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Dr. Henry Ngai

Skin tightening with SOFWAVE™- Better and Gentler



One of the telltale signs of ageing is the appearance of skin laxity on the face. It can manifest as wrinkles and skin folds on the face. Skin laxity occurs as a result of loss of elastic tissue and collagen in the tissue. Other factors such as bone resorption and fat loss or atrophy also play a crucial role.


For many years, surgery is the only and primary method of combating skin laxity. With the introduction of ablative carbon dioxide lasers, people have another option of skin tightening. However, these methods always involve significant recovery time, and are associated with complications or side effects.


We now live in a world where we do have other options of tightening the skin without going under the knife or undergoing a painful laser procedure with long recovery time. They are two primary non-invasive procedures for skin tightening nowadays. The first is using radio frequency (RF) and the second one is ultrasound technology. The first device that had been used for skin tightening is a monopolar device. It gained a lot of popularity when it was first introduced, being the only one non-invasive device that was approved for skin tightening at that time. About 10 years ago, a device using focused ultrasound (HIFU) came into the market. The advantage is it can penetrate to a deeper layer of the skin called the SMAS. However, treatments with these devices are very painful and many people have trouble tolerating it. Some places offer pre-procedure opioid narcotics as well as intravenous sedation. Many practitioners decide to turn down the intensity of the treatment on account of the level of pain, thus compromising the result.


A couple of years ago, a new fractional high intensity ultrasound device called Sofwave™ was introduced in the United States for treatment of wrinkles and skin laxity. Unlike HIFU, which can only deliver sequentially tiny dots of ultrasound energy, Sofwave™ delivers 7 parallel cylindrical high energy beams simultaneously to the mid-dermis at a level of 1.5 mm depth. It creates volumetric heating zones in the skin which result in inflammatory change with subsequent collagen stimulation. The skin is cooled during the delivery of the energy, thus providing comfort and protection to the skin. Unlike both monopolar RF and HIFU, Sofwave™ technology does not incur any damage to nerves, fat or blood vessels. There have been no reported cases of fat loss, facial paralysis or skin blisters after Sofwave™. The level of discomfort is significantly less during the procedure, and there has not been any need for any pain management other than simple topical anesthesia.


At Reviva, we introduced the technology less than 2 months ago. We have performed over 2 dozen Sofwave™ procedures and the results so far are really “uplifting”. Our clinic has experience with both HIFU and monopolar RF, yet Sofwave™ really stands out as it delivers good, consistent and visible results (within weeks in most cases), with almost no side effects. All patients are surprisingly pleased, surprised and relieved after the first few pulses of Sofwave™ treatment as the procedure so easily tolerated.


Sofwave™ is safe in all skin types. There are no age criteria and it is suitable to be performed year-round. It is a truly great technology.



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