Microfocused Ultrasound With Visualization for Body Indications: A Global Expert Consensus on Best Practices for Treatment of the Abdomen and Arms

Journal of Cosmetic Dermatology
Open Access

Clinical Summary

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What was studied

An international, multidisciplinary panel developed consensus recommendations for using microfocused ultrasound with visualization (MFU‑V; Ultherapy/Ultherapy PRIME) to treat mild to moderate skin and soft tissue laxity of the abdomen and upper arms, based on published clinical evidence, expert experience, and structured virtual discussions.

Key findings

The panel affirmed MFU‑V as a safe, effective noninvasive option, citing three abdominal studies (n=54) and five upper‑arm studies (n=113) showing clinician‑ and patient‑reported improvements with no serious or unexpected adverse events, with effects often sustained for 6 months or longer after maximal improvement.

Study limitations

Recommendations derive from expert consensus and small prospective studies; large, comparative trials and longer follow‑up are lacking. The work was funded by Merz Aesthetics, and all panelists reported financial relationships with the device manufacturer.

Clinical implications

Use real‑time ultrasound to individualize depth and density: abdomen typically treated with a 12‑column (2×4 cm) grid delivering a median 720 lines using dual‑depth (4.5 and 3.0 mm) with optional 1.5 mm for crepiness, avoiding the umbilicus. For upper arms, treat only the middle third with a 6‑column grid per region and a median 240 lines, using 1.5/3.0 mm anteriorly and 3.0/4.5 mm posteriorly, with caution near neurovascular structures and in low‑BMI or post‑weight‑loss patients.