Clinical Experience and Practical Considerations of High-Intensity Focused Ultrasound for Eyelid Sagging
Main Article Content
Abstract
Background: Eyelid sagging is a common sign of aging that impacts both aesthetic appearance and visual function. Non-invasive modalities, including high-intensity focused ultrasound (HIFU) have emerged as promising alternatives to surgical correction.
Methods: This prospective observational study evaluated the efficacy and safety of HIFU for upper and lower eyelid sagging. Twenty Korean women aged 35–57 years with mild-to-moderate eyelid sagging underwent a single HIFU session using a 2.0‑mm, 4‑MHz probe. Topical anesthetic cream was applied for 40 minutes before treatment. Standardized photographs were obtained at baseline and 12 weeks post-treatment. Two blinded clinicians evaluated outcomes using a 4‑point clinical grading scale. Patient satisfaction and changes in eyelid length were also assessed.
Results: Seventeen of 20 patients (85%) demonstrated visible improvement at 12 weeks. Clinician assessment confirmed improvement in 15 patients (75%), and mean eyelid length was reduced compared to baseline. No severe adverse effects were reported.
Conclusion: HIFU is a safe and effective non-invasive option for upper and lower eyelid sagging, providing measurable improvement with minimal downtime. Future controlled studies with larger cohorts are warranted to validate and expand these findings.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Parikh S, Most SP. Rejuvenation of the upper eyelid. Facial Plast Surg Clin North Am. 2010;18(3):427‑433.
3. Gupta MA, Gupta AK, Schork NJ, Ellis CN, Voorhees JJ. The aging face: a psychocutaneous perspective. J Dermatol Surg Oncol. 1990;16(10):902‑904.
4. Ayatollahi A, Gholami J, Saberi M, Hosseini H, Firooz A. Systematic review and meta‑analysis of safety and efficacy of high‑intensity focused ultrasound for face and neck rejuvenation. Lasers Med Sci. 2020;35(5):1007‑1024.
5. Chan NP, Shek SY, Yu CS, Ho SG, Yeung CK, Chan HH. Safety study of transcutaneous focused ultrasound for noninvasive skin tightening in Asians. Lasers Surg Med. 2011;43(4):366‑375.
6. Shome D, Vadera S, Ram MS, Khare S, Kapoor R. Use of micro‑focused ultrasound for skin tightening of mid and lower face. Plast Reconstr Surg Glob Open. 2019;7(4):e2498.
7. White WM, Makin IR, Barthe PG, Slayton MH, Gliklich RE. Selective creation of thermal injury zones in the superficial musculoaponeurotic system using intense ultrasound therapy: a new target for noninvasive facial rejuvenation. Arch Facial Plast Surg. 2007;9(1):22‑29.
8. Phenix CP, Togtema M, Pichardo S, Zehbe I, Curiel L. High‑intensity focused ultrasound technology: its scope and applications in therapy and drug delivery. J Pharm Pharm Sci. 2014;17(1):136‑153.
9. Hwang Y, Yi KH. The efficacy of intense focused ultrasound treatment for sagging of upper and lower eyelids. Korean Assoc Laser Dermatol Trichol. 2022;3(1):1‑5.
10. Damasceno RW, Avgitidou G, Belfort R Jr, Dantas PE, Holbach LM, Heindl LM. Eyelid aging: pathophysiology and clinical management. Arq Bras Oftalmol. 2015;78(5):328‑331.
11. Kwon HH, Lee WY, Choi SC, Jung JY, Bae Y, Park GH. Combined treatment for skin laxity of the aging face with monopolar radiofrequency and intense focused ultrasound in Korean subjects. J Cosmet Laser Ther. 2018;20(8):449‑453.
12. Park JY, Byun EJ, Kim HS. Rejuvenation of periocular region in Koreans: a multimodal approach combining botulinum toxin, fillers, and micro‑focused ultrasound with visualization for optimal results. Dermatol Ther. 2020;33(3):e13159.
13. Suh DH, So BJ, Lee SJ, Song KY, Ryu HJ. Intense focused ultrasound for facial tightening: histologic changes in 11 patients. J Cosmet Laser Ther. 2015;17(4):200‑203.
14. Lam SM, Azizzadeh B. Asian Facial Cosmetic Surgery. Elsevier; 2015.
15. Kwon JH, Kim Y, Lee D, et al. Ethnic and anatomical considerations in aesthetic eyelid surgery: a systematic review. Plast Reconstr Surg. 2020;145(2):456e‑465e.
16. Shome D, Kapoor R, Vadera S, et al. Anatomical differences in East Asian eyelids and considerations for nonsurgical treatments. J Cosmet Dermatol. 2019;18(3):692‑698.
17. Suh DH, Park HJ, Lee SJ, Song KY, Shin MK. Superficial intense focused ultrasound on periorbital wrinkle. J Cosmet Laser Ther. 2019;21(7‑8):412‑416.
18. Park JY, Byun EJ, Kim HS. Rejuvenation of periocular region in Koreans: a multimodal approach combining botulinum toxin, fillers, and micro‑focused ultrasound with visualization for optimal results. Dermatol Ther. 2020;33(3):e13159.
19. Suh DH, Park HJ, Lee SJ, Song KY, Shin MK. Superficial intense focused ultrasound on periorbital wrinkle. J Cosmet Laser Ther. 2019;21(7‑8):412‑416.