Complications from microfocused transcutaneous ultrasound: Case series and review of the literature

Lasers Surg Med. 2018 Jan;50(1):13-19. doi: 10.1002/lsm.22768. Epub 2017 Nov 20.

Abstract

Background and objective: Microfocused ultrasound (MFUS) technology has been utilized since 2009 for improvement in mild to moderate skin and soft tissue laxity of the face and neck. Few complications have been previously reported, the majority of which include mild and transient erythema, edema, ecchymosis, and nerve paralysis. Rare yet serious potential complications of MFUS for noninvasive skin tightening of the face and neck are, however, possible.

Methods & materials: Retrospective multicenter case series of five patients from the authors' practice who developed serious adverse events directly related to MFUS with a commercially available device (Ultherapy; Merz North America, Inc., Raleigh, NC).

Results: Five patients developed blistering, erosion/ulceration, cutaneous, or subcutaneous tissue edema with resulting atrophy, and/or cutaneous necrosis following single sessions of MFUS.

Conclusion: Despite their rarity, serious adverse events secondary to MFUS are nevertheless possible and may be underreported. Early management of complications includes local wound care, patient reassurance, and topical corticosteroids and/or pulsed-dye laser to mitigate inflammatory sequelae. Other cosmetic and surgical therapies should be utilized when conservative measures have failed. Lasers Surg. Med. 50:13-19, 2018. © 2017 Wiley Periodicals, Inc.

Keywords: cutaneous ulceration; intense focused ultrasound; noninvasive skin tightening; soft tissue laxity; subcutaneous tissue atrophy.

Publication types

  • Case Reports
  • Multicenter Study
  • Review

MeSH terms

  • Adult
  • Cosmetic Techniques / adverse effects*
  • Cosmetic Techniques / instrumentation
  • Face
  • Female
  • High-Intensity Focused Ultrasound Ablation / adverse effects*
  • High-Intensity Focused Ultrasound Ablation / instrumentation
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skin Aging*