title: High-intensity focused ultrasound treatment for skin: ex vivo evaluation.
abstract: OBJECTIVE
  High-intensity focused ultrasound (HIFU) has been used for skin tightening. However, there is a rising concern of irreversible adverse effects. Our aim was to evaluate the depth of thermal injury zone after HIFU energy passes through different condition.
  
  
  METHODS
  To analyze the consistency of the HIFU device, phantom tests were performed. Simulations were performed on ex vivo porcine tissues to estimate the area of the thermal coagulation point (TCP) according to the applied energy and skin condition. The experiment was designed in three orientations: normal direction (from epidermis to fascia), reverse direction (from fascia to epidermis), and normal direction without epidermis.
  
  
  RESULTS
  The TCP was larger and wider depending on the applied fluence and handpieces (HPs). When we measured TCP in different directions, the measured area in the normal direction was more superficially located than that in the reverse direction. The depth of the TCP in the porcine skin without epidermis was detected at 130% deeper than in skin with an intact epidermis.
  
  
  CONCLUSIONS
  The affected area by HIFU is dependent on the skin condition and the characteristics of the HP and applied fluence. Considerations of these factors may be the key to minimize the unwanted adverse effects.
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: S-D
authors.initials: SD
authors.lastname: Lim
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Jongno S&U Dermatologic Clinic, Seoul, Korea.
authors.forename: U C
authors.initials: UC
authors.lastname: Yeo
mesh_terms: D000818:Animals; D032701:Biomimetics / Q000379:methods*; D002056:Burns / Q000209:etiology; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects* / Q000295:instrumentation; D009132:Muscles / Q000033:anatomy & histology / Q000473:pathology; D012867:Skin / Q000033:anatomy & histology / Q000473:pathology*; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology; D050151:Subcutaneous Fat / Q000166:cytology / Q000473:pathology; D013552:Swine
keywords: ex vivo experiment; high-intensity focused ultrasound; porcine skin; skin condition; treatment parameter