The Ultraformer, a non-surgical facelift for the face and body.

Over time, the production of collagen gradually decreases, as does that of elastin. Consequently, the skin loses firmness, sags, and then slackens. While this phenomenon is natural, it can be accelerated by external aggressors, notably pollution and UV rays. This skin laxity can be observed on various areas of the body, such as the face, stomach, and arms.

The ultra-former is one of the solutions adopted to address skin laxity. It is a high-frequency ultrasound device that emits at a high temperature (65-70°C) across all subcutaneous cells and the SMAS (Superficial Musculo-Aponeurotic System), which is the system on which the entire dermis rests. This practice can be carried out through the use of coagulation micropoints launched at different depth levels. The high temperature activates the retraction of the SMAS and stimulates dermal fibroblasts, promoting the creation of new fibres of elastin, collagen, and reticulin. Following these two actions, the ultra-former promotes skin firmness.

Prior to an ultra-former session, no specific care is required in the preceding weeks, but it is advised to avoid excessive sun exposure to minimise the risk of skin irritation. The skin should be clean, free from makeup or cream. There is no need for specific preparation, although some practitioners may recommend intense skin hydration in the preceding days.

During the session, the professional begins by meticulously cleaning the area to be treated, then applies a contact gel similar to that used for ultrasounds to facilitate the diffusion of high-intensity focused ultrasound (HIFU). No protective glasses are required, as the technology used does not emit light, but ultrasonic waves.

The ultra-former device is then applied to various areas of the face such as the forehead, the facial oval, the cheekbones, the cheeks, the eye contour, the mouth contour, the neck or even the décolletage. It can also be used on the body, notably the abdomen, the arms, the knees or the buttocks. A session lasts between 30 and 90 minutes depending on the size of the area treated.

The ultra-former targets various depths: 1.5 mm for the epidermis and superficial dermis, 3 mm for subcutaneous tissues and fat, and up to 4.5 mm to reach the SMAS, the structure targeted during a lift procedure. For body areas with more adipose tissue, the cartridges can reach depths of up to 13 mm.

In terms of sensations, the pain is generally moderate. Patients often experience slight tingling, a feeling of warmth or mini-electric shocks, particularly on bony or sensitive areas. If necessary, an anaesthetic cream can be applied beforehand to improve comfort.

At the end of the session, the skin may be slightly red or sensitive, but these effects fade within a few hours. There is no social downtime, and regular activities can be resumed immediately. However, good hydration and sun protection are recommended after the treatment to maintain the results and protect the skin.

Due to the contraction of elastic fibres, the patient may feel a sensation of already tightened skin after the session, but the results continue to improve gradually. Indeed, the targeted fat cells are permanently eliminated over the weeks, while the fibroblasts, responsible for collagen production, are activated and only start to act after 60 to 90 days. Thus, the lifting effect progressively strengthens and reaches its peak after about three months, with an average duration of about two years. Generally, one ultra-former session is sufficient. However, if necessary, a second session can be scheduled after 4 to 6 weeks. After the lift, redness or swelling may appear on the treated area. The patient may also feel some tingling. Often, these effects disappear after 24 hours.

Even though the procedure does not require surgical intervention, the ultra-former is not recommended for pregnant or breastfeeding women as a precautionary measure, as the effects of high-intensity focused ultrasound on the foetus or infant are not sufficiently studied. Moreover, hormonal fluctuations during this period can make the skin more sensitive or reactive. The treatment should also be avoided in cases of active skin disorders, such as inflammatory acne, skin infections or open lesions. Indeed, the heat produced by the ultrasound could exacerbate inflammation, promote the spread of infection or lead to poor healing. These precautions aim to limit risks and ensure optimal results.

• YONG SONG K. & al. Intense Focused Ultrasound Tightening in Asian Skin: Clinical and Pathologic Results. Dermatologic Surgery (2011).

• RINKY K. & al. Use of Micro-focused Ultrasound for Skin Tightening of Mid and Lower Face. Plastic and reconstructive Surgery-global Open (2019).

• SCHORTINGHUIS J. & al. A Systematic Review of the Efficacy of Microfocused Ultrasound for Facial Skin Tightening. International Journal of Environmental Research and public Health (2023).

• JONG SEO K. Three-dimensional Analysis of Lifting Effects after High-intensity Focused Ultrasound (Ultraformer-MPT) across Seven Facial Aesthetic Units Considering SonoAnatomy. Plastic and reconstructive Surgery-global Open (2024).