{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T03:15:00Z","timestamp":1785726900744,"version":"3.56.0"},"reference-count":85,"publisher":"Wiley","issue":"S4","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Skin quality is a multidimensional concept encompassing four emergent perceptual categories (EPCs): firmness, surface evenness, tone evenness, and glow. Microfocused Ultrasound with Visualization (MFU\u2010V; Ulthera System) is a non\u2010invasive device FDA\u2010cleared for lifting and tightening of the skin in specific areas. Through the generation of thermal coagulation points at defined depths, MFU\u2010V initiates neocollagenesis and elastin remodeling, which may support improvements in features related to overall skin quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate clinical and preclinical evidence for the impact of MFU\u2010V across the four EPCs of skin quality, including firmness, surface evenness, tone evenness, and glow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Methods<\/jats:title>\n                    <jats:p>A structured narrative review was conducted across PubMed, Google Scholar, and Cochrane databases. Of 703 unique records screened, 67 studies met inclusion criteria. Eligible studies evaluated MFU\u2010V, alone or in combination, reporting outcomes mapped to one or more EPCs of skin quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MFU\u2010V demonstrated consistent improvements in firmness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200952 studies), including elasticity and tautness, with sustained effects beyond 6\u2009months. Improvements in surface evenness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935) included wrinkle reduction, pore refinement, and scar remodeling. Effects on tone evenness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) were observed in melasma and erythema models, with good tolerance in Fitzpatrick skin types III\u2013VI. Glow (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) was indirectly supported by improved texture and structure. Combination protocols involving MFU\u2010V and fillers or neuromodulators reported positive outcomes. Adverse events were rare and transient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MFU\u2010V provides a safe and versatile platform for enhancing multiple aspects of skin quality. Its effects are well supported in firmness and texture, with emerging evidence for tone and glow. The integration of EPC\u2010based outcomes may inform individualized treatment planning and future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70364","type":"journal-article","created":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T12:43:22Z","timestamp":1755953002000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Microfocused Ultrasound With Visualization in Skin Quality: A Narrative Review"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4511-8661","authenticated-orcid":false,"given":"Tatjana","family":"Pavicic","sequence":"first","affiliation":[{"name":"Private Practice for Dermatology and Aesthetics Dr. Tatjana Pavicic  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6205-0319","authenticated-orcid":false,"given":"Jeremy B.","family":"Green","sequence":"additional","affiliation":[{"name":"Skin Research Institute and Skin Associates of South Florida  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Je\u2010Young","family":"Park","sequence":"additional","affiliation":[{"name":"Apkoo\u2010Jung Oracle Dermatology Center  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3183-0432","authenticated-orcid":false,"given":"Gabriela","family":"Casabona","sequence":"additional","affiliation":[{"name":"Ocean Clinic Marbella  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7328-939X","authenticated-orcid":false,"given":"Vasanop","family":"Vachiramon","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Faculty of Medicine Ramathibodi Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7285-3501","authenticated-orcid":false,"given":"Julieta","family":"Spada","sequence":"additional","affiliation":[{"name":"Julieta Spada Dermatology and Aesthetics  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Levine","sequence":"additional","affiliation":[{"name":"Lenox Hill Hospital and Manhattan Eye, Ear, and Throat Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Muniz","sequence":"additional","affiliation":[{"name":"Dermatology Private Office  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Akers","sequence":"additional","affiliation":[{"name":"Global Medical Affairs, Merz Aesthetics  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5063-5413","authenticated-orcid":false,"given":"Alec","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Global Medical Affairs, Merz Aesthetics  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5392-845X","authenticated-orcid":false,"given":"Matthew J.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Global Medical Affairs, Merz Aesthetics  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/ccid.s309374"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.16638"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/14764172.2015.1022189"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000231"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104725.2011.02094.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/14764172.2019.1689272"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.36849\/JDD.2020.4625"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4236\/jbm.2021.97012"},{"issue":"5","key":"e_1_2_8_10_1","first-page":"E70","article-title":"Customized Treatment Using Microfocused Ultrasound With Visualization for Optimized Patient Outcomes: A Review of Skin\u2010Tightening Energy Technologies and a Pan\u2010Asian Adaptation of the Expert Panel's Gold Standard Consensus","volume":"14","author":"Park J. 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