Published Feb 13, 2025

Is HIFU really the best facelift option right now?

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Introduction

“Doctor, the HIFU facelift that I did was so PAINFUL, I don’t want to do it again!”

Few years ago in my previous skin and aesthetics practice, this was a common feedback from patients who did HIFU (high intensity focused ultrasound) for facelifts.

And it is true. HIFU USED TO BE painful. Ask anyone who has done Ulthera (a popular and effective HIFU equivalent from USA) back in the days, and some of them might tell you it was rather painful.

Thankfully, HIFU has improved so much over the last 4-5 years that it’s now much more comfortable.

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But why HIFU in the first place if it was painful?

Short answer: Because the alternatives are invasive and ALSO painful.

For anti-aging facelifts, the treatment aim is to restore skin firmness and elasticity. Aging causes loss of collagen and skin on the face to become saggy and lax, and this is the main problem we want to address. However, let’s look at our options:

Option #1: Face lifts with surgery (most invasive)

This has to be done by trained and experienced plastic surgeons. Although it often has superior results compared to threadlifts and HIFU, they are very expensive and come with standard surgical risks and possible complications. Most people don’t enjoy being sliced by a scalpel too.

surgical facelift — Not mainsteam choice

Typical prices in Singapore: $6000 to $13000

Option #2: Threadlift insertions (still invasive)

This is done via insertion of a series of surgical threads in the face e.g. PDO threads that will dissolve with time. It works by physically lifting the skin on the face and stimulating collagen synthesis with the threads. Downtime from swelling and bruising over the next few days is common. Haematoma (big blood clot and bruise) and infection are possible complications too.

Threadlifts have excellent immediate results if done by experienced doctors.

However many patients still find it rather invasive with downtime though.

Typical prices in Singapore: $3000 to $5000

Option #3: HIFU facelifts (non-invasive)

HIFU delivers high intensity focused ultrasound energy into the deep plane (~4.5mm) of the face, targeting the SMAS tissue (superficial musculo-aponeurotic system) of the face, to cause focal points of contraction for facelift results. In fact, this SMAS tissue is also the same tissue plane that is targeted during surgical face lift.

HIFU Face Lifting — HIFU penetrates directly into the SMAS layer where skin lifting is most effective

Here’s one of my patients who came to me for HIFU last week:

Facelift Options Comparison

Surgical Facelift (Most Invasive)	Main Pros Superior results compared to HIFU and threadlifts.	Main Cons Standard surgical risks & complications. Possible scarring.	Duration of results Can last few years.
Threadlifts (Still invasive)	Main Pros Immediate results.	Main Cons Needles. Downtime from swelling and bruising. Haematoma and infection are possible.	Duration of results Can last 1-2 years.
HIFU (Non-invasive)	Main Pros No needles. No downtime. Minimal side effects. More comfortable nowadays.	Main Cons Results are gradual over 6-8 weeks period.	Duration of results Usually last 9-12 months.

Compared to options #1 and #2 which are both INVASIVE, PAINFUL with DOWNTIME, HIFU is a welcome alternative as no needles are involved. Because it uses only an ultrasound cartridge applicator over your face instead of needles, you get much less bruising, swelling, pain and downtime.

Wait, doctor, surely HIFU can’t be that good right?

Actually, HIFU IS that good and results are visible. However, HIFU results are NOT IMMEDIATE.

When clinics push HIFU as THE facelift treatment to go, some conveniently neglect to mention that HIFU can take up to 6 or 8 weeks to see results. If you want immediate results yet can tolerate several needles going into your face, threadlifting is a better choice over HIFU.

The reason why HIFU takes a longer time to see results is because it penetrates deep into the skin to stimulate natural production of collagen GRADUALLY. This means that HIFU results, though gradual, will look very natural. Even the wearing off of results is gradual near 9-12 months.

If you ever hear anyone telling you that results are fast with HIFU, don’t be fooled as it is not true

My preferred way of doing HIFU

Personally, I prefer to use more HIFU shots and a particular vectoring (ie angle of the shots) method. Some of my patients seem to think I do this to ensure quicker results. It is not.

This method has been developed over the years to ensure that the HIFU effect is stronger, but it still takes a bit of time to see good results.

If you are willing to wait a little while to see good facelift results with no needles, no downtime and almost no side effects, I highly recommend HIFU as the first choice for facelifts.