Clinical efficacy and safety of focused-image ultrasonography: a 2-year experience.

BACKGROUND Focused-image ultrasonography produces controlled waves that image dermal and subdermal structures in real time, with precise thermal coagulation points in a linear pattern, for eventual nonsurgical lifting. OBJECTIVES The authors evaluate the effectiveness of single and dual planes of ultrasound treatment by varying the directions of treatment lines, depths, and cumulative joule energies and compare the safety and efficacy of treatment with these variations. METHODS In this prospective, 2-part study, patients were treated by single- or dual-treatment depth with differing directions of treatment lines while the number of treatment lines and amount of energy delivered to brows or marionette lines remained constant (Study 1) or with lower or higher joule energy to opposing areas while the dual depths and number of vectored lines remained constant (Study 2). Lifting was measured using the matched-orientation function of specific mirroring software. Clinical outcomes were assessed with global aesthetic improvement scales. RESULTS Vertical vectoring of 15 treatment lines in both tissue depths produced significant lifting over the 15 horizontally-placed treatment lines in the opposing brows and marionette lines. Sites with more treatment lines and higher joule energy at dual depths resulted in significantly greater lifting (Study 2). Side effects were minimal. CONCLUSIONS Focused-imaged ultrasound therapy to facial tissues is safe and effective when performed as described.