Ultrasound

INTRODUCTION

In the ever-evolving world of cosmetic surgery, technology continues to play a pivotal role in improving outcomes and patient satisfaction. One of the most exciting advancements is the use of ultrasound technology. In the world of non-surgical cosmetic treatments, ultrasound therapy has emerged as a leading technology for skin tightening and rejuvenation. With its ability to deliver precise, superficial or deep-tissue thermal treatment without the need for incisions or downtime, ultrasound therapy offers a compelling option for those seeking to enhance their appearance without undergoing surgery, to treat problem healing, or to speed up recovery from plastic surgery.

Basically, what most patients think of with ultrasound is a technology that uses this safe,high-frequency sound waves to create images such as during pregnancy, guide needles and cannulas in procedures, and help identify growths or fluid. However, in addition to these, there are very specific applications of this technology in plastic surgery The use in plastic surgery is different and there are numerous new applications of ultrasound therapy in cosmetic surgery. Ultrasound has been used for cosmetic purposes since around the early 1980’s. Widespread therapeutic usage, safety, precise control and excellent, predictable results have made ultrasound an important addition to cosmetic surgery practices such as mine. New and current uses of ultrasound include facial and body skin rejuvenating treatments, reduction of stretch marks, treatment of contracture and scar tissue such as around breast implants, and the pre- and post-operative treatment of plastic surgery patients to accelerate healing and recovery after procedures such as face lifts, tummy tuck, and liposuction. Ultrasound applied over certain creams and serums contributes to greater effectiveness through deeper and more thorough penetration of the products.

The mechanisms of action of ultrasound should be considered in terms of four categories. First is the thermal effect, which relates to the heat generated into the deeper tissues and especially the collagen, and the benefits derived from this. Second is the mechanical effect, which relates to the high-speed vibrations that act on the tissue just like a micro massage. Third is the cavitation effect. This refers to the production of countless microscopic droplets of oxygen from the vibrational process. Fourth are the biological effects, which include blood vessel dilatation, improved blood flow and circulation, sonopheresis, improved lymph flow, muscle relaxation, reduced inflammation, and pain relief.

THE ULTRASOUND PROCESS.

Ultrasound energy is applied by means of a specific industry standard machine. The wavelength of ultrasonic waves, the size of the applicator device (head), the depth of treatment, the duration of application of energy and the pulse character of the ultrasonic energy wave are all variable and customized according to your anatomy, the area to be treated, the nature of your condition, and more.

For the procedure, to begin, your skin will be cleansed, and an ultrasound gel will be applied to the treatment area to ensure smooth and effective sound-wave energy transmission. The transducer or “head” is then moved over the treatment area on your skin, delivering focused energy to the targeted areas. You may feel a mild warmth or tingling sensation as the ultrasound energy is applied. The procedure typically takes between 30 minutes to an hour, depending on the area being treated. One of the biggest advantages of ultrasound therapy is that there’s no downtime. You may experience mild redness or swelling, but these side effects are temporary and usually resolve within a few hours.

TREATMENT CATEGORIES

COLLAGEN STIMULATION. First there is “Natural Regeneration”. As the body heals from these tiny thermal injuries, it begins to produce new collagen, the key protein responsible for skin elasticity and firmness. It also stimulates the elastic fibers present to tighten. Second ther is “Gradual Tightening”. Over the next few months, as collagen builds, patients notice a gradual tightening and lifting of the skin, leading to a more youthful appearance.

BREAST IMPLANT CAPSULE CONTRACTURE and Scar Tissue. This is by far the greatest use and most often requested application of ultrasound in my practice. Scar tissue is improved tremendously with ultrasound. Most believe this is due in large part to the thermal effects of ultrasound with the loosening, stretching, and re-orientation of collagen tissue. This has demonstrated great effects in speeding the healing and discoloration of firm or bruised areas occasionally seen after face lift, tummy tucks, or liposuction. Patients with breast implants and some hardening have appreciated softening of the implants and breasts. Treatments sessions last 15-30 minutes and involve application of the ultrasound over the firm areas followed quickly by aggressive home exercises of stretching and massaging techniques (foam roller) and special cream applications. Only 1-2 or 3 treatments are needed to see if this will work. If so, then six to twelve treatments provide the best results with improvements seen usually after four sessions. Home exercises and massage preserve the results. The ultrasound energy applied, the wavelength, the depth of treatment and the type of pulse form and duration are all very specific for treating the scar tissue around breast implants. This same technique and routine will work for other scars on your body.

SKIN TREATMENTS. These are made more effective since deep cleansing, exfoliation and moisturizing is improved. This is achieved by high frequency ultrasonic vibrations that penetrate deep into pores and hair follicles to break up old, dead cells, secretions and oily blockages. Also, skin metabolism is increased which causes lymph flow to increase which causes waste products to be removed more rapidly and effectively. The more waste products removed the better penetration and absorption of your skin care products. Deep tissue micro massage improves skin tone, softness and texture. All combined these create younger looking skin. Treatment sessions take about 30-45 minutes and patients report feeling immediate tightening and softer, smoother skin. The skin looks more supple, and friends will comment about your “healthy glow”.

STRETCH MARKS, fine lines, and sun-damaged skin are improved through dermapheresis or sonopheresis. These are the terms that have been applied to the use of ultrasound in stimulating deeper penetration of products into the skin. To achieve this even better, we bring together the positive effects of microdermabrasion, ultrasound technology, and potent creams. Microdermabrasion removes the thickened and sun-damaged outer layer of skin then ultrasound application can deliver special creams deeper into the lower layers of the skin. In this way the ultimate effects of the creams are much more potent. Multiple treatments are usually required, and it is safe for all skin colors and types. The number and frequency of your treatments depend on your skin type and response to therapy. Improvements are seen usually by the fourth treatment.

ULTHERAPY. “Ultherapy” and other named specific vendors and technologies, are non-invasive cosmetic treatments that use focused ultrasound energy to heat the deep layers of the skin, stimulating collagen production. This leads to skin tightening and lifting, particularly in areas like the face, neck, and décolletage.

In summary, ultrasound has been used to shatter kidney stones, examine the fetus during pregnancy, research dolphin’s language, train dogs, and clean contact lens. Unconsciously, ultrasonic products have become common commodities in our everyday life. Ultrasonic sound waves are the basis of this technology and are generated at a frequency that is above the level heard by the human ear. The rate of ultrasound means the numbers of vibrations that occur in a second. Hertz is the unit of measurement. Medical and cosmetic ultrasound units are manufactured to typically deliver ultrasonic waves at frequencies of 1 and 3 MHz with duty cycles ranging from 20 to 100 percent. Duty cycles less than 100% are called pulsed ultrasound while a 100% duty cycle is called continuous. For our purposes, most machines are utilized at 1 to 3 MHz with continuous and pulsed modes. Ultrasonic sound waves cannot be transmitted through the air and need some sort of liquid medium though which to pass. For this reason, a gel is applied between the treatment head of the machine and your skin.

For further information or to ask any questions please contact Dr. Romano at 415-981-3911 or visit his website at www.jromano.com.