title: Complications using intense ultrasound therapy to treat deep dermal facial skin and subcutaneous tissues.
abstract: BACKGROUND
  Intense focused ultrasound is an FDA-approved noninvasive technology for facial/brow lifting procedures. During the course of our experience, several patients had complications with this technology, some of which have not been reported in the literature.
  
  
  OBJECTIVE
  The purpose of this study was to assess the spectrum and duration of complications associated with administering intense focused ultrasound at the Duke Aesthetic Center.
  
  
  METHODS
  This retrospective IRB-approved chart review evaluates all 39 patients treated at the Duke Aesthetic Center from November 4, 2011 to October 9, 2012. Thirty-eight patients had concurrent ablative fractionated laser skin resurfacing using the Lutronic eCO2 system over the neck. The charts and photograph archive were reviewed to determine the amount and location of treatment and complications experienced by each patient.
  
  
  RESULTS
  Overall, 23% of patients had a complication. These included mandibular ecchymosis, facial edema, transient lip and brow paralysis, and pseudofacial fat atrophy.
  
  
  CONCLUSIONS
  Although most of the complications were transient in nature, 1 patient developed persistent facial edema that became a scar and another developed pseudomelolabial fat atrophy. Furthermore, 3 patients experienced previously unrecognized transient lip and/or brow paralysis. All patients tolerated concurrent neck ultrasound and ablative fractionated CO₂ laser resurfacing well.
authors.affiliation: *Both the authors are affiliated with the Department of Oculoplastics, Duke Eye Center, Durham, North Carolina.
authors.forename: Esfandiar J
authors.initials: EJ
authors.lastname: Sabet-Peyman
authors.forename: Julie A
authors.initials: JA
authors.lastname: Woodward
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D001284:Atrophy / Q000209:etiology; D003131:Combined Modality Therapy; D003357:Cosmetic Techniques / Q000009:adverse effects*; D004438:Ecchymosis / Q000209:etiology; D004487:Edema / Q000209:etiology; D005138:Eyebrows; D005145:Face; D005148:Facial Dermatoses / Q000209:etiology; D006801:Humans; D053685:Laser Therapy; D008046:Lip; D010146:Pain / Q000209:etiology; D010243:Paralysis / Q000209:etiology; D012189:Retrospective Studies; D015595:Skin Aging; D040521:Subcutaneous Tissue; D014464:Ultrasonic Therapy / Q000009:adverse effects* / Q000379:methods