomfortable, to say the least, but deep breaths, and keeping the results centre of mind will get you through. Plus, the treatment takes less than an hour and what’s an hour of discomfort when the results are months of taut, plump-looking skin?

hifu treatment guide
Suzanne Scott

As for the second question, there isn’t really any downtime. Afterwards, your skin will feel warm and look a little red, but it subsides quickly. I was able to wear makeup the next day and for a week or so just kept to a very simple routine of Aesop Parsley Seed Anti-Oxidant Intense Serum, a generous heap of Avène Cicalfate and for the daytime, a layer of La Roche-Posay Anthelios 50+, (It’s the only SPF that I’ll use when my skin is sensitised). Then, just to keep redness at bay and support healing, I used SkinCeuticals Phyto Corrective Masque a couple of times a week. It’s excellent for overheated, fragile skin and a must after any kind of treatment, in my opinion.

How often do you need to have a HIFU treatment to keep up results?

The answer to this question really depends on your budget because, truthfully, it’s not cheap but excellent treatments rarely are. It’s an investment, for sure, but one I’m willing to make. For Focus Dual (with prices starting at £1,800 a session), Dr Haus recommends up to three treatments, three to six weeks apart. Standalone HIFU treatments start around £600 for 30 minutes, depending on the clinic. Depending on how your skin responds and what you’re hoping to treat, you could have it done as often as every three months, or just once a year.

What other treatments does it work well with?

Most aestheticians will now tell you that a serious programme of facial maintenance or rejuvenation cannot rely entirely on one element of your routine. And I wholeheartedly agree. Budget and time-allowing, a long-term skin protocol should enlist non-invasive treatments like Focus Dual and HIFU treatments alongside any non-surgical treatments you desire, and resurfacing treatments such as gentle peels and/or laser. This being said, you can’t underestimate the importance of at-home care, either. While you can’t use retinol a week prior and post-treatment, otherwise, it’s a great ingredient to weave into your nightly routine to help maintain results between appointments.

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