What is HIFU (UTIMS A3)? Non-invasive sagging (skin laxity) treatment — how much tightening can you expect?

HIFU (high-intensity focused ultrasound) is a treatment that concentrates ultrasound waves deep in the skin, converting them to heat, and uses the skin's collagen-regeneration process to tighten sagging (skin laxity)[1]. According to guidelines from the Japan Society of Aesthetic Surgeons, it is effective for wrinkles and sagging (skin laxity), but its results do not match those of surgery or injectable treatments[2]. UTIMS A3 is one of the HIFU devices, but there are few studies examining this device alone, so here we explain based on research on HIFU as a whole[3].

How much tightening can you expect?

It is realistic to think of the change as "somewhat tightened." A systematic review of 16 studies showed that eyebrow lift was 0.47–1.7 mm, and the area under the chin decreased by 26–45 mm²[4].

Physician assessment showed improvement in tightening and wrinkles in 92% of participants at day 90, and this state continued through 1 year[4]. In contrast, the percentage of participants who perceived improvement in their own assessment was 42% at day 90 and 53% at day 360, which is lower[5].

In other words, there is a difference between the change visible to physicians in photographs and the change felt by the individual. Note that all studies included in this systematic review were conducted in women.[4].

How long does the effect last?

Research has confirmed results for approximately 1 year[4]. There is no data yet for longer periods[4].

How long one session lasts depends on skin condition, age, and lifestyle, and is not fully understood[3]. Textbooks also state that eyebrow lift from ultrasound tightening is minimal and shorter-lasting than surgery[6].

How does it differ from surgery or Thread lift?

If you seek significant change, surgery is more suitable. The advantages of HIFU are that it is non-invasive, scarring is rare, and the risk of complications is low.[2].

Research using UTIMS probes (the radiating component) includes a report of 58 participants who combined it with Thread lift, and ratings improved with each session[3]. However, these are combined results, so it is unclear how much change HIFU alone produced.

What about pain and side effects?

Pain during treatment ranged from mild to moderate, and post-treatment pain was minimal, with most resolving within about 2 days[7]. A meta-analysis of the research also rated pain as moderate[8].

Common side effects are redness, swelling, bruising, and tenderness on pressure — all mild to moderate[8]. Temporary sensory changes such as numbness are reported in approximately 2%[5].

Caution is needed around the eyes. Cases have been reported where white cloudiness remained in the iris after irradiation near the eye[1]. If you are having the eye area irradiated, confirm in advance how the eye will be protected.

What should a consultation confirm to see if it suits you?

You want to confirm the amount of sagging (skin laxity), skin thickness, and how much change you expect. If sagging (skin laxity) is severe, HIFU alone may feel insufficient.

Also ask about the range and depth of irradiation, whether the eye area is included, and the interval for repeat sessions. Whether HIFU is suitable cannot be decided from an article alone, so it is most reliable to have a physician examine your face in person before deciding.