Medically reviewed by Dr Sukhsagar Ratol, MBBS, MDPunjab Medical Council Reg. No. 32252Last updated
WHAT TO KNOW
|
Loose skin on the jawline and neck is one of the first changes people notice with age!
In a review of 42 studies around 84% of patients reported some aesthetic improvement after microfocused ultrasound with visualisation (Amiri et al., 2025), so many people now want to try a lift without surgery.
Most people who ask about this procedure are worried about one of these two things. Some feel that a cheap HIFU session will give the same result as Ultherapy and others feel that the treatment will make their face look swollen or hollow.
Usually neither is fully true because the result depends more on whether your skin is suitable and who is doing it than on the name of the machine.
Considering non-surgical skin tightening? Understand which options may be appropriate for your concerns.
What is HIFU Treatment?
HIFU treatment is a way of tightening loose skin without surgery, where ultrasound energy is given under the skin with a handpiece and nothing is cut.
This energy heats very small spots in the deeper layers of your skin while the top layer stays as it is. As these spots heal your body makes new collagen and that is why the skin slowly becomes firmer over the next few months (Haykal et al., 2025).
On the day of the treatment a gel is applied on your face and the doctor moves the handpiece over the area to be lifted. You may feel some heat or prickling but there are no stitches and most people go back to work on the same day.
| Worth Knowing There are many HIFU devices on the market. This means that HIFU is not a specific device. There are varying levels of power, depth and research. A review in 2025 found that HIFU can be helpful for tightening the lower face and neck however the studies were varied and there is still limited evidence for long term results (Haykal et al., 2025). Therefore you cannot expect the same results from all HIFU devices. |
What is Ultherapy Treatment?
Ultherapy is a brand name of this treatment, so when a clinic says Ultherapy they mean one particular machine while HIFU can mean any of the many machines available.
The main difference you will notice is that in Ultherapy the doctor can see your skin layers on a screen while treating you. This helps the doctor to give the energy at the right depth, which matters more if your face is thin, and it is also one of the reasons why Ultherapy usually costs more than HIFU.
| Ultherapy was initially cleared by the US FDA in 2009 for raising the brow. It was later cleared for loose skin under the chin, neck and lines on the chest (US FDA, 2014). These are US regulatory indications, not clearance for every area or device in India. A full face and neck treatment will take between 60-90 minutes. |
HIFU vs Ultherapy
Now you know what HIFU and Ultherapy are, it is important to understand the differences between them. Below is a table to show the differences.
| Difference | HIFU Treatment | Ultherapy |
| Description | General term for many ultrasound devices | Specific brand |
| Live Screen | Most do not have one | Available |
| Depth | 1.5 – 4.5mm (dependent on cartridge) | 1.5mm, 3.0mm, 4.5mm |
| US FDA Cleared | Different for each device | Brow, under chin, neck, chest lines |
| Research | Done on many devices, difficult to compare | Many studies on one device |
| Pain | Heat or prickling – varies | Many find it moderately painful |
| Price | Usually cheaper | Usually more expensive |
There are not many studies comparing Ultherapy to a specific HIFU device. This table will just help you understand the differences between the two.
What can HIFU and Ultherapy Treat?
These treatments are mainly used for mild to moderate loose skin. They are commonly used on:
- Brows – can be raised slightly if they are slightly drooping. Ageology also offer brow lifting using alternative methods.
- Jawline and Jowls – can be helpful if there is loose skin. If there is volume loss in your cheeks then it would be facial volume loss and drooping which would require alternative treatments.
- Under the chin – One of the most researched areas.
- Neck – Can improve early loose skin. Horizontal lines will be treated differently. See more information on neck lines and laxity.
HIFU and Ultherapy Results
Some people may notice their skin appears tighter straight away however this is likely due to swelling. The real results will be gradual as new collagen is formed. Most studies will look at the results after 3 months. Some people will continue to see improvements up to 6 months.
In the review, 84% reported some level of satisfaction. In studies that included a neutral response option, the pooled satisfaction figure was 62%. Many of these studies did not have a control group so results may look better than they really are (Amiri et al., 2025).
Some clinics describe results lasting around 6–12 months or longer, but this is only an estimate and varies by device and person. However most studies do not follow patients for this long. Skin continues to age, and any further session should be decided after an individual assessment.
HIFU and Ultherapy Side Effects
During treatment you may feel heat, a deep prickling or aching on the bone. Common side effects after treatment include redness, slight swelling and tenderness. These will usually subside after a few days. Some people may also experience small bruising and numbness in a small area. These will subside after a few weeks.
| Serious side effects are uncommon. Burns, nerve irritation and fat loss have been reported. A review in 2025 found that patients reported fat loss, nerve issues and scarring to the US FDA (Humphrey et al., 2025). We do not know how common these side effects are but it will be more of a concern if you have a thin face. Below is a table to show what is normal and when to contact your clinic. Voluntary reports also cannot establish whether treatment caused the event. |
| Side Effects | What it generally means |
| Redness/Swelling for a few days | Normal. Will subside. |
| Tenderness on touch | Usually normal |
| Increasing swelling/pain daily | Contact clinic |
| Blisters/Burns | Contact clinic immediately |
| Numbness for longer than a few weeks | See your doctor |
| Facial weakness/Uneven smile | Contact clinic immediately |
When should You avoid HIFU or Ultherapy?
Below are some general indications when the treatment is generally avoided. Your doctor may adapt these based on your condition.
- Infection, open wound or active pimples on the area.
- Pregnant or Breastfeeding.
- Pacemaker or metal implants close to the treatment area.
- Recent fillers, threads or surgery to the same area.
- Very loose skin or heavy jowls – very minimal results.
HIFU or Ultherapy – Which is right for you?
Honestly, it will depend on what changes have occurred in your face. If you only have slightly loose skin and full cheeks then ultrasound can be a good option. However, if your cheeks are flat or sunken then there will have been less support to your jawline. This may mean discussing other options, including dermal fillers or Sculptra, if suitable after assessment. If you have heavy jowls and hanging skin on your neck then non-surgical tightening will not make much of a difference.
If ultrasound is suitable for you then it will depend on how thin your face is, what area you are treating and how experienced your doctor is with the device. Ultherapy has a live screen which is helpful for thin faces as depth is very important. However this doesn’t necessarily mean that more energy will lift your skin better. In thin faces, treatment depth and energy need particular care because unwanted volume loss has been reported. Ageology also offer AI Radiofrequency and Morpheus8, which may be considered for selected concerns after assessment.
| Dermatologist’s Perspective “Patients and families usually show me a photo of their jawline and ask which machine is better. But what I always tell them is that the photo does not show whether the skin is loose, the cheek fat has reduced or the bone support has changed, so I check all three first. Someone with mild loose skin and good facial fat may do well with ultrasound, but in a thin face it has to be done very carefully. If the jowls are heavy then I tell the patient honestly that surgery will give a better result.” Dr Sukhsagar Ratol, MBBS, MD, Founder & Director, Ageology Skin Clinic, Reg. No. 32252 |
Questions to Ask Before HIFU or Ultherapy
Ask these questions during your consultation:
- What specific device/model will be used?
- Who will be performing the treatment and how experienced are they with the device?
- How much change will I see in my skin?
- How will the pain be managed?
- Will volume loss be a reason for my skin sagging?
- Who should I contact if I have a problem?
HIFU and Ultherapy in Chandigarh
Many clinics in Chandigarh have HIFU listed on their price list however the device used can vary greatly. Always ask what machine will be used. At Ageology we have Ultherapy and Ultracel Q+. During your consult we will assess your skin, facial volume and jawline. Once this has been done we will tell you if ultrasound will make a visible difference. We will then discuss what results you can expect, recovery, risks and cost.
Still unsure if HIFU or Ultherapy is right for your skin? Speak to Ageology.
Frequently Asked Questions
Is Ultherapy better than HIFU?
Not for everyone. Ultherapy has a live screen and more research. However there are not enough studies comparing it directly to all HIFU devices.
Does HIFU hurt?
You may feel a hot or deep prickling sensation with each line. This will generally be felt around the jawbone. Ask your clinic how they will manage the pain.
How many sessions of HIFU/ Ultherapy will I need?
Generally only 1 session will be performed. Some people will have another session after 1 year. There is no universal schedule; any further treatment should depend on the device and individual response.
Can HIFU/ Ultherapy replace a facelift?
No. It can tighten mild to moderate loose skin but will not lift heavy jowls or remove excess skin.
Can HIFU cause fat loss?
Yes. It has been reported. We do not know how common it is. It will be more of a concern in thin faces so care should be taken to choose the correct depth and energy.
Is HIFU safe for Indian skin?
Ultrasound does not target skin tones like many lasers. Therefore it is generally thought to be a suitable treatment for Indian skin. However burns and markings can occur if the settings aren’t correct.
References
Amiri, M., Ajasllari, G., Llane, A., Casabona, G., Pavicic, T., Sevi, J., Spada, J., Vachiramon, V., Vasconcelos, R., Tuck Wah, S., Muka, T. and Fabi, S.G. (2025) ‘Microfocused Ultrasound With Visualization (MFU-V) Effectiveness and Safety: A Systematic Review and Meta-Analysis’, Aesthetic Surgery Journal, 45(3), pp. NP86–NP94.
Haykal, D., Sattler, S., Verner, I., Madhumita, M. and Cartier, H. (2025) ‘A Systematic Review of High-Intensity Focused Ultrasound in Skin Tightening and Body Contouring’, Aesthetic Surgery Journal, 45(7), pp. 690–698.
Humphrey, V.S., Rambhia, P.H., Gmyrek, R. and Chapas, A. (2025) ‘Micro-Focused Ultrasound With Visualization: A Systematic Review of Adverse Events and Risk of Subsequent Facelift Compromise’, Dermatologic Surgery, 51(4), pp. 424–429.
US Food and Drug Administration (2014) Ulthera System, 510(k) Premarket Notification K134032. Decision date 20 June 2014.
