Dual-approach High-intensity Focused Ultrasound for Facial Contour Modulation and Submental Reduction

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Background: Facial aging produces region-specific convexity excess and sulcus depletion, requiring compartmental rather than uniform energy delivery. Dual-mode high-intensity focused ultrasound (HIFU) enables depth- and geometry-selective remodeling of superficial fat and the superficial musculoaponeurotic system. Methods: In this prospective case series, 38 Korean adults underwent a single session of compartment-programmed dual-mode HIFU across 7 predefined zones (4 facial, 3 submental). Zone-specific intent dictated mode geometry (dot for focal microsupport; linear for broader compaction). Outcomes included 3-dimensional stereophotogrammetry-based volumetry, cervicomental angle, jawline definition index, blinded Global Aesthetic Improvement Scale, and patient satisfaction at baseline, week 4, and week 12. Results: Thirty-two participants completed week 12 follow-up. Volumetry demonstrated intention-consistent change: central perioral–marionette zone showed microaugmentation (+0.7 cm 3 ), whereas lateral facial zones decreased (zygomatic–nasolabial −2.4 cm 3 ; lateral zygomatic −2.1 cm 3 ; mandibular border −1.5 cm 3 ). Submental volume decreased (central −3.3 cm 3 ; lateral −1.9/−2.0 cm 3 ). Cervicomental angle improved (+6.4°), and jawline definition index increased (+17.1%) ( P < 0.001). At week 12, 93.7% were rated “improved or better” on the Global Aesthetic Improvement Scale; satisfaction was 4.5 ± 0.4. Adverse events were mild and transient. Conclusions: Compartment-programmed dual-mode HIFU produced coordinated, zone-specific facial and submental contour change by week 12. A longer follow-up is required to confirm durability beyond early remodeling.