Lifting Clinic    SMAS & subcutaneous fat - HIFU (3mm, 4.5mm)

• Lifting (moderate to high intensity)

• Whitening (mild)
• Wrinkle improvement (mild)
• Elasticity enhancement(mild)
• Enlarged pore (mild)

JD Clinic only operates on parts with subcutaneous fat caused by ageing. (side jaw, face, splayed region, etc.)
The procedure is not carried out on the areas where subcutaneous fat loss is permanent. (Forehead, temple, canthus, etc.)

Duration: 30 minutes to1 hour

Interval: 6 Months (depends on the individual)

⦁The Principle of HIFU (Ultraformer)

A new type of lifting treatment using ultrasound (HIFU) has been developed to lift tissues deeper than the skin (such as SMAS).
It uses ultrasound to generate heat in tissues deeper than the skin and coagulate them.
It is similar to the phenomenon in which a plastic bag shrinks when heat is applied at 1cm intervals.

HIFU (Ultraformer, Ulthera, etc.) was mainly created to target the SMAS layer, but can induce thermal damage at depths of 4.5mm, 3mm, and 1.5mm.
Two models, 'Ulthera' and 'Ultraformer', are currently available for 1.5mm deep treatments.

1.5mm deep thermal damage does not target the SMAS layer,
but generates thermal damage just below the skin, and can be expected to improve wrinkles, elasticity, skin texture, and whitening effects without interfering with daily life.
Therefore, patient satisfaction can be increased through treatments at various depths.

⦁ Advantages of HIFU (high intensity focused ultrasound) treatment

It can lift tissues deeper than the skin to a moderate degree without interfering with daily life and without damaging the epidermis.

⦁ Disadvantages of HIFU treatment
If you are over 40 years old or have many cracks and wrinkles, you will not be satisfied with HIFU treatment alone.
The effect is so clear that you can immediately check the results in the mirror immediately after the treatment, but patients usually have high expectations.

⦁ As aging progresses, the surface of the skin becomes irregular, and saggings, changes in skin texture, pigmentation, wrinkles, etc. appear.
Various lasers (CO2 fractional laser, etc.) targeting the skin layer,
Microneedle RF (microneedle radio frequency),
Radiofrequency (thermage, etc.),
IPL,
Botulinum toxin (skin botox, etc.),
Laser toning, etc. are necessary treatments that effectively improve skin aging.

In addition, such skin treatments have the effect of slightly improving the ‘sagging’ phenomenon.
Through the process of tissue contraction and remodeling, the skin becomes firm.

However, the above treatments cannot correct the damage caused by the tissues deeper than the skin (subcutaneous fat, SMAS, etc.),
and have the effect of lifting only the skin tissue, so it cannot be said that they have a significant effect on the damage phenomenon.

⦁By the way, the tissues are composed in the order of skin, subcutaneous fat, and SMAS.

Ultrasound treatment mainly targets the SMAS layer, and non-surgical methods that can lift the subcutaneous fat layer can be done using dissolvable threads (Omega lifting, V-LOC, etc.) unlike protrusions.

Surgical face lifting can lift the tissue under the skin (SMAS, etc.), but complications related to the procedure and scars around the ears can be a problem.
Furthermore, there may be limitations to surgical face lifting for the common problems of nasolabial folds and wrinkles around the mouth (marionette lines).
Furthermore, as with other procedures, the results of surgical face lifting can vary greatly depending on the practitioner.
If you only consider the effect and duration, it can be said that surgical methods are the best.

When the skin of the face, arms, legs, etc. begin to sag, the most common treatment method is the surgical method.
The methods that have been used for the past 20 years to relieve skin pain non-surgically are
Radio frequency and laser (various fractional lasers), and have shown various results.
Infrared and radio frequency treatments cause thermal damage to a depth of 3-4 mm from the skin,
Lasers cause thermal damage to a depth of about 0-1 mm.
Such thermal damage (volumetric tissue heating) causes immediate collagen contraction,
inducing the gradual production of new collagen over a period of 6 months or more, and skin elasticity is felt to increase.
Infrared and radio frequency treatments can improve the phenomenon of sagging skin,
but they have disadvantages such as the need for multiple treatments, pain, cost, and uneven results.

HIFU equipment (Ultraformer, Ulthera, etc.), which was introduced relatively recently, can be performed deeper and on multiple layers (planes) than existing equipment, and can be used effectively for various skin popping phenomena.
HIFU equipment can perform treatment at depths of 1.5mm, 3mm, and 4.5mm.
A depth of 3 to 4.5mm was almost impossible to treat with existing high frequency and infrared devices.
In one tissue test, ultrasound penetrated to a depth of 7.8mm with HIFU equipment.

One of the features of such HIFU equipment is that it can lift the SMAS layer of the face and increase elasticity.
Another disadvantage is that it can treat deep into the skin, but the treatment effect on shallow layers is less.
However, recently, treatments to a depth of 1.5mm have become possible with the Ultraformer.
As treatments to shallower layers of the skin have become possible, wrinkles, elasticity, and whitening effects have increased without interfering with daily life.
Until recently, HIFU equipment has been mainly used for lifting the face and neck.

As intuitively expected, treatments to a multi-layer depth of 4.5mm, 3mm, and 1.5mm are combined to produce better results.

However, HIFU treatments may reduce the thickness of the subcutaneous fat layer,
so care must be taken when performing treatments in areas where the loss of the subcutaneous fat layer is not allowed.
High frequency and laser treatments have been mainly used for areas other than the face,
HIFU equipment can treat areas deeper in the skin without interfering with daily life, leading to more effective results.

Another advantage of HIFU (Ultraformer, etc.) is that there is almost no epidermal damage and melanin does not absorb ultrasonic energy,
so even if the treatment is performed regardless of the skin type, the possibility of side effects such as post-inflammatory hyperpigmentation and deposition (PIH) is extremely small.
When combined with non-surgical lifting methods
CO2 fractional laser (Neoscum, etc.)
Fractional microneedle RF (microneedle radio frequency)
Dissolving thread lifting (Ultra V, Omega lifting, etc.)
Better results can be achieved.

Generally, you can resume your daily life immediately after the procedure.
In rare cases, swelling or redness may occur.

In most cases, it does not interfere with daily life.

•Swelling
HIFU causes thermal damage to human tissues, so edema (swelling) may occur. Swelling may depend on the depth, strength, and number of shots of the treatment, and is also related to the individual's constitution. The degree and duration of swelling varies. Swelling may occur only on one side. Slight swelling may last up to 4 weeks. After receiving Ultraformer treatment, cooling the treatment area will help improve it quickly.

•Erythema (redness of the treatment area)
Erythema also depends on the depth, strength, number of shots of the treatment, and constitutional factors. This usually disappears within a few to 48 hours after treatment.

•Linear striations
They can be seen forming here and there at the treatment site like hives. These are formed on the outside of the skin due to the ultrasound reaching the area. They are most likely to occur when a shallow treatment of 1.5mm or 3mm is performed for the purpose of skin texture, wrinkles, elasticity, etc. When they occur, most people will recover if they take steroids orally.

•Pain
The majority of pain will disappear immediately after treatment. Sometimes, a slight pain may persist. It will gradually disappear over time, but it may last up to 4 weeks.

HIFU equipment) is an efficient device that allows mid-level lifting without interfering with daily life.
However, like other medical procedures, there are situations in which the decision to perform the procedure must be made carefully.

1. open wound at the treatment site.
2. severe cytic acne at the treatment site.
3. metal stent at the treatment site.
4. The areas where fillers have been injected.
5. The areas where electrical devices have been implanted.
6. The areas where mechanical implants are present.
7. The areas where there are keloids.

The procedure cannot be performed in the following cases.

8. Pregnant women and those breastfeeding
9. Children
10. Those with hemorrhagic disorder or hemostatic dysfunction
11. Herpes Simplex
12. Autoimmune disease
13. Diabetes
14. Epilepsy
15. Areas with facial nerve paralysis (Bell's palsy)

Therefore, those planning to undergo HIFU treatment should explain to their doctor in detail all medical, surgical, plastic surgery, etc., past treatments and whether or not they have been performed.

•A hard nodule may occur.
Reported cases have been on the forehead, and it is rare and will disappear over time.
This is the area that has been coagulated by ultrasound, and most will disappear after about 4 weeks.
The treated area may disappear (ball, forehead, etc.).
This may be because the heat energy from the ultrasound coagulates the subcutaneous fat layer, not the SMAS layer, and the facial tissue will lift, and the hidden burnt subcutaneous fat area will become noticeable. It is also a phenomenon that can occur.
•Sensory abnormalities can occur.
Due to the nature of the facial nerve distribution, it is most likely to appear on the forehead and corners of the mouth, and most will recover within the time of ordering without any special treatment.
Although it is extremely rare, facial motor nerve paresis can occur.
It occurs when the thermal energy from the ultrasound damages the facial nerve and causes an inflammatory reaction.
Nerve damage can usually be confirmed immediately to within 12 hours after the procedure.
•Nerve paralysis of the facial nerves usually occurs around the mouth and forehead, which are located close to the skin, and causes muscle spasms, resulting in an asymmetric mouth or forehead.