Clinical Efficacy and Safety of Shallow-Dermal Linear HIFU for Fine-Wrinkle Reduction in Asian Skin

High-intensity focused ultrasound (HIFU) is an established technique for improving fine wrinkles through thermally induced collagen remodeling. As interest in superficial-dermal applications-particularly in Asian skin with distinct dermal characteristics-grows, there is a need to define reproducible, anatomy-guided parameters for dermis-targeted HIFU. This study evaluated the clinical and biophysical effects of a standardized shallow-dermal HIFU protocol for full-face and neck rejuvenation in Asian women. Thirty Asian women (Fitzpatrick skin types III-IV; ages 33-59) who underwent a single full-face and neck shallow-dermal HIFU treatment between January and June 2024 were retrospectively evaluated. Outcomes assessed at baseline and at weeks 4 and 12 included 3-dimensional profilometric wrinkle depth, surface roughness, cutometric elasticity indices (R2 and R5), blinded Global Aesthetic Improvement Scale ratings, patient satisfaction scores, and safety profiles. At week 12, wrinkle depth decreased by 19.3% and surface roughness by 15.9%, while gross and net elasticity increased by 21.6% and 18.1%, respectively. Blinded evaluators rated 93% of participants as improved or better, and mean patient satisfaction increased to 4.6±0.4. Only mild and transient adverse events were observed, including erythema (10%) and edema (6%). Shallow-dermal HIFU demonstrated consistent improvements in wrinkles, elasticity, and skin texture with favorable tolerability in Asian skin. These findings support an anatomy-guided framework for dermis-focused HIFU and underscore the need for further controlled studies to refine optimal treatment parameters and evaluate long-term durability.