Patient Satisfaction Following Treatment With Microfocused Ultrasound With Visualization: Results of a Retrospective Cross-Sectional Survey

January 2019 | Volume 18 | Issue 1 | Original Article | 75 | Copyright © January 2019

José Raúl Montes MD FACS FACCS and Elizabeth Santos DrPH

Jose Raúl Montes Eyes & Facial Rejuvenation, San Juan, PR

BACKGROUND: A device that uses microfocused ultrasound with visualization (MFU-V) is cleared in the United States and European Union as a noninvasive procedure that lifts and tightens the skin (Ultherapy® System; Merz North America, Raleigh, NC, USA). The objective of this patient survey was to obtain more in-depth information on patient satisfaction during the MFU-V treatment procedure and satisfaction with their aesthetic results. METHODS: Survey participants had received MFU-V treatment and completed at least 6 months of follow-up. A hyperlink to an online survey was distributed via email and respondents completed the survey anonymously. The satisfaction survey consisted of 13 questions related to the treatment process and post-treatment outcomes. A validated Age Appraisal Visual Analog Scale was also included to evaluate patient pre- and post-treatment self-assessments of their age. RESULTS: The survey was completed by 52 patients, and the majority of surveyed patients received treatment on the lower face (100%) and submentum (92.3%). Many patients (41%) reported their treatment outcome met or exceeded their expectation. About one-half of patients (n=27; 52%) needed a follow-up appointment with photos to be able see post-treatment changes. Following MFU-V treatment, 50% believed they looked 1 to 15 years younger. Most (73%) would recommend MFU-V to others. CONCLUSION: About half of patients undergoing MFU-V were Very Satisfied or Satisfied with their results and a large number reported their treatment outcome met or exceeded their expectations. The number of follow-up appointments appeared to be related to patient satisfaction. Treatment with MFU-V is very well tolerated. J Drugs Dermatol. 2019;18(1):75-79.


To meet the ever-growing demand for minimally invasive cosmetic procedures,1 a device has been developed which uses microfocused ultrasound with visualization (MFU-V) to produce small (2 resulting in the tightening of lax skin. Available MFU transducers ensure that ultrasound energy can be delivered to a range of appropriate depths up to 4.5 mm beneath the superficial dermis.2,3 The device is unique in that ultrasound visualization can be used to confirm that the device is accurately coupled to the dermis for proper energy delivery and optimized outcomes, and to visualize non-target tissues such as bone and large blood vessels. This MFU-V device has been cleared in the United States4 and the 28 countries of the European Union as a non-invasive pro- cedure that lifts and tightens the skin. In the US, MFU-V is the only non-invasive FDA-cleared procedure for lifting the brow5,6 and submental and neck tissue,7-9 and for improving lines and wrinkles of the de?collete?.10 In Europe, it is indicated for sculpting and lifting the upper face, lower face, neck, and de?collete?. Additional studies have shown MFU-V to be effective for treating lax skin on the knees, thighs, buttocks, elbows, upper arms,12 and lower eyelids,15 and for improving the appearance of atrophic acne scars,16 striae,17 and cellulite.18 MFU-V has demonstrated a very good safety profile. Adverse events associated with proper treatment technique primarily consist of local tenderness, redness, and mild edema.19 Overall patient satisfaction following MFU-V treatment appears high, although this assumption has been limited to a few brief questions during clinical trial follow-up, such as a 4- or 6-point satisfaction rating or recommending treatment to family or friends.7,9,10 The following survey was performed to obtain more in-depth information on patient satisfaction during the MFU-V treatment procedure and satisfaction with their aesthetic results. The ultimate goal is to improve future patient treatment expectations and tailoring the MFU-V procedure to optimize treatment outcomes.


Survey participants were at least 21 years old, received MFU-V treatment between October and December 2014, completed at