A systematic review was carried out on the main clinical findings of the use of micro-focused ultrasound and collagen biostimulation, with or without combination with calcium hydroxyapatite and poly-L-lactic acid, in the aesthetics of human skin, to highlight the safety, efficacy, and risk of bias.

Introduction: In the context of skin aesthetics, the spotlight is focused on non-invasive cosmetic procedures. Studies have shown that micro-focused transcutaneous ultrasound (MFU). A commercially available device combines MFU with high-resolution ultrasound imaging. Some clinical studies have shown clinical synergy of MFU-high resolution with poly-L-lactic acid and a fractional or diluted CO2 laser with calcium hydroxyapatite.

Objective: A systematic review was carried out on the main clinical findings of the use of micro-focused ultrasound and collagen biostimulation, with or without combination with calcium hydroxyapatite and poly-L-lactic acid, in the aesthetics of human skin, to highlight the safety, efficacy, and risk of bias.

Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from May to June 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 20 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument.

Results: A total of 112 articles were found, and 12 articles were included in the systematic review. It has been shown that MFU-high resolution enables non-invasive tightening and lifting of sagging skin, and when combined dilute calcium hydroxyapatite, polycaprolactone, and/or poly-L-lactic acid is effective in improving sagging skin.

Conclusion: It was concluded that MFU-high resolution targets the facial superficial musculoaponeurotic system, achieving non-invasive tightening and lifting of sagging skin, and when combined with dilute calcium hydroxyapatite, polycaprolactone, and/or poly-acid L-lactic is effective in improving sagging skin and cellulite.

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