What Is IPL?

It is basically a natural light. As the name implies, it is first intensified and then emitted in a pulsed manner.

Natural light is a continue spectrum of wavelengths, ranging from 510nm to 1200nm. Within this spectrum, it consists of red, orange, yellow, green, blue and violet, as seen in a rainbow.

Difference Between IPL & Laser

One laser has only one specific wavelength, and different lasers therefore have different wavelengths, for examples:

Pulsed Dye Laser 510 nm
Ruby Laser 694 nm
Alexandrite Laser 755 nm
Nd:Yag Laser 1064 nm

Each particular wavelength will mainly have one single target, and is used to treat mainly one aesthetic problem on the skin. When there are multiple problems, very often more than one laser type is needed.

IPL is continuous, from 510 nm to 1200 nm, therefore IPL is like emitting multiple lasers at the same time. Because of this, it can be used to treat multiple problems in a single treatment. Few different filters are used to block part of the spectrum below a certain wavelength, for example a 590nm filter will only allow the passage of 590 nm – 1200 nm, blocking the wavelength below 590 nm.

Although IPL can treat different problems at the same time, but usually when only one single problem is present, laser is more effective in targeting this. For example, in removing freckles and tattoo, laser is far more effective and quicker in clearing them up.

Laser causes some redness and swelling afterwards, and it needs about one week to subside. When used correctly, IPL has a low chance of causing redness and pigmentation, and people can go to work as usual. However, it does not mean that IPL is totally safe and will not burn. People think it is mild, but it is not, and in fact is still a very high energy light source. There have been numerous cases of inappropriate use by doctors or beauticians, and resulted in serious burn marks.

Protective eye wears are so still necessary for the operators and patients.

Applications of IPL

  IPL Pigment
Freckles, Pigmentation
Pigment Birthmarks
Uneven Skin Tone
Vascular Marks
Red & Blue Lines
Reducing Pores
Stimulate Collagen
Improve Fine Lines
Hair Removal
Depressed Scars

As can be seen above, when dealing with ANY one single problem, there is always a laser that works far better. The improvements provided by IPL are very modest, and has always been over promised in the past. Now that it is almost abandoned in the medical aesthetic market. There are still some service providers who use it to treat mild pigmentation, even skin tone, and do hair removal.

The treatment does not require topical anaesthetic cream. Each treatment takes about 15 - 20 minutes. Only a warm feeling is noticed and there should not (normally and if used appropriately) cause any redness after. Usually a course consist of 4 - 6 treatments, each separated by 3 - 4 weeks.

LED is nothing new. Ordinary fluorescent lights used at home or office is an example of LED. The principle is not complicated. The light is generated by hitting a medium with electrons passing at high speed, from the positive to the negative end.

This technology originates from NASA researches. Where researchers utilise different light sources to influence the cellular activities, stimulate or inhibit certain metabolic functions. A well-known example is how green plants make chlorophyll when they are stimulated by daylight.

Scientists call this photo-modulation, photo-regulation, or photo-bio-stimulation. Apart from the stimulation on collagen and elastin, it has a positive effect on the whole dermal matrix.

Difference With Laser / IPL

This new concept is very different. Laser and IPL use high energy and the heat generated to damage targets, with subsequent removal or regeneration.

LED, on the other hand, is a low energy device, and uses a combination of light signals to alter the cells behaviour.

Some proven evidences include:

  • Diminish the enzymes which break down collagen during normal metabolism, Matrix Metallo-proteinases MMP-1 and MMP-2
  • Stimulate the mitochondria inside cells to generate the source of cell energy, Adenosine Tri-phosphates ATPs

Treatment Effects

  • Improve acne and red marks
  • Reduce fine wrinkles
  • Reduce pore sizes and improve smoothness
  • Increase elasticity and tightening
  • Reduce fine blood vessels and facial redness

The Treatment Procedure

LED is suitable for all skin types. It contains different ranges of wavelengths, with different colours. The tratment usually lasts for 15 - 30 minutes, and is done once or twice a week. Because it is non-invasive and non-heat orientated, it is very safe and there is no feeling during the treatment, and no downtime after.

It may be combined with other treatments, for example a light chemical peeling or micro-dermabrasion just before the LED may enhance the effect. Some may use it together with IPL. Overall, it can be an important part of a whole therapeutic regime.

Some LED treatments use only 1 single range (colour) and the signaled effects may be limited. We use a system which has pre-set programmes to emit multiple wavelengths ranges, from 400nm to 700nm, in different combinations and orders. You just need to lie down and relax, with the robotic arm going round your face automatically.

The initial course comprises 6 - 8 treatments. Thereafter it is up to you to decide how often you need to do an intermittent maintenance treatment.

What is High Intensity Focused Ultrasound?

Multiple high energy ultrasound waves are transmitted through the superficial skin layers and focused on a single spot in the deeper levels, while leaving the superficial layers without damages. Multiple emissions are done on a short line, creating an almost continuous line of thermal injury.

What are the Effects?

HIFU creates a temperature of 60° Celsius and this technique has been proven to uplift and tighten skin laxity in different areas. There are 3 levels of liftings. When the energy is focused at 3–4.5mm depth it hits the SMAS (a fibrous layer connecting most of the facial tissues) layer and the heat will contract the whole SMAS layer and the connective tissues next to it, resulting in skin tightening and improvement of wrinkles.

3 mm penetration will focus on the deep dermis, and stimulate the regeneration and re-alignment of collagen and elastic tissues, smooth out the deeper wrinkles.

1.5mm penetration will focus on the superficial dermis, and is applicable to the thinner skin area such as around the eyes. It can reduce pores, smooth out fine lines, and improve skin tone.

More commonly treated areas include:

  • Full face
  • Lift up eyebrows
  • The saggy lower face
  • Under-chin and upper neck

Treatment Procedure

It is a non-invasive procedure without cutting, and the ultrasound is transmitted from outside the skin to deeper levels. Numbing cream is applied for 30 minutes before the procedure. According to different skin types and sagging situations, the therapist will choose to perform the HIFU over different areas on the face, with different selections or combinations of penetration depths, such as 4.5mm, 3mm and 1.5mm, as well the number of shots to be done. The whole procedure takes about 30 to 60 minutes, and the level of pain is rather minimal.

After the treatment, there is no wound, and usually there is no redness or swelling, and normal working or social schedules can be resumed immediately.

HIFU started as one time treatment in the early years but is modified to become a 3 sessions course, with each session separated by about 1 to 2 months. After a single treatment, there is mild to moderate facial skin tightening seen gradually over 1 to 2 months, and that continues to improve for about 6 months. After the whole course, the benefit can last for about 18 months, after which 1 more treatment can be repeated.

Is there any Risks?

Under the correct techniques in an experienced hand, there should not be any risks. Perhaps at most there may be some mild, short-lasting scratch-like redness and swelling. The therapist should aware of the distribution of nerves over the face, and avoid using 4.5mm probe over the sensitive areas, otherwise the nerves may be damaged, resulting in some long-lasting if not permanent nerve pain. A lot of aesthetic centres do not mention any risks and it is not so appropriate.

As the HIFU may have some effect in reducing fat to a certain extent, it has been in the literatures that some people complain of a worse looking, even more sagging facial appearance after the HIFU. This may happen in the thinner people and so it is better not to not HIFU if someone is thin and saggy, and these people would benefit more from volume enhancement such as by using Sculptra.

Finally, there are different HIFU models manufactured from the US, Korea, and even mainland China. According to experience, although the US model has a longer history and is more reputable, its treatment seems to be a lot more painful while the Korean models has only very mild discomfort during treatment, and yet the results are very comparable, if not the same or even better. The prices with the Korean models are also a lot more reasonable and as a result they are more popular in the local aesthetic market.

What is Radio-Frequency?

Radio-frequency (RF) is a form of high frequency alternating electro-magnetic wave, the frequency ranges between 300KHz to 300GHz. Radio-frequency has been widely used in communication technologies but it also has many different applications in medicine. It has been used in surgical cutting and cauterization, and it is now used in aesthetics for skin tightening, smoothing out wrinkles, and speed up the metabolism of fatty tissues.

Radio-frequency achieves wrinkles reduction in a non-invasive manner and is currently one of the safe and effective treatments for this.

Mechanism of Wrinkle Reduction with Radio-frequency.

Radio-frequency penetrates through the superficial layers to a depth of 3mm or more, evenly heating up the dermis and the collagen there to 55° to 65° Celsius, stimulating the collagen to regenerate and the elastic tissues to contract, thereby uplifting the sagging skin, reducing the wrinkles, and causing a re-modelling of the facial contour. At such high temperature, it will promote the fat cells to liquefy and enter the lymphatic system more effectively. Together with the skin tightening, it will reduce the cellulite.

Radio-frequency can be divided into mono-polar, bi-polar, tri-polar, as well as multi-polar. Mono-polar is supposed to penetrate deeper with a better result and there was a US model once highly valued by doctors in being extremely effective as a one off treatment. So many people went for this treatment only to find that the treatment was very painful, the charges was very expensive, and yet the final result was very disappointing, perhaps only a modest improvement in a small fraction of people.

Hence we never recommended this mono-polar treatment but rather focus on the tri-polar model. Although it has only a mild to moderate benefit, the improvement is consistent, the treatment is painless and most importantly the price is much more reasonable, which make it possible to be used as a continual maintenance therapy to tighten up the lax skin.

Treatment Process

Radio-frequency is a non-invasive, non-ablative treatment. The time for treatment is about 30 to 45 minutes, depending on the areas needing treatment and the energy level used. There is no redness or swelling after treatment, and normal daily activities can be resumed immediately. The number of treatment required depends on the severity of the skin laxity but as said, it can be continued as a regular maintenance for prevention of skin laxity.

Treatment Areas

  • Tighten sagging facial skin
  • Tighten and improve the silhouette of the neck line
  • Reduce fine lines around the eyes
  • Tighten tummy skin, for example after child delivery
  • Tighten upper arms, thighs, and buttock, and reduce cellulite.

Mechanism of Micro-needling RF

The mechanism of radio-frequency has been mentioned. However, that is about RF treatment which works from outside the body, and transmit the energy to heat up the skin inside slowly to an effective temperature.

Micro-needling RF aims to deliver the energy directly inside the skin, and target accurately to the treatment zone, as well as avoiding the risk of thermal injury to the superficial skin.

To achieve this, a probe with multiple fine needles is used and when the needles enter to a specified depth of the skin, RF is emitted through only the tips, and essentially it acts as a multi-polar RF inside the skin. As the body of the needles is insulated, there is no risk of burning either, to other areas except at the very tip.

As usual, the RF stimulates the regeneration of collagen, and tightens the skin, as well as softens deep scar and reduces pores size.

Advantages of Micro-needling RF

Advantages of RF emission inside the skin :

  1. Energy is highly focused
  2. Insulation outside the tips avoiding thermal injury in other areas
  3. Depth of treatment zones can be selected

Treatment Process

Every person will have a personal needles probe so that there is no risk of cross infection. There is some moderate pain and therefore numbing cream is applied for 30 minutes before the procedure. The time of the treatment depends on the size of area being treated. After treatment there are tiny needle wounds, the skin is red but should not be swollen, which would normally subside in 1 - 2days. The wounds will heal in short time, probably within hours. Antiseptic cream is applied.

In the following few days, use mild facial cleanser, and then again put the antiseptic cream on. It is necessary to avoid strong sun exposure.

Risks of the Treatment

  1. It is not suitable for people who have a heart pacemaker, and also those with serious irregular heartbeats.
  2. For those will difficulty in blood clotting, the recovery time can be much longer due to excessive bruises.
  3. Wound infection can happen but in the proper medical setting, the risk is very low.
  4. Inappropriate operation leading to burning injury to the skin

Area of Applications

  • Indented scarring
  • Enlarged skin pores
  • Tummy lines after delivery
  • Skin laxity


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