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Is HIFU really the answer to repair saggy skin?

August 13, 2021

One of the greatest markers of ageing is from our face; as we grow older, we develop skin laxity resulting in smile lines and loose skin under the chin and neck. If you’re well past 30, where collagen loss starts to accelerate, you’d have already noticed these effects of ageing. In aesthetics, procedures like threadlifts and fillers are well known to maintain our youthful glow and correct signs of ageing. 

But the truth is for mature individuals, merely using injectables is not enough if your goal is to look fresher and younger. Instead, combining those with something slightly more ‘invasive’ such as HIFU would be a better option. 

What is HIFU? 

HIFU, short for high-intensity focused ultrasound, is a minimally invasive technique that uses ultrasound energy to lift and tighten skin. It is considered the closest non-surgical option to a facelift (non-surgical facelift). 

As its name suggests, HIFU works by using focused ultrasound energy to target and heat up tissues just beneath the skin. Once the cell tissues reach a certain temperature, they go through cellular damage and are stimulated to produce more collagen. Collagen, as we all know, is key to tighter and firmer skin. 

Most patients who do HIFU enjoy aesthetic benefits including: 

  • Tighter and smoother skin on the face and neck 
  • Wrinkle reduction 
  • Defined jawline 
  • Tighter décolletage 
  • Lifting effect on the cheeks, eyebrows and eyelids 

Note that we say most patients — because while HIFU has been proven to work, this anti-ageing procedure is not suitable for patients with photo damaged skin or severe skin laxity due to extensive collagen loss. It is also not recommended for patients with cystic acne and open skin lesions at the target area. 

Simply put, the best candidate for HIFU is someone from their 30s with mild to moderate skin laxity and no existing serious skin conditions. 

Is HIFU safe?

Before HIFU made its way into aesthetics, it was actually used in cancer therapy. It was not till later that scientists discovered the benefits of HIFU in cosmetic treatments. While HIFU as a medical technology for aesthetics in general was formally approved by the FDA, many brands of HIFU devices such as Ultrafomer 3 are Korea FDA, Europe SE and HSA Singapore-approved. 

Please note that even without US FDA approval, it does not necessarily mean a medical device is unsafe — especially if the device or technology in question has received approval from other health regulatory bodies. For the most part, getting a stamp of approval from US FDA is an expensive and time consuming process and in most businesses’ eyes only worth it if there’s commercial demand. HIFU is currently widely adopted in Asian countries including Korea, Taiwan, China and of course Singapore, where aesthetic medicine and anti-aging technologies are billion dollar industries. 

Several clinical studies can also back up the safety and efficacy of HIFU, including a 2017 study[1] in which patients showed significant improvements on skin elasticity of the cheeks, thighs and lower abdomen after 12 weeks with no adverse side effects. Another study[2] done the same year also confirmed consistent clinical efficacy of over 90% with no adverse events. 

At Ozhean Zoey Aesthetics, we pride ourselves on only bringing in products and treatments that are safe and clinically tested.

What’s the difference between HIFU and a facelift? 

A facelift, medically known as a rhytidectomy, is a surgical procedure to improve visible signs of ageing in the face and neck. During a facelift, the tissues beneath the skin are surgically pulled back to alter the contour of the face. 

Compared to HIFU, a surgical facelift lasts a lot longer (about 10 years) but is a lot more expensive and carries more risks. Here’s a summary of the major differences between the two. 




Mode of mechanism 

High frequency ultrasound waves to heat up and damage cells to trigger collagen production in the body

Surgically pull back and remove excess tissue 


Minimally invasive, no incisions required

Invasive procedure that requires sutures and stitches 

Side effects

Mild redness and swelling

Possible side effects include anaesthesia risks, blood clots, scarring and pain 


Results take about 3 months to see visible effects; lasts for about a year; subsequent HIFU treatments are required to maintain results 

Results last for about 10 years or more


Minimal downtime

Downtime of 2 weeks 

Is HIFU painful?

Compared to other anti-aging injectable procedures, HIFU does carry a bit more discomfort and pain. This is due to the heat from the ultrasound waves. However, it is nothing too uncomfortable; most patients describe the pain as a light prickly sensation. Our doctors will do their best to minimise pain and make you feel as comfortable as possible. 

So is HIFU suitable for me if I’m older? 

For patients in their 60s with severe collagen loss, reversing ageing would be slightly more challenging compared to younger individuals. Most doctors would recommend a surgical facelift as the best option, but if you’re looking to slow down signs of ageing without going under the knife, we recommend combining HIFU with another non-surgical facelift procedure. 

Again, this is just a generalisation and our doctors will have to assess your condition to advise better. 


  1. Ko, E. J., Hong, J. Y., Kwon, T. R., Choi, E. J., Jang, Y. J., Choi, S. Y., Yoo, K. H., Kim, S. Y., & Kim, B. J. (2017). Efficacy and safety of non-invasive body tightening with high-intensity focused ultrasound (HIFU). Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI), 23(4), 558–562. https://doi.org/10.1111/srt.12371
  2. Chilukuri, S., Denjean, D., & Fouque, L. (2017). Treating multiple body parts for skin laxity and fat deposits using a novel focused radiofrequency device with an ultrasound component: Safety and efficacy study. Journal of cosmetic dermatology, 16(4), 476–479. https://doi.org/10.1111/jocd.12448
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