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Ultrasound Facelift


Facial Rejuvenation
Over time, natural aging, gravity and exposure to the sun and other elements take their toll on the body. The effects are especially noticeable on the face. Fine lines eventually become deeper wrinkles and the skin becomes drier and thinner, and loses its elasticity.

Facial aging eventually catches up with everyone. But people don’t have to live with it. Facial rejuvenation procedures are generally classified into one of two groups. Ablative procedures, like chemical peels, dermabrasion and CO2 laser therapy, cause intentional destruction of the outer layer of skin. Nonablative therapies, like IPL treatment, radiofrequency energy and pulsed dye lasers, cause heat-induced injury in the dermis without damaging the outer skin. Ablative treatments tend to provide the best results, but are associated with potential side effects, such as significant swelling, redness, infection, and skin changes. While nonablative treatments have fewer side effects, they are less effective than ablative treatments.

The American Society for Aesthetic Plastic Surgery estimates in 2009, more than 2.53 million facial rejuvenation procedures were performed in the U.S. The most extreme type of facial rejuvenation is a facelift. More than 94,200 facelifts were done in 2009.

Ultrasound for Facial Rejuvenation
Some physicians are now using Ulthera®, an ultrasound therapy, for facial rejuvenation. It’s similar to the technology that’s been used for years to take fetal images in pregnant women. First, the ultrasound transducer is placed over the target area on the face. The physician uses the images to “see” the underlying structures. The target is a layer of tissue, called the superficial musculoaponeurotic system (SMAS). The SMAS covers the underlying muscles and is connected to the dermis.

During the therapy, a fan-like array of high energy sound waves passes through the skin. Individually, each ultrasound wave is harmless. But inside the body, the waves converge onto a single focal point. Here the combined energy causes the molecules in the target tissue to vibrate, generating heat. Matthew White, M.D., Facial Plastic Surgeon with NYU Langone Medical Center in New York City, explains the thermal damage causes a wound healing response in the SMAS, causing it to tighten. The procedure is very safe because the ultrasound images enable the physician to monitor the effects of the treatment on underlying skin.

White says the effects of Ulthera are more subtle than those from other types of facial rejuvenation procedures. Patients often report feeling an increase in firmness in the skin right after treatment. Over the next two to three months, the skin will continue to tighten, gradually improving the results. White says usually only one treatment is needed. However, it can be repeated as necessary. Ulthera can be done on the whole face or portions of the face.

White says Ulthera is best for people with mild to moderate signs of facial aging. Although the therapy won’t completely turn back the clock on facial aging, it can buy some time for patients who aren’t ready for more invasive rejuvenation procedures. A single area of the face may take as little as 15 minutes, while a full facial treatment takes about 45 minutes. Side effects are minimal. Though some people have some mild pain and redness, symptoms are generally gone within 48 hours. In White’s office, the cost of Ulthera starts at $1,500.

AUDIENCE INQUIRY
For information on Ulthera®, or to find a local practice, go to http://www.ulthera.com

For general information on facial skin aging or cosmetic procedures:
American Academy of Dermatology, http://www.aad.org
American Society for Aesthetic Plastic Surgery, http://www.surgery.org
American Society for Dermatological Surgery, http://www.asds.net

BIBLIOGRAPHY
Gliklich, Richard, M.D., et al., “Clinical Pilot Study of Intense Ultrasound Therapy to Deep Dermal Facial Skin and Subcutaneous Tissues,” Archives of Facial Plastic Surgery, March/April 2007, Vol. 9, No. 2, pp. 88-95.

Laubach, Hans, M.D., et al., “Intense Focused Ultrasound,” Dermatologic Surgery, May 2008, Vol. 34, No. 5, pp. 727-734.

White, W. Matthew, M.D., et al., “Selective Creation of Thermal Injury Zone in the Superficial Musculoaponeurotic System Using Intense Ultrasound Therapy,” Archives of Facial Plastic Surgery, January-February 2007, Vol. 9, No. 1, pp. 22-29.

White, W. Matthew, M.D., et al., “Selective Transcutaneous Delivery of Energy to Porcine Soft Tissues Using Intense Ultrasound Therapy,” Lasers in Surgery and Medicine, February 2008, Vol. 40, No. 2, pp. 67-75.

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