Ultrasound is ultra cool: Ulthera, Liposonix, JeNu

With technologies such as Ulthera, Liposonix, and JeNu, a new era of aesthetic medicine – nonsurgical skin rejuvenation and body contouring – is here.   Lasers and radiofrequency (RF) devices (Thermage, Viora, Exilis, Accent, Aluma, TriPollar and ReFirme to name a few) continue to proliferate but they all have significant limitations. Ultrasound enables more precision, control, and versatility. It has been a special interest of mine since I became involved with Liposonix as an advisor when it was a startup company, little more than a twinkle in the eye of its investors. I quickly came to appreciate the potential of ultrasound to overcome the inadequacies of other technologies such as RF, especially in the emerging area of nonsurgical aesthetic treatments.

RF treatments all rely on the placement of heat into tissues, which - if the peak temperatures are high enough - results in a healing response that generates new collagen. This in turn translates into tighter, firmer tissues. But achieving the necessary temperatures in a controlled manner is difficult, because different tissues absorb the energy differently. Controlling the depth of penetration is tricky too. Lasers also rely on heating, but have limited penetration and have only a few specific wavelengths.

Ultrasound, on the other hand, can be focused like a lens right through the skin, and the point of convergence of the ultrasound waves can be placed with precision and high intensity. Liposonix was the first device to use High-Intensity Focused Ultrasound (HIFU) for noninvasive body contouring by focusing in the fat layer. A single Liposonix treatment can produce an inch or more of waist circumference. Ultherapy also uses focused ultrasound, but targets the layers directly under the skin. This is where the collagen and connective tissues are, so there is a lifting and firming effect. What’s more, because ultrasound can also be used for imaging, we can see the area to be targeted. Ultherapy also requires only a single treatment. New treatment protocols make the procedure almost pain-free for many patients.

The versatility of ultrasound is demonstrated by JeNu, which uses non-focused low energy ultrasound to enhance the permeation of active skin care ingredients into the skin. Since the outer layer of the skin (called the stratum corneum) is a barrier, getting ingredients such as retinol through that layer into the cells underneath where they have more effectiveness is the trick. JeNu accomplishes this with only a minute per day, at home.

Ultimately, the sky’s the limit with ultrasound. But because the result with nonsurgical techniques depends on the body’s individual response, there will always be patients who are better served with surgery.