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The world of aesthetic treatments is fast-moving, but the latest trend that everyone’s talking about is not a new innovation or breakthrough – in fact, it’s all about combining treatments for better results.

This is a response to customers who’ve been demanding for greater personalisation, and want to see more effective solutions. Hence, the act of combining treatments allows aesthetic doctors to truly the target the skin concern using a multi-pronged strategy, and to deliver more amplified results.

Dr KK Chew at NU.U Aesthetics & Wellness is a fan of this approach, and uses the combined treatment method to combat ageing. In particular, he believes that combining HIFU and Restylane fillers can significantly reduce signs of ageing by stimulating collagen production and lifting and contouring saggy skin.

We get the lowdown from Dr Chew.

Dr KK Chew

What is HIFU?

Essentially, HIFU treats fine lines, wrinkles, and even hyperpigmentation on the face by using ultrasound energy to target regions of the skin such that it stimulates collagen regeneration to give a skin tightening effect.

HIFU is a generic description – it stands for a high-intensity focused ultrasound. There are a few HIFU devices in the aesthetic world, and the most well-known one is Ultherapy.

At NU.U, we use Ultraformer, which is Korean. I have tried many other devices, and this is the most painless one.

We were using the Ultraformer III device until recently, and have since switched to Ultraformer MPT (multi pulse tech). It’s different because it delivers the ultrasound waves in a different way – before, it was delivered in dots. Now, the dots are very close together.

And what effect does the new device have?

It means that there is not much space between the dots anymore, and the heating is more concentrated.

Does it make it more painful?

No, it’s just the opposite. Because the speed is increased, the tech is faster, more effective and less painful.

What do you mean by more effective?

You see the results faster. They’re more obvious immediately after the session, and it helps the patient achieve a more vertical, natural lift on the face.

HIFU can also be used to do facial contouring, to make the jawline more defined and to lift the cheeks.

How did the combination treatment of HIFU and Restylane come about?

It came from my older patients, who said they need something a little extra to their HIFU treatment.

HIFU already targets quite deep into the skin into the SMAS layer [which is the layer just above the muscle]. Surgeons generally target the muscle when they do surgery, but we’re not doing that. HIFU contracts the SMAS layer, which is why we get immediate results.

Compare this with a treatment that stimulates collagen: It will take time to see results because collagen takes time to reproduce.

With HIFU, the patient will see even more results in six to eight weeks as the collagen production further lifts the skin.

What HIFU cannot do is target the ligament, as that is attached to the bone. So that’s where Restylane fillers come in, as we can inject the filler into the base of the ligament. As the ligaments weaken, we need to push them back up again. Hence, it’s injected right to the bone.

Will the patient’s face look very different?

No, it’s not a surgical lift. When my patients ask if they will look different or unrecognisable, I always tell them to dream on! This is not surgery, it does not change facial features, it just enhances.

So this rejuvenates the layer under the skin?

Yes, it produces collagen while the contraction of the SMAS layer gives your skin an instant lift, and Restylane does the ligament lift. So basically, we’re targeting everything that ages you, down to the skin, fat, muscle and ligament.

At what age would you recommend the Restylane and HIFU combination?

Anyone who is showing visible signs of ageing. There is also a trend of prejunevation, where younger people in their early 20s want to slow down ageing, and are opting for this.

How many sessions are needed?

One session is enough, and results can last from nine to 12 months. A session lasts about two hours.

Any side effects?

No. But people with sensitive skin might see some redness. The Restylane injection might cause some soreness for a couple of days as well.

Does our skin type or colour make a difference to the effects of this combined treatment?

Both HIFU and Restylane are colour blind. Irrespective of your skin colour, the results are the same. Ditto for skin type.