Ultrasound facial consent form and treatment protocol

An ultrasound facial uses high-intensity focused ultrasound, or HIFU, to heat the deep support layer of the face so the skin tightens without surgery. Energy converges at 4.5mm, the depth of the SMAS layer a surgeon tightens in a facelift. The patient sees no change on the day, and the lift builds over three to six months.

That delay is where practices get into trouble. A patient who expected a facelift result by Friday will be back at reception on Monday. The record you made beforehand is what settles it.

Screening, risks, timelines and photo permissions all belong on the form. The template below gives you one, and the rest of this page covers how to use it.

Key takeaways

An ultrasound facial heats the SMAS layer at 4.5mm, which is why the lift reads as structural rather than superficial.

Screen every patient for implants, pregnancy, active infection and recent isotretinoin before you take a deposit.

Results build over three to six months, so put the timeline in writing before the first session.

Record screening, risks, photo consent and device settings on the form, because that note is what protects the practice.

Practice management software like Pabau keeps the signed form, the photos and the recall on one patient record.

What is an ultrasound facial?

An ultrasound facial is a non-invasive skin-tightening treatment that uses focused ultrasound to stimulate collagen.

The energy passes through the epidermis and concentrates in the dermis and the SMAS layer beneath it. SMAS stands for superficial musculoaponeurotic system, the sheet of tissue a surgeon lifts in a facelift.

Ultherapy is the device most practices recognize, and it has been FDA-cleared for the face since 2009. It delivers microfocused ultrasound in precise thermal zones.

Sofwave is the newer option, running several parallel beams at once. Both rely on the same principle. Heat the deep tissue, and the body rebuilds it.

How the energy reaches the SMAS layer

The energy reaches the SMAS layer because the transducer focuses it at a fixed depth, the way a magnifying glass concentrates sunlight.

The surface stays cool, and heat appears only where the beams converge. Each zone reaches roughly 60 to 70°C, which is hot enough to contract collagen on the spot.

Ultherapy runs three transducer depths, and the one you pick decides what the patient notices. The diagram below maps each depth to the layer it heats.

• Energy delivery: Ultrasound waves focus into a tight beam, heating tissue to 60 to 70°C in discrete zones.
• Depth: 4.5mm reaches the SMAS layer, 3.0mm the deep dermis, and 1.5mm the superficial dermis.
• Epidermis: The surface is spared, so there is no wound to dress and no recovery time to book out.
• Collagen cascade: Thermal injury activates fibroblasts, which lay down new collagen fibers over three to six months.
• Session length: 30 to 90 minutes, depending on the area treated and the device you run.

Which treatment areas respond, and how quickly

Every area with loose skin responds, but not at the same speed. The brow tends to move first, often inside six to twelve weeks, while the jawline keeps sharpening for six months. Name the area you are treating at consultation, and give the patient the timeline that goes with it.

Why patients pick HIFU over a surgical lift

Patients choose this treatment because they can go back to work the same afternoon. There is no general anesthetic, no dressing and no scar. The trade-off is scale. A tightening is what the device delivers, and heavy sagging still needs a surgeon.

• No downtime: Patients drive home and go back to work the same day.
• Natural progression: Collagen builds slowly, so the change reads as a good run of sleep rather than a procedure.
• One protocol, several areas: Face, jowls, neck and brow all respond to the same device.
• Tolerable in the chair: Most patients describe brief heat and prickling rather than pain.
• No injectables: The treatment uses no filler, no toxin and no prescription medicine.

Contraindications that should stop the treatment

Some patients should never be treated, and others need a conversation before you book them. Screen for both at consultation rather than on the day, because a deposit already taken makes the answer harder to hear. Write the answers on the form.

Absolute contraindications (do not treat):

• Implanted metallic devices in the face or neck, including pacemakers and metal implants near the treatment zone
• Pregnancy
• Active skin infection or severe acne in the treatment area
• Cosmetic surgery in the same region within the past three months
• Isotretinoin (Accutane) use within the past six months

Relative contraindications (discuss and document carefully):

• Thin or very sensitive skin
• A history of keloid formation or abnormal scarring
• Active autoimmune skin conditions such as lupus or severe eczema
• Recent sun exposure or sunburn
• Uncontrolled hypertension or a clotting disorder

The American Institute of Ultrasound in Medicine (AIUM) publishes a safety statement on cosmetic ultrasound. Cite it in your training file and your consent wording, so the position you are relying on is on record.

What belongs in the consent form

A consent form earns its place by proving the patient understood what they agreed to. Nine sections do that work. The one you leave out is usually the one a complaint turns on.

• Patient identification: Name, date of birth, medical record number.
• Medical history screening: Medications, prior surgeries, implants, allergies, skin conditions.
• Treatment description: A plain explanation of how HIFU works, the energy levels used, and what the patient will feel.
• Contraindication checklist: Explicit yes or no questions covering every absolute and relative contraindication.
• Risk disclosure: Redness, swelling, temporary numbness, and rare burns or nerve irritation.
• Expected outcomes: Three to six months for full results, 12 to 18 months of longevity, and individual variation.
• Alternatives: Laser, radiofrequency and surgical lifting, so the consent is genuinely informed.
• Photography: Separate permission to photograph results for the record, and again for marketing.
• Signature and date: Patient signature, practitioner signature, and a witness where your jurisdiction asks for one.

Medical history is the section most practices under-build. If you are starting from a blank page, a med spa consultation form gives you screening questions you can lift straight across.

The treatment protocol, step by step

A written protocol keeps six practitioners delivering the same treatment. Walk the patient through it at consultation, so the day itself holds no surprises.

1. Consultation: Review medical history, run the contraindication screen, explain the mechanism and the timeline, show comparable before-and-after cases, and take consent.
2. Skin prep on the day: Cleanse the face and neck, remove makeup and sunscreen, dry the skin, then apply coupling gel.
3. Delivery (30-90 minutes): Work the transducer in overlapping lines, adjust intensity to patient comfort, and cover every planned area systematically.
4. Aftercare instructions: Avoid hot water and hard exercise for 24 hours. Moisturize gently, use broad-spectrum SPF 30 or higher, and expect mild redness to settle within hours.
5. Follow-up: Message the patient 48 hours later, check in at two weeks, and book the review that carries the six-month photo.
6. Documentation: Record the area treated, the energy settings, patient tolerance, any adverse effect, and the photo set.

Hand the aftercare sheet over before the patient leaves, rather than emailing it that evening. If you do not have one yet, these HIFU aftercare instructions cover the same 24-hour window.

Ultrasound facial before and after: What to promise patients

Promise a gradual change over three to six months, and no dramatic shift in the first two weeks. Patients who hear that at consultation rate the same result more highly than patients who were sold a lift by the weekend.

The timeline below is the one to read out:

• Immediate (0-1 week): Mild redness and swelling settle. The skin can feel tighter as collagen contracts, but the lift is not visible yet.
• Early (4-8 weeks): Subtle tightening appears as new collagen forms. Fine lines soften and jowl definition starts to improve.
• Peak (3-6 months): Collagen remodeling finishes. This is where texture, jowl definition and overall lift look their best.
• Longevity: Results usually hold for 12 to 18 months as collagen breaks down again. A maintenance treatment at that point sustains the change.
• Variation: Age, skin quality, degree of laxity, sun exposure and smoking all move the result. Younger patients with mild laxity see it sooner.

Choosing between Ultherapy and Sofwave

Ultherapy carries the longer clinical record and the larger patient base. Sofwave is faster in the chair and, by most reports, more comfortable. Treatment volume and patient tolerance usually settle the decision.

Both devices are FDA-cleared for non-invasive lifting and tightening, so throughput and capital budget usually decide it. Medical spa software like Pabau tracks how often each handpiece is used and what it earns per hour. That second number is the one that answers the lease question.

How Pabau keeps consent, photos and recalls on one record

Most practices run this workflow across three places. The signed consent form sits in a filing cabinet or a shared drive. The before-and-after photos live on somebody’s phone. The six-month recall depends on a person remembering.

Pabau keeps all three against the same patient record. You send the form before the appointment, the patient signs on their own phone, and the signed copy attaches itself to their file. Digital intake forms mean nobody is scanning paper at 7pm.

Photos work the same way. Before-and-after photo tools store each set against the treatment, so the six-month comparison takes two clicks instead of a hunt through a camera roll. Recalls then go out automatically at the interval you set.

That last part is where the repeat revenue on this treatment sits. A patient treated in March is due back the following spring. The system should be the one remembering that, not your front desk.

Keep consent, photos and recalls on one record

Pabau sends the ultrasound facial consent form before the appointment and files the signed copy against the patient. Every before-and-after set is stored with the treatment note. Six-month recalls then go out on their own.

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Conclusion

The device does the easy part. Whether an ultrasound facial works for your practice is decided in the three months afterward. That is when the patient waits, and wonders whether it was worth the money.

So customize the form to your jurisdiction, put the timeline in writing, and photograph every case against the same background and the same light. Patients who can see the change at six months are the ones who rebook.

Keeping those three records together is where software earns its place. Book a demo to see how Pabau handles consent, photos and recalls for an ultrasound facial list.

Continue your research

Storing before-and-after photos properly? Before-and-after photos for med spas covers consent, storage and the rules on using treatment results in marketing.

Not sure where consent fits in your wider compliance file? Med spa compliance walks through the records an inspector asks for and how long to keep them.

Running other collagen-induction treatments? Skin needling consent form gives you a second template built on the same screening and risk-disclosure structure.

Frequently asked questions