What to Expect: HIFU —
Mapped First, Then Treated

Your first visit is a consultation with Dr Sin Yong, who examines and treats every patient himself. He looks at your face at rest and as it moves, and checks skin thickness, fat, laxity and bone support area by area.

Tell him about any filler, threads or implants (what, where and when), pregnancy, infection or active acne in the area, and any history of keloid scarring. Recent filler or threads can mean waiting, or leaving some areas out. Mention any regular medicines too, but do not stop a prescribed medicine for this treatment without asking the doctor who prescribed it.

Photographs are taken, with your consent, for your medical record only, and are never published. You leave with a written plan covering the areas, the depths, the device and your follow-up, and no treatment is always one of the options. If the examination points to a different approach, Dr SY explains why before any energy is used.

1. Plan confirmed. Dr SY goes over the plan with you and examines your face again.
2. Cleansing and numbing. The skin is cleansed and numbing cream is applied, then removed before treatment.
3. Mapping. He feels the thickness of skin and fat over each planned area, such as the jawline, under the chin, midface, brow or neck, and marks the lines and depths. The 4.5 mm depth, which reaches the SMAS, is kept to areas with enough soft tissue over the bone; thinner areas get the 3.0 mm or 1.5 mm depth.
4. Areas left out. Nothing is marked over the thyroid, the bony rim around the eye, or the path of the nerve that runs along the jaw border.
5. Gel. A layer of ultrasound gel lets the transducer make proper contact with the skin.
6. Treatment. The transducer is held flat on the skin and lines of energy are delivered area by area, following the map, usually deeper first and shallower after. The number of lines is set for each area.
7. Finish. The gel is wiped away, your skin is checked, and you are given written aftercare.

More on how depths are chosen is on the HIFU treatment page.

Each line brings a deep warmth or a brief ache. It is usually strongest over the jawline and other bony areas and gentlest over the fuller part of the cheek. At the deeper settings it can feel like sharp heat or a deep prickle, and some lines along the brow feel more like pressure than heat.

Numbing cream takes the edge off, but you will still feel the treatment. Comfort is checked as you go, and the energy and order of lines are adjusted to what you tell Dr SY. If a line feels electric, or the ache lingers after it, say so straight away so that line can be reassessed.

What to do in the first day and week is set out in HIFU aftercare.

How you are likely to look, and when work and events can resume, is in HIFU downtime.