column (e.g. in newspaper)
2025.07.19
The Era of HIFU for Sagging Treatment and Prevention
As an Assistant Professor, Associate Ward Director, and Chief of Dermatopathology at the university hospital dermatology department, I deepened my expertise through academic presentations and paper publications both domestically and internationally. I have handled a wide range of treatments, from birthmark therapy in children to adult pigmentation concerns, utilizing various lasers and injection therapies, while also contributing to community healthcare. Through encountering numerous cases, I strongly felt the potential and necessity of aesthetic medicine, resolving to pursue further expertise. Building upon my solid dermatological knowledge and meticulous diagnostic skills, I value treatments that gently support each individual's skin while bringing out its inherent beauty.
Have you heard of HIFU? It's a leading treatment for sagging skin.
Some people might feel a bit hesitant about threading the needle.
Or, for those who don't need threading yet but want to take preventive measures for the future—this treatment is highly recommended!

Studying skin and treating it—both medically and cosmetically—is practically a hobby for me, isn't it?
I'm Aya Hayama, a dermatologist, and that's what I've been thinking lately.
This is a personal matter, but I also provide insurance-covered medical services concurrently.
Personally, I was relieved to see such improvement in a young patient who suffered from severe, recurrent eczema symptoms due to inadequate topical treatment for atopic dermatitis. Both the child and the mother found it distressing that the condition wouldn't heal despite persistent topical application, and the mother even felt burdened by the constant need to apply medication. barring lichenification (roughness), hyperpigmentation, skin atrophy, or persistent scratching, the condition will likely resolve with age.
But back to the topic at hand—sagging!!
Individuals prone to significant weight fluctuations, or those with bone structures that make nasolabial folds more prominent.
While there are individual differences, as long as Earth has gravity, the battle against sagging (among other things...) continues in this era where lifespans are said to range from the 40s to 100 years.
Treatment options include HIFU, radiofrequency, hyaluronic acid, thread lifts, surgery, and more. Today, I'd like to introduce one of these options: HIFU.
HIFU is a lifting treatment device that utilizes high-intensity focused ultrasound energy.High-Intensity Focused Ultrasound (HIFU)HIFU is commonly referred to as "HIFU" from its initials. By concentrating ultrasound energy at a single point, it targets the deep layers of the skin, specifically the SMAS layer—a fascia deeper than the underlying fat tissue that forms the skin's foundation. This approach is expected to tighten the skin from deep within and lift sagging areas.

Bianca Clinic has introduced UltraCel Zi, the latest version of the flagship HIFU series "ULTRAcel".
UltraCell Zi features bidirectional irradiation with exceptionally fast single-shot delivery (minimizing discomfort while delivering high energy for superior results). In addition to lifting sagging cheeks and double chins, UltraCell Zi can also be used around the eyes.
It also addresses fine lines around the eyes, under-eye areas, and eyelid sagging, helping to reduce ptosis. Some patients even report that their eyes open more easily and feel more comfortable.
The UltraCell Zi comes with several cartridges, each designed for specific areas you wish to tighten. Each cartridge features both "Dot Mode" and "Linear Mode," allowing you to switch between irradiation modes with a simple toggle.
<Dot Mode>
Cartridges target the epidermis layer 1.5mm below the skin surface, the subcutaneous fat layer 3.0mm below, and the SMAS layer 4.5mm below. Depending on facial thickness, they deliver dot-shaped thermal energy to each layer, aiming to tighten sagging skin.
<Linear Mode>
Compared to dot mode, which heats in a dotted pattern, linear mode irradiates thermal energy in a linear fashion, making it more effective for areas with pronounced sagging. It can help reduce double chins and sagging around the corners of the mouth.

The UltraCell Zi is equipped with a special sensor designed to prevent overlap at the turning point of irradiation, ensuring thermal energy is not delivered to the same location twice. While conventional devices risked energy overlap at the turning point, the UltraCell Zi achieves safe, uniform irradiation. By preventing energy overlap in both dot and linear modes, the risk of burns is significantly reduced.
https://biancaclinic.jp/treatment_category/aging-care/aging_02/hifuzi/
Here's a personal musing from me, a dermatologist...
Also, I'll introduce it again at a later date, but high-frequency waves work exceptionally well with HIFU.
Compared to HIFU, the temperature is slightly lower, and the focus shifts from the deep dermis to the fat tissue. While it provides a tightening effect, it also stimulates collagen production (particularly promoting the production of Type III collagen, which decreases with age), resulting in plump, supple skin.
Both treatments can be performed on the same day. While HIFU is recommended every six months to a year, we suggest maintenance treatments every 1-3 months in between sessions!!