Although COVID has been a trying time, it’s also been one full of new and wondrous discoveries. Finding out your partner is a ‘let’s circle back guy’, wearing the same clothes for weeks on end, or discovering new angles of your face you didn’t know existed, thanks to Zoom


Yes, many of us have fallen victim to the so-called ‘zoom effect’. While you listen to your ‘favourite’ co-worker go on his 6th tangent of the hour, you start looking, or rather staring, at your digital reflection. Those eyes? Must be the light. Sunken cheeks? Also, definitely the light. Jowls? Oh, who are we kidding?! If you are one of the many that are trying to remember where the time has gone, may we offer you some tantalizing solutions that require neither a nip, nor a tuck. 




First up is high intensity focused ultrasound (HFU). What the FDA had originally approved to treat tumours, can now also be used to tackle those hooded eyes. HFU first appeared on the aesthetics market in 2008, as the product Ulthera System. Since then, Ultherapy has been given the nod of approval for brow lift, neck lift, and for the overall improvement of lines and wrinkles of that sought after décolletage.1 Although (not yet!) approved, studies on Ultherapy for other body parts are promising. A recent study described significant improvement (their words, not mine) when using HFU on the upper arms, knees, and inner thighs.2 


How does it work? Ultherapy works by using ultrasound waves, projected to various depths of the skin and underlying tissues, to promote collagen production. This increase in collagen is what gives the skin a youthful lift. 



What’s the process? First, a painkiller is given to “take the edge off”.  Once that has been given time to work, the skin is cleaned and a conductive gel (ie. ultrasound gel) is applied. Next, the ultrasound probe will be applied to the targeted areas and those magical ultrasound waves are sent to do their thing! Overall, each session lasts between 30-90 minutes. Luckily, most people only require one treatment session! Unfortunately, good things take time: you gotta wait 2-3 months to see the full extent of your new lift. On a plus side, there is no recovery time!


How long do results last?  Studies have shown that results (and your satisfaction) last at minimum to the year mark!3


So what does all of this tightening and lifting go for? The pricing of this treatment varies greatly but typically ranges from $500-$5000 per problem area.4


So what are the downsides? Well, this procedure hurts. 54% of one study’s participants would say, like a b*tch.5 That being said, pain can be controlled with the use of topical numbing creams for superficial treatments and pain pills. Common side effects are redness and swelling, and approximately ~25% of people notice some bruising.5 Short-lasting numbness or muscle weakness has also been noted. No serious side-effects have been reported. 




Alright, if this ultrasound thing hasn’t tickled your fancy, let me introduce you to option 2: radiofrequency (RF). No, we’re not trying to contact aliens or getting a little too into Stranger Things. Instead, we’re using a combination of radiowaves and microwaves to target and heat the dermis (the under layer of the skin). The most common devices on the market are Thermage and Pellevé.6 In 2013, the FDA granted Thermage approval for the treatment of eye wrinkles, and the temporary improvement of the appearance of cellulite.7 Pellevé was approved in 2009 for the treatment of mild to moderate wrinkles. 


How does it work? Like HFU, RF has been shown to boost collagen production. As well, it has effects on overall elastin (responsible for all that laxity) in the skin, to nudge that lift: sag ratio in your favour.8 


What’s the process? First, the skin is cleaned. Next, a conductive gel is applied to the skin. Now the probe can get to work! Overall, each session lasts between 30-60 minutes. The jury is out, however, on how many sessions one actually needs. Thermage and Pellevé cite one treatment is often sufficient, however, many cosmetic dermatologists quote 6-12 sessions (it does of course depend on the precise technology used). Like, HFU, you gotta wait 2-3 months to see the full extent of your new-and-improved face. 



How long do the results last? As cited by their site, Thermage claims 1-2years of benefit.9 Dermatologists seem to support this. 


That cost: RF is quoted at $600-$1000… yes, this is per session.10 


Any downsides? Unlike HFU, RF causes little pain or discomfort during the procedure.9 As well, post-procedure redness and swelling are reported to be minimal, with most of it subsiding within 24 hours. With zero downtime, you can get back to that spin class or hot yoga ASAP; no excuses here!


Now, if you’re still unimpressed, let me offer you a final option. Last, but not least, we have an intradermal option; radiofrequency microneedling (RFmN). Unlike HFU and RF, RFmN uses needles that penetrate the skin (and into the dermis, to be precise) to deliver its boosting waves. Now, these just aren’t any needles, but 37 gold-plated needles that ‘stamp’ the skin, with the claim to minimize wrinkles, even out skin texture (including acne scarring), tighten those plate-sized pores, and overall tighten that sagging face.11,12 There’s even research to suggest RFmF can be used to minimize cellulite and reduce fat; what a dream!13,14 


How does it work? RFmN works like RF by delivering radiofrequency to the dermis but with the advantage of causing microdisruptions in the skin, producing the results of increased collagen production, as well as stimulating tissue regeneration. 



What’s the process? First, an anesthetic (topical numbing cream) is applied to the face. Nerve block injections are used if the energy delivered is higher. Once that has been given time to work, the skin is cleaned and it’s go-time! The device is placed to the skin and those little gold needles stamp away, creating microchannels and delivering radiofrequency to the dermis, all at the same time; magic! Overall, each session lasts between 60-90 minutes. Again, as we’re still on this collagen train, it takes about 2-3 months to see the full extent of your new lift. Preliminary results, however, should be apparent in 2 weeks' time. 


How long do the results last? Up to 5 years!!11 However, maintenance treatments are recommended every 12-18 months. 


Like the other treatments, RFmN comes with a premium price of $250-$2100 per session, depending on the area treated. Again, multiple sessions are recommended.10,11 


And downsides? This procedure is painful, though probably not as bad as HFU. Experienced Providers will completely numb up your face before radiofrequency needling so ask before you go. In that case, the treatment itself is painless.  Redness and dry skin are common for about the first week but resolve shortly after.11 Your skin may also be more prone to hyperpigmentation, so strict hat and sunscreen use post-treatment is a must. Also, avoiding any makeup or sports for the first 24 hours post-treatment is recommended. 


Hopefully, this has been more pleasurable than a self-scrutinizing video call and has provided you with options to give your face that extra oomph!




1.       Unique Technology | Ultherapy. Accessed July 23, 2020.

2.       Alster TS, Tanzi EL. Noninvasive lifting of arm, thigh, and knee skin with transcutaneous intense focused ultrasound. Dermatologic Surg. 2012;38(5):754-759. doi:10.1111/j.1524-4725.2012.02338.x

3.       Shome D, Vadera S, Ram MS, Khare S, Kapoor R. Use of Micro-focused Ultrasound for Skin Tightening of Mid and Lower Face. Plast Reconstr Surg - Glob Open. 2019;7(12):e2498. doi:10.1097/gox.0000000000002498

4.       L. C. The Truth About Ultherapy. Accessed July 24, 2020.

5.       Chan NPY, Shek SYN, Yu CS, Ho SGY, Yeung CK, Chan HHL. Safety study of transcutaneous focused ultrasound for non-invasive skin tightening in Asians. Lasers Surg Med. 2011;43(5):366-375. doi:10.1002/lsm.21070

6.       Hunter A. 7 things you need to know about radiofrequency treatments. Accessed July 24, 2020.

7.       (No Title). Accessed July 24, 2020.

8.       El-Domyati M, El-Ammawi TS, Medhat W, et al. Radiofrequency facial rejuvenation: Evidence-based effect. J Am Acad Dermatol. 2011;64(3):524-535. doi:10.1016/j.jaad.2010.06.045

9.       Thermage | Skin Tightening Treatment. Accessed July 24, 2020.

10.     Rhue H. How Laser Skin Tightening Works - Radiofrequency Skin Treatment Details. Accessed July 24, 2020.

11.     Microneedling with Radiofrequency - Procedure Overview, Cost, Recovery, Before & After | AEDIT. Accessed July 24, 2020.

12.     Elawar A, Dahan S. Non-insulated fractional microneedle radiofrequency treatment with smooth motor insertion for reduction of depressed acne scars, pore size, and skin texture improvement: A preliminary study. J Clin Aesthet Dermatol. 2018;11(8):41-44. /pmc/articles/PMC6122511/?report=abstract. Accessed July 24, 2020.

13.     Yu V, Juhász MLW, Mesinkovska NA. Subcutaneous Radiofrequency Microneedling for the Treatment of Thigh Skin Laxity Caused by Weight Loss: A Case Study. J Clin Aesthet Dermatol. 2019;12(6):60-62. Accessed July 24, 2020.

14.     Dayan E, Chia C, Burns AJ, Theodorou S. Adjustable Depth Fractional Radiofrequency Combined With Bipolar Radiofrequency: A Minimally Invasive Combination Treatment for Skin Laxity. Aesthetic Surg J. 2019;39(Suppl 3):S112. doi:10.1093/ASJ/SJZ055

August 23, 2020