HIFU downtime:
redness, tenderness and what is not normal

What happens on the day of HIFU?

On the day of HIFU the treated zones look slightly pink once the gel is removed, feel warm, and are tender when pressed along the lines where energy was placed. During treatment most people feel a deep warmth or a brief ache, strongest over the jawline and other bony areas, and Dr Sin Yong adjusts energy and sequence to that feedback rather than running a preset. Because focused ultrasound heats points at depth and spares the surface, there is no wound to dress, and most people return to ordinary activity the same day. The HIFU page describes the depths and zones.

You leave with written aftercare: gentle cleansing, a bland moisturiser, sun protection, and the signs to report.

What do the following days feel like?

Over the following days the pinkness fades quickly, but tenderness on pressure, chewing or smiling can persist over the jawline, the cheeks and under the chin; it is the deep tissue, not the skin, that was heated. Slight swelling along the jaw, a small bruise where a line crossed a vessel, or a patch of tingling or altered sensation can occur and are reviewed if they do not settle. Some people notice the skin feels firmer early on; that early firmness is swelling and tissue contraction, not the remodelling itself, which develops gradually in the weeks and months that follow.

No special care is needed beyond plain skincare and sun protection, and strong actives can usually resume once the skin feels normal, as advised.

“"HIFU or radiofrequency, which is better?" Wrong question. They don't do the same job.”

Dr Sin YongOn choosing an energy device

What is not normal after HIFU, and when should you call?

Not normal: numbness that persists rather than fades; weakness or asymmetry when you smile, purse your lips or raise your brow; a raised welt, a line of blisters or a burn mark along a treated line; marked or one-sided swelling; or new hollowing over a treated area. Each has a mechanism. Numbness and weakness point to heat near a nerve branch, usually along the jaw or above the brow. A welt or blister points to energy delivered too superficially or with poor coupling. Hollowing points to heat placed into thin fat in a lean face. Contact the clinic on +65 8023 7170 during clinic hours; the complication care page lists what goes to an emergency department.

These problems are the reason depth and energy are set by a doctor after palpating tissue thickness zone by zone, keeping the deeper cartridge to areas with enough depth above bone, and avoiding the thyroid, the orbital rim and the course of the marginal mandibular nerve.

Can I wear make-up, exercise and go in the sun after HIFU?

Make-up can usually go on once the pinkness has calmed, since the surface is intact; if a welt or blister has formed, that area is left bare until it is reviewed. Exercise is generally fine from the following day, though heat and exertion can make the jawline feel more tender; saunas and very hot showers are better left until the tenderness has settled. Sun protection applies throughout, as it does for any heated skin, with shade, a hat and broad-spectrum sunscreen in Singapore's year-round sun.

Why does the firmness I feel early not mean the result?

Firmness on the day or in the first days is the tissue's immediate response to heat and the swelling that accompanies it. The change HIFU is planned for comes from collagen remodelling around each coagulation point, and that develops gradually over the weeks and months afterwards. Review is timed to allow for it rather than booked straight away, and how much change follows varies with age, skin quality, the degree of laxity at the outset and sun exposure. The sequence from enquiry to review is set out under what happens at a consultation.

How should you plan HIFU around work and events?

HIFU is one of the few energy treatments that can usually be fitted around a working day, because the visible phase is short and the surface is intact. Plan instead around tenderness: chewing can be uncomfortable over the jawline for a period, and pressing on the face, as in a facial or a dental appointment, is better left until it has settled. A face that bruises easily should allow for a small bruise to fade before a photograph or an event. If you are still deciding whether focused ultrasound is the right tool, the HIFU treatment guide compares it with the alternatives.