Non-invasive facial and body contouring procedures have gained increasing attention from patients and physicians due to their proven effectiveness, minimal downtime, and lower risk of complications compared to invasive methods, such as plastic surgery. Microfocused ultrasound (MFU), injectable biostimulators – including poly-Llactic acid (PLLA) and calcium hydroxyapatite (CaHA) – and fractional radiofrequency microneedling (FRM) are widely employed for treating skin laxity, a prevalent concern in dermatology practice. Although the combination of these treatments in same-day sessions is regarded as safe and effective, there remains a significant gap in the literature assessing the simultaneous use of multiple technologies and injectable treatments for skin laxity and body contouring. We propose a “Sandwich Protocol,” which integrates MFU, injectable biostimulators (PLLA or CaHA), and FRM in a same-day session for the treatment of skin laxity. This protocol involves 1–4 sessions, spaced at least 30 days apart, with the number of sessions tailored to the severity of skin laxity and the patient’s financial considerations, given the high cost of these treatments. The sequential application of these techniques represents a comprehensive and individualized approach to addressing skin laxity and enhancing body contouring outcomes.
Dal’Forno-Dini et al. (2026) studied this question.