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Non-invasive lifts of eyebrow, neck and chin are effective: study(2)


(Photos courtesy of Sabrina Guillen Fabi, MD)

(press release from ASDS)

The micro-focused ultrasound therapy known as Ultherapy effectively - and non-surgically - lifts and tightens skin on the eyebrow and neck and under the chin without adverse effects for patients of all ages, according to a just-released study.

Sabrina Guillen Fabi, MD, a member of the American Society for Dermatologic Surgery, released results of the retrospective study on the procedure today at the 2014 ASDS Annual Meeting, being held through Nov. 9 in San 

Dr. Fabi and 2013-14 ASDS President Mitchel P. Goldman, M.D., evaluated the results of Ultherapy's micro-focused ultrasound treatment on 48 women, ages 39 to 85, treated in 2011. Assessments in the procedure's effectiveness included photographs taken before and immediately after treatment and at 90 and 180 days, plus physician and patient scoring of global aesthetic improvement. Physicians also conducted appraisals of the upper, mid- and lower facial areas.

Drs. Fabi and Goldman are with Cosmetic Laser Dermatology (Goldman, Butterwick, Fitzpatrick, Groff & Fabi) in San Diego. Both conduct numerous clinical trials and studies, including this examination, "A Retrospective Evaluation of Micro-focused Ultrasound (MFU-V) for Non-invasive Treatment of Skin Texture and Laxity of the Neck and Face."

The dual-depth ultrasound procedure treats first the muscle and then the skin, said Fabi. It stimulates collagen production by delivering ultrasound energy to the superficial muscular tissue made up of collagen, on the face and neck. "The stimulation at that plane results in a meaningful lift as well as superficial tightening of the skin," she said.

"It is the only energy-based treatment that effectively and consistently penetrates to the depth of the superficial muscular plane that classically has been targeted with surgery. It truly is a game-changer," Fabi said.

Since 2010, the FDA has approved Ultherapy four times - for non-surgical eyebrow lifts, non-invasive treatments for lifting the neck and under-chin areas, treatments with visualization to pinpoint delivery and, most recently, non-invasive treatments of the fine lines and wrinkles of the chest.

Ulthera Inc., recently acquired by Merz Aesthetics, developed Ultherapy.

More than 80 percent of study patients noted improvement, with 62.5 percent reporting being satisfied or very satisfied at 90 and 180 days after treatment, Fabi said. The average improvement score from the physician assessments was 1.8 - corresponding to fair improvement - at 180 days, on a scale from 1 to 4. "That is a good result for a single, non-surgical, no downtime procedure," she said.

Dr. Fabi said current protocols call for higher density - known as lines of treatment - than in the 2011 study period, increasing the treatment's effectiveness."In 2011, we used approximately 500 lines per treatment. Now the recommendation is up to 800 lines for full treatment of the face and upper neck. That will provide more consistent and better results," she said.

Drs. Fabi and Goldman eliminated patients from the study group who had other procedures in addition to Ultherapy. "We wanted to know that Ultherapy alone works, not in partnership with another therapy," she said.

The patients had an average Body Mass Index of 22; a BMI of 25 is considered overweight and 30 is considered obese. "This is not simply melting fat in fuller faces," Dr. Fabi said. "This study shows targeting and treating the superficial muscular layers provides a meaningful lift."

Drs. Fabi and Goldman also studied patient age to see if guidelines for treatment recommendations would result. They stratified the patient groups, with half more than 60 and half younger than 60.

"We found there were good results no matter what the age of the patient, which helps us know to whom we can recommend the treatment," she said. "Will you look like a 40-year-old if you're 60? No, but you will still have a meaningful result."

The study also reveals important information on aging skin, the effectiveness of various treatments and the need to educate patients in advance of procedures, Dr. Fabi said. "I'm very frank about realistic expectations."

She said no single treatment will be the "be-all and end-all." While a particular procedure may provide improvements in one area, she said the patient perhaps will still need fillers for volumizing and neuromodulators for wrinkles.  

"The micro-focused ultrasound treatments stimulate collagen production but will not restore volume loss from fat or bone, which women lose as they age. People must be realistic, and physicians must educate their patients about what can be accomplished based on the treatment recommended," she said.

Particularly for patients who want to avoid invasive surgery, Ultherapy is another useful treatment tool that delivers improvements, she said. "It provides 'natural' results," she said. "The goal is to help people look and feel their best at any age."


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