In medical aesthetics, RF Microneedling (also known as Gold RF Microneedling) and HIFU (High-Intensity Focused Ultrasound) are two of the most popular and trusted treatments among beauty seekers due to their proven effectiveness and widespread use. Most clients typically choose either RF Microneedling or HIFU as a standalone procedure.
But can the two be combined in a single treatment plan?
What results can be expected from this combination therapy?
And what’s the best order to perform them?
Let’s explore the science and strategies behind combining RF Microneedling and HIFU.
01. Mechanisms of RF Microneedling and HIFU
RF Microneedling (Gold Microneedling)
RF Microneedling, often referred to as Gold Microneedling due to the gold-plated tips of the microneedles, uses fractional radiofrequency delivered through minimally invasive needles. These needles penetrate the skin at precise depths to deliver controlled heat energy into the dermis and upper subcutaneous layers, effectively stimulating collagen regeneration, enhancing tissue remodeling, and offering anti-inflammatory and antibacterial effects.
Unlike traditional laser or RF devices, RF Microneedling offers:
- Accurate depth control
- Minimal surface damage
- Effective energy delivery without surface burns
The insulated microneedles protect the epidermis from thermal injury, reducing the risk of scabbing and hyperpigmentation. RF Microneedling is widely used to treat:
- Skin rejuvenation
- Acne scars
- Enlarged pores
- Active acne
- Hyperhidrosis (underarm sweating)
- Stretch marks
HIFU (High-Intensity Focused Ultrasound)
According to the 2025 Expert Consensus on the Application of HIFU for Facial and Neck Rejuvenation, HIFU devices typically operate at frequencies of 4–10 MHz with treatment depths ranging from 1.5 to 4.5 mm.
HIFU delivers focused thermal energy to specific layers of skin and connective tissue without damaging the surface, creating thermal coagulation points less than 1 mm in diameter. These thermal effects trigger:
- Collagen contraction
- Neo-collagenesis (new collagen growth)
- Long-lasting skin tightening and wrinkle reduction
Different HIFU cartridges (also called transducers) are used to target multiple layers of tissue in a linear or planar mode, allowing for comprehensive lifting and tightening.
02. Clinical Outcomes of RF Microneedling + HIFU Combination Therapy
In a clinical study involving 90 patients seeking facial rejuvenation:
- Control Group (45 cases): Treated with RF Microneedling only
- Treatment Group (45 cases): Treated with HIFU + RF Microneedling
HIFU Protocol (Control Group):
- Application of coupling gel
- Sequential treatment with M4.5 and M3.0 cartridges
- Parameters adjusted based on patient tolerance (average of 194 shots per cartridge per side)
- Additional treatment with D4.5 and D3.0 cartridges (5–10 minutes each)
- Gel cleaned off after treatment
HIFU + RF Microneedling Protocol (Treatment Group):
- Local anesthesia and disinfection
- Use of insulated 49-pin RF microneedle cartridge
- Parameters: 100–200 ms pulse width, 8–14 W energy, 0.8–2.0 mm depth
- Treated 600–800 shots using a grid-like pattern to avoid missing areas
- Applied growth factors post-treatment and used cold medical masks
RF Microneedling was performed 30 days after HIFU.
Results:
- Overall efficacy in the treatment group was 95.56%, significantly higher than 77.78% in the control group.
- Patient satisfaction was also markedly improved.
Conclusion: Combining HIFU and RF Microneedling yields superior results compared to RF Microneedling alone.
03. Is Immediate Combination Safe and Feasible?
Typically, HIFU is performed first, followed by RF Microneedling after 1 month. But can both treatments be done in one session?
International Research:
A study examining the thermal interaction of HIFU and bipolar RF on cadaver skin concluded that the thermal damage zones induced by both devices were distinct and did not interfere with each other. This suggests that immediate combination treatment is safe and technically feasible.
Chinese Market Research:
In a clinical setting, patients were treated with HIFU followed immediately by RF Microneedling using a multi-layer approach.
Results showed:
- Improved efficacy compared to using HIFU alone
- Only mild side effects (redness, swelling), which resolved within 3–5 days
- No severe adverse reactions reported
This proves that HIFU + RF Microneedling can be safely and effectively combined in a single session, as long as HIFU is performed before RF Microneedling.
04. Summary for Clinics and Distributors
- Combining HIFU and RF Microneedling offers enhanced outcomes for facial rejuvenation, improving fine lines, wrinkles, skin laxity, and overall skin texture.
- Immediate combination treatment is safe and can achieve better patient satisfaction and long-term results.
- However, clients with active inflammation, severe acne, pustules, urticaria, or hypersensitive skin are not suitable for combination treatments and should be treated cautiously.
As a professional beauty equipment manufacturer, Mico Aes provides high-performance RF Microneedling and HIFU devices suitable for salons, clinics, and distributors aiming to offer advanced anti-aging and skin rejuvenation solutions. Contact us for more information about our OEM/ODM solutions and global distribution support.
