Quantified Facial Rejuvenation Utilizing High Intense Focus Ultrasound with Multiple Penetrative Depths

BACKGROUND: Multiple penetration depths of high-intensity focused ultrasound (HIFU) treatment for facial rejuvenation have not been quantified. METHODS: We enrolled 12 participants (n=24) to undergo one session of HIFU rejuvenation between January 1, 2019, and January 10, 2020. We used a 2-, 4.5-, and 6-mm focal depth transducer on the upper and middle face. We evaluated efficacy on days 60 and 90 by using our specific assessment system. RESULTS: The average eyebrow peak and pupil–eyebrow peak angles significantly increased by 2° (p < 0.0005) and decreased by 1° (p < 0.0001), respectively, at day 90. The shortened eyebrow–iris length indicated that the forehead tissues had lifted and moved medially to the central face. Supraorbital tissues were also vertically elevated, marked by the eyebrow–orbital (p = 0.0016) and vertical palpebral fissure lengths (p = 0.0052), which both exhibited a 0.8-cm elevation. For the midface, the increased canthus–oral–nasal angle (p = 0.5881) and decreased tragus–oral length (p = 0.5881) indicated that laxity had been corrected through lifted oral commissure, though the data were not statistically significant. No serious side effects were observed. CONCLUSION: HIFU treatment with multiple depths quantitatively improved both upper-facial rejuvenation and midface rejuvenation after a single session.