Four things focused ultrasound does not do, the honest list of side effects, and every reason we decline to treat someone. Written to be read before you pay, not after.
Every clinic page lists what a treatment does. This one lists what ours does not, and who we send elsewhere, because the fastest way to an unhappy client is a session that was never going to work.
Four things HIFU does not do
It does not remove skin. Focused ultrasound tightens skin by making your body build collagen in it. Skin that has become surplus stays surplus. Pinch under your jaw: a fold that stays folded is surplus, and only a surgeon removes it.
It does not replace volume. A face that reads as tired because it has gone flat needs filling. Tightening a hollow face pulls the remaining tissue tighter over the hollow and makes it more obvious. We have seen people spend on three sessions for a problem that was never laxity.
It does not remove fat. Under a double chin there is often a firm pad that does not fold. Ultrasound tightens the skin over it and leaves it where it is. Devices that reduce fat with ultrasound exist, at different settings, for a different purpose, and clinics blur the two in their advertising.
It does not change your skin surface. Pores, texture, pigment, acne scars and fine surface lines are not what this treats. Those belong to resurfacing and to radiofrequency microneedling.
The honest list of side effects
Common, and they settle: redness for one to three hours, tenderness for two or three days, mild swelling, small bruises where the handpiece crossed bone.
Common and slower: a tingling or numb patch along the jaw, lasting two to four weeks, when energy passes near a nerve branch.
Uncommon, and they come from wrong depth or wrong settings rather than from the treatment itself: a surface burn, a dent where fat has thinned, temporary weakness in a facial muscle. A therapist who chooses depth from your own facial assessment rather than from a fixed protocol is what keeps these rare. This is also why a very thin face, a face that lost weight fast, and a face with filler placed recently need extra care.
Who we turn away, and why
Anyone whose skin hangs. The pinch test decides this, not the calendar. We say it at the consultation and we do not sell a session as a cheaper facelift.
Anyone pregnant or breastfeeding. No safety data exists for focused ultrasound in pregnancy, and the responsible answer to no data is no treatment.
Open wound, active infection or cystic acne in the treatment area. Heating inflamed or infected skin makes it worse.
Metal plates or implants in the face or neck, and pacemakers. Raise it at the consultation and we work around the area or decline.
Filler placed in the last two weeks. Heat can move fresh filler. Wait.
Accutane in the last six months. Skin repairs differently on isotretinoin and for months after.
Keloid history. Not an automatic no, and a conversation before rather than a surprise after.
Anyone booking two weeks before a wedding. The result arrives at eight to twelve weeks. Booking for an event inside that window buys disappointment at full price.
Anyone who wants a dramatic change in one step. That is a surgical conversation. Ultrasound gives a firmer version of your own face, and people notice that you look rested rather than that you had something done.
What happens at the consultation
A therapist looks at your face, does the pinch test, asks what bothers you in photographs and what you have had done before. Then she tells you which of three things is true: this treatment suits you, this treatment suits you alongside something else, or this treatment is the wrong purchase for your face.
The consultation costs nothing and it happens before payment. Those two facts are the whole point. A clinic that assesses you after taking your money has no reason to give you the third answer.
Frequently Asked Questions
What are the negatives of HIFU?
Redness, swelling and a tingling or numb patch along the jaw for up to four weeks are the common ones. Rare problems come from wrong depth or settings: a burn, a dent where fat thinned, or temporary muscle weakness. The treatment also does nothing for volume loss, surplus skin, fat or surface texture, and being sold it for those is the most common bad outcome.
Can HIFU damage your face?
Poorly set energy at the wrong depth can, which is why depth is chosen from your own facial assessment rather than a fixed protocol, and why a thin face or one with recent filler needs extra care. Serious problems are rare and they are not random.
Who should not get HIFU?
Anyone pregnant or breastfeeding, anyone with an open wound, active infection or cystic acne in the area, anyone with metal implants in the face or neck or a pacemaker, anyone with filler placed in the last two weeks or Accutane in the last six months, and anyone whose skin already hangs.
Does HIFU work on a double chin?
It tightens the skin over one. If the fullness is fat rather than loose skin, the outline changes a little and the fat stays. Pinch it: skin that folds is laxity, a firm pad that does not fold is fat.
Will HIFU help my pores or acne scars?
No. Those are surface problems and this treatment works below the surface. Radiofrequency microneedling and resurfacing treat texture.
Can HIFU make my face look hollow?
On a face that has already lost volume, tightening can make the hollow more noticeable. This is why the assessment checks for volume loss before booking, and why the answer is sometimes filler rather than a lift.
What happens if I have already paid and you decide I am not suitable?
We tell you before you pay. The consultation is free and comes first for exactly this reason.
Sources
- Welc N et al. High-Intensity Focused Ultrasound: Application, Effects and Complications. Australas J Dermatol, 2025. PubMed 40095285
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At ICONIQUE Peninsula
At ICONIQUE, on the lobby level of The Peninsula Manila in Makati, HIFU costs ₱1,295 for your first session booked online (regular ₱15,000). A visit takes 45–60 minutes including the consultation. No deposit: you pay at the clinic after the treatment.
Book HIFU at The PeninsulaWritten by
Maria Manuela ValenciaSenior Clinical Therapist · Over 10 years in skin and aesthetics
Maria has worked in skin and aesthetics for over ten years, the last two of them at ICONIQUE inside The Peninsula Manila. She runs PicoLaser and HIFU treatments at the Makati branch.
Book with Maria Manuela Valencia
The consultation is free, and it is where we say whether the treatment you came for is the right one for your skin.