Safety and Efficacy of Ulthera in the Rejuvenation of Aging Lower Eyelids: A Pivotal Clinical Trial

Pak, Chang Sik; Lee, Yung Ki; Jeong, Jae Hoon; Kim, Ji Hoon; Seo, Jae Don; Heo, Chan Yeong

doi:10.1007/s00266-014-0383-6

Cited by 53 publications

(32 citation statements)

References 19 publications

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“…MFU-V spares the epidermis and is therefore ideal for Asians who are prone to post-inflammatory hyperpigmentation (White, Makin, Slayton, Barthe, & Gliklich, 2008). MFU-V is also indicated for treating the lower palpebral bulge that is induced by aging by stimulating the suborbicularis oculi muscle (1.5-mm probe) and the intraseptal fat (3-mm probe) (Pak et al, 2014). MFU-V is also indicated for treating the lower palpebral bulge that is induced by aging by stimulating the suborbicularis oculi muscle (1.5-mm probe) and the intraseptal fat (3-mm probe) (Pak et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Rejuvenation of periocular region in Koreans: A multimodal approach combining botulinum toxin, fillers, and micro‐focused ultrasound with visualization for optimal results

Park

Byun

Kim

2019

Dermatologic Therapy

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Periorbital aging involves all layers of the skin, fat, and the bony orbit. Therefore, a multimodal approach is necessary. Twenty Korean subjects who required periorbital rejuvenation were enrolled in this study. First, micro-focused ultrasound with visualization (MFU-V) was performed across the supra-brow area, lateral canthus, and the infraorbital area. Next, the filler was injected into the sunken upper eyelid, lateral eyebrow, and the infraorbital area. Lastly, botulinum toxin was administered into the forehead, glabella, crow's feet, and the lateral orbital rim below the brow on the same day. Photographs were taken at baseline; immediately after treatment; and at 1, 4, and 12 weeks of follow-up. The average eyebrow height was increased by 3.5 mm, and the maximum height was elevated by 3.9 mm at week 12. Physician visual analogue scale (VAS) scores regarding the whole periorbital area and eyebrow ptosis were continuously improved throughout the observation period. Physician VAS scores for infraorbital hollow and superior sulcus deformity improved immediately after the procedure and were maintained at week 12. Adverse events were mild and transient. We believe that a multimodal approach combining MFU-V, fillers, and botulinum toxin results in significant periocular rejuvenation. K E Y W O R D Sbotulinum toxin A, hyaluronic acid fillers, MFU-V, multimodal approach, periorbital rejuvenation

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Section: Discussionmentioning

confidence: 99%

Rejuvenation of periocular region in Koreans: A multimodal approach combining botulinum toxin, fillers, and micro‐focused ultrasound with visualization for optimal results

Park

Byun

Kim

2019

Dermatologic Therapy

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“…laser resurfacing and Ultherapy ® [Ulthera, Inc., Meza, AZ, USA]) may be useful in selected cases as an adjunct for periorbital rejuvenation [32]. New advances in technology, such as noninvasive polymer emulsion, may receive use in the future.…”

Section: Discussionmentioning

confidence: 99%

“…Laser resurfacing cannot correct or reposition prolapse of orbital fat or treat palpebral bulging. Skin damage and post-inflammatory hyperpigmentation can occur and are the most important adverse effects to note for in Asian populations [32].…”

Section: Palpebral Bagsmentioning

confidence: 99%

“…The 3 mm transducer of Ultherapy ® (Ulthera, Inc., Meza, AZ, USA) (HIFU, high intensity focal ultrasound) can treat both deep dermis and superficial muscular aponeurotic characteristics, sparing the dermis, and the 1.5 mm transducer can coagulate the lower epidermis and dermal layer [32]. There is evidence to suggest that the thermal effect of Ultherapy ® (Ulthera, Inc., Meza, AZ, USA) (HIFU) can tighten the orbicularis muscle, orbital septum and intra-orbital fat, which therefore can be beneficial as a non-invasive rejuvenation technique to restore the shape of the lower palpebral bag in a subset of Asian patients.…”

Section: Palpebral Bagsmentioning

confidence: 99%

“…These are young patients (<50 years old), whom have never had previous surgery or treatment at the lower orbital rim (e.g. face-lift, soft tissue augmentation, medium depth peels and/or dermal photo-rejuvenation) [32]. A recent advancement in peri-orbital rejuvenation is the addition of a noninvasive polymer emulsion.…”

Section: Palpebral Bagsmentioning

confidence: 99%

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The troublesome triad: festoons, malar mounds, and palpebral bags

Phoebe¹

2017

J Cosmet Med

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The ill-defined lid-cheek junction continues to be one of the most challenging regions for rejuvenation. Malar mounds, festoons or palpebral bags, may occur alone, or in combination, in the infraorbital area. These pathological variants are distinctly different and may contribute to patients' perception of their eyebags. Traditional lower blepharoplasty (fat repositioning/ removal) with skin adjustment alone may be insufficient in addressing all of these pathologies, and recurrence may occur. This literature review aims to look at current definitions and treatment of festoons, malar mounds, and palpebral bags in Asian blepharoplasty. A Medline literature search for articles with anatomic descriptions of malar mounds, palpebral bags and festoons, particularly in Asian eyelids, was performed. This was supplemented by a manual search of the references of articles obtained. The details of all of the different surgical options for eyelid rejuvenation are beyond the scope of this review article. Thus, only the basic concepts that illustrate the anatomical relationship and the natural progression of malar mounds, festoons, and palpebral bags will be discussed in this article. Some of the treatment options, both invasive and non-invasive, will also be reviewed. There is no singular treatment for malar mounds, festoons, and palpebral bags. Standard lower blepharoplasty with skin excision is ineffective to lift and re-drape malar mounds or festoons. Repositioning of the malar septum, on the other hand, allows for resolution of the edema (malar festoons) above its cutaneous insertion. A number of liposculpturing techniques to volumize deficient areas, such as fat repositioning (cheek, suborbicularis and descended malar fat pad) with lifting of the midface, can be beneficial to restore a smooth lid-cheek junction.Non-invasive techniques like laser resurfacing and Ultherapy ® (Ulthera, Inc., Meza, AZ, USA) may be useful in periorbital rejuvenation in selected cases.

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Complications from microfocused transcutaneous ultrasound: Case series and review of the literature

Friedmann

Bourgeois²,

Chan

et al. 2017

Lasers Surg Med

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Background and Objective Microfocused ultrasound (MFUS) technology has been utilized since 2009 for improvement in mild to moderate skin and soft tissue laxity of the face and neck. Few complications have been previously reported, the majority of which include mild and transient erythema, edema, ecchymosis, and nerve paralysis. Rare yet serious potential complications of MFUS for noninvasive skin tightening of the face and neck are, however, possible. Methods & Materials Retrospective multicenter case series of five patients from the authors’ practice who developed serious adverse events directly related to MFUS with a commercially available device (Ultherapy; Merz North America, Inc., Raleigh, NC). Results Five patients developed blistering, erosion/ulceration, cutaneous, or subcutaneous tissue edema with resulting atrophy, and/or cutaneous necrosis following single sessions of MFUS. Conclusion Despite their rarity, serious adverse events secondary to MFUS are nevertheless possible and may be underreported. Early management of complications includes local wound care, patient reassurance, and topical corticosteroids and/or pulsed‐dye laser to mitigate inflammatory sequelae. Other cosmetic and surgical therapies should be utilized when conservative measures have failed. Lasers Surg. Med. 50:13–19, 2018. © 2017 Wiley Periodicals, Inc.

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Safety and Efficacy of Ulthera in the Rejuvenation of Aging Lower Eyelids: A Pivotal Clinical Trial

Abstract: Tightening of infraorbital laxity and skin can be achieved using the Ulthera System. Patients showed a minimal pain level during treatment, and topical analgesic cream was able to manage pain during the procedure.

Cited by 53 publications

References 19 publications

Rejuvenation of periocular region in Koreans: A multimodal approach combining botulinum toxin, fillers, and micro‐focused ultrasound with visualization for optimal results

Rejuvenation of periocular region in Koreans: A multimodal approach combining botulinum toxin, fillers, and micro‐focused ultrasound with visualization for optimal results

The troublesome triad: festoons, malar mounds, and palpebral bags

Complications from microfocused transcutaneous ultrasound: Case series and review of the literature

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