How does the HIFU procedure help with sagging skin and localized fat?

As we age, after significant weight loss or as a result of hormonal and physiological changes, the skin gradually loses its elasticity and firmness. In addition, some fat deposits, especially in areas such as the abdomen, thighs, arms and knees, prove resistant to diet and exercise. High‑Intensity Focused Ultrasound (HIFU) is established as a non-invasive method for tightening loose skin and reducing local fat.

How does HIFU work on skin and fat cells?

HIFU technology uses focused ultrasound energy that reaches different layers of the skin and subcutaneous tissue without disturbing the epidermis. The depth of penetration depends on the specific area and purpose of the procedure:

• 1.5 mm to 4.5 mm – for collagen stimulation and skin tightening
• 6 mm to 13 mm – for breakdown of fat cells (in areas with subcutaneous fat)

At each focusing point, thermal coagulation is created, at which the temperature reaches 60-70°CThis causes the following effects:

Skin tightening

• Immediately shortening of collagen fibers
• Long-term neocollagenesis (synthesis of new collagen and elastin)
• Improved skin structure and elasticity

Degradation of fat cells

• Ultrasonic energy destroys adipocytes (fat cells)
• Fat is eliminated naturally through the lymphatic system

Areas of application and results

HIFU is effective for moderately loose skin and localized fat deposits. Common treatment areas include:

• Abdomen
• Inner and outer thighs
• Headquarters
• Above the knees
• Hands
• Back fat ("bra fat")

Expected results:

• Gradual improvement within 2 to 3 months
• Expressed lifting and tightening
• Circumference reduction in the treated area
• Smoother and tighter contour
• Sustainable result: average duration up to ~18 months, depending on individual factors. Results vary by age, skin condition and lifestyle.

Suitable choice for:

• People with mild to moderate skin laxitywho are looking for visible tightening without surgery
• Customers with local fat (belly, buttocks, thighs), resistant to diet and exercise
• Women and men who stay in shape with normal to slightly elevated body mass index (BMI ≤ 30)
• People no active skin infections, kidney or liver disease

Safety and recommendations

• It is only performed by trained specialists with medical experience
• The device used must have CE/FDA certificates and option for real-time ultrasound visualization (e.g. Ultherapy) .
• Avoid if you have hormonal problems, metal implants, pregnancy, or severe chronic conditions.

HIFU vs. invasive methods

HIFU cannot replace surgical liposuction or facelift, but it has a number of advantages:

Clinical evidence

• Ko et al., 2017 – рандомизирано клинично проучване с 32 участника от Корея (лице, корем, бедра): значително подобрение в еластичността на кожата – измерена с Cutometer на 4 и 12 седмици след процедурата, без дългосрочни странични ефекти. ResearchGate
• Azin Ayatollahi et al., Lasers Med Sci, 2020 – мета-анализ с 477 пациенти: средна оценка за ефективност 2.7/5, умерен болков праг (~4.2/10), без постложения като хиперпигментации. PubMed
• Haykal et al., Aesthetic Surg J, 2025 – систематично преглеждане на 45 клинични проучвания: HiFu показва 18–30 % подобрение на кожната отпуснатост и контурите на тялото. ResearchGate+PubMed
• AIUM (American Institute of Ultrasound in Medicine) confirms that HiFu is safe and effective in breaking down fat, with good tolerability and minimal risk, and that should not be applied without appropriate qualification. ResearchGate