HIFU — Focused Ultrasound Skin Lifting

HIFU focuses ultrasound energy at depths of 1.5–4.5 mm, reaching the deep dermis and the SMAS layer to create thermal coagulation points that contract existing collagen and stimulate new collagen production over 2–3 months. It is suitable for mild to moderate skin laxity in the cheeks, jawline, and neck; it does not replace thread lifts or a surgical facelift for significant skin excess; results typically last 6–12 months.

Medically reviewed by BS.Ths.CKI Kim Kha — BonBoz Clinic

Mechanism of Action

The ultrasound transducer delivers focused energy to precise micro-points at predetermined depths, instantly raising the local temperature to 60–70°C. This is sufficient to coagulate and contract collagen fibers while triggering neocollagenesis. The skin surface remains intact as energy concentrates solely at the focal point. Transducers of varying depths—1.5 mm (superficial dermis), 3 mm (deep dermis), and 4.5 mm (SMAS)—are selected based on the treatment area.

What Real Results Can You Expect?

HIFU improves skin firmness and refines the jawline in cases of mild-to-moderate laxity, with progressive results developing over 2–3 months and lasting 6–12 months. For significant skin excess, pronounced jowling, or a large double chin, HIFU cannot excise or lift excess tissue—a thread lift or surgical intervention is required. To be clear: HIFU is designed for "skin tightening," not "surgical lifting." Having realistic expectations prevents disappointment.

Who Is an Ideal Candidate?

Individuals aged 30–50 experiencing early signs of laxity, mild jawline softening, or fine lines around the eyes and neck, who prefer a non-invasive approach and are willing to undergo maintenance treatments. Thin individuals with minimal facial fat require careful assessment, as delivering energy at an incorrect depth can worsen facial volume loss.

Why Must a Physician Perform the Procedure?

Incorrect depth and energy settings can lead to burns, subcutaneous fat atrophy (sunken cheeks), or temporary facial nerve damage. The jawline and periocular regions feature critical anatomical landmarks that must be carefully avoided. HIFU is not just about having an advanced device—the practitioner holding the handpiece determines clinical efficacy and safety.

The BonBoz Approach

A physician directly assesses your degree of laxity, skin thickness, and fat volume to determine whether HIFU is sufficient or if thread lifting/surgery is indicated; customizes cartridge depths and line counts for each zone; and treats with precise control around high-risk anatomical areas. If your laxity exceeds what HIFU can achieve, our doctors will be completely honest rather than simply selling a treatment.

How is it performed?

The treatment area is mapped with a grid, and ultrasound gel is applied. The doctor delivers energy along lines with the transducer, addressing each depth in sequence (4.5 → 3 → 1.5 mm)—taking 45–90 minutes for a full-face session. Patients feel rhythmic, deep prickling heat, with the jawline and forehead being more sensitive; topical numbing or pain relief may be used. The procedure concludes with cooling.

Before the procedure

Thoroughly remove makeup; inform the clinic of any implanted electronic devices, metal implants in the treatment area, recent dermal fillers (under 4 weeks), pregnancy, or active dermatitis; no pre-treatment downtime required.

After the procedure

Mild redness and slight swelling lasting a few hours up to 1–2 days; mild tenderness to the touch may occur for a few days; resume normal daily activities and makeup after 24 hours; apply sun protection. Results progressively improve over 2–3 months; follow-up evaluation at the 3-month mark; repeat the treatment after 6–12 months if indicated.

Possible risks — your doctor explains them before treatment

Redness, mild swelling, and tenderness for a few days
Transient numbness around the jawline and cheeks lasting a few days to a week
Pinpoint bruising or small linear bruises
Cheek hollows or fat loss if incorrect depths are applied to lean individuals
Burns or temporary facial muscle weakness if energy levels or placement are incorrect — which is why a doctor is essential
Lower efficacy than expected in cases of severe skin laxity

Who should NOT have this?

Excessive skin laxity, pronounced jowls, or a large double chin (HIFU cannot achieve adequate lifting — thread lifts or surgical options are recommended)
Very lean individuals with minimal facial fat (risk of facial hollowing)
Presence of cardiac pacemakers, implanted electronic devices, or metal implants in the treatment area
Recent dermal filler injections within 4 weeks in the treatment area
Pregnancy; active dermatitis, severe inflammatory acne, or herpes infection in the treatment area
Facial neuropathy or uncontrolled bleeding disorders

BS.Ths.CKI Kim Kha

Aesthetic Dermatology

Graduated as a General Practitioner — Tay Nguyen University (2018)
Specialist Level I in Dermatology — Pham Ngoc Thach University of Medicine, degree awarded in 2025
Medical Practicing Certificate No. 009784/ĐL-CCHN — Issued by the Department of Health of Dak Lak Province on 15/10/2021
Over 8 years of experience in aesthetic dermatology practice (since 2018), including over 4 years of practice with an official Medical Practicing Certificate
Primary Specialization in Plastic and Reconstructive Surgery; Certificates in Dermatological Procedures & Minor Surgery, Microsurgery, and Lasers & Light Therapies in Dermatology
Certificates in Dermal Fillers, Botox, and Thread Lifts; Certificates in Emergency Resuscitation and Infection Control
Formerly practiced at the Aesthetic Dermatology Unit — Post and Telecommunications General Hospital (2019–2021) and Venus Sunrise Clinic (2022–2024) before joining BonBoz Clinic (2025)
Former lecturer in Aesthetic Dermatology Theory at Ana Aesthetic Training School (2018–2019)
Over 5,000 clinical dermatology cases treated

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Frequently asked questions

Is HIFU painful?

You will feel deep, rhythmic prickling heat; the jawline and forehead are more sensitive. Topical numbing cream or oral pain medication can be administered as prescribed by the doctor. It is well-tolerated by most clients.

How soon will I see results?

Immediate mild tightening occurs due to collagen contraction; full results become gradually visible within 2–3 months as new collagen forms.

How long do results last?

Typically 6–12 months depending on age and individual anatomy; periodic maintenance sessions are recommended.

Can HIFU replace thread lifts?

No, not for skin with noticeable excess laxity. HIFU tightens tissue, while thread lifts physically elevate it; they often complement each other for moderate sagging.

Can HIFU cause cheek hollowing?

It can occur in naturally lean individuals if a 4.5 mm depth is applied to areas with minimal fat. The doctor will assess your subcutaneous fat layer and select appropriate depths to prevent this.

Can I get fillers after HIFU?

Yes, it is recommended to get filler injections after HIFU (avoiding the reverse in close succession) so the thermal energy does not affect the newly injected filler.

How many sessions are needed?

Usually 1 session per treatment course, reassessed after 3 months; some cases require 2 sessions spaced 3–6 months apart.

Is there any downtime?

No; you may experience mild redness for a few hours, but you can return to work immediately.

What is the difference between HIFU at a spa versus a medical clinic?

The difference lies in who assesses the clinical indication and operates the transducer: determining precise depths, energy levels, and nerve-avoidance zones—incorrect application can lead to burns or cheek hollowing.

Who performs the procedure at BonBoz?

A non-surgical aesthetic doctor consults and directly performs the treatment; cases requiring thread lifts or surgery are referred to a plastic surgeon.