HIFU or Gold Microneedling? Choosing the Right Treatment for Sagging + Skin Quality (Clinical Decision Guide 2026)

Perhaps half of the patients who come for consultation ask the same question: "Doctor, should I get HIFU or gold microneedling?" This question is one of the most common clinical decision questions I encounter, as it doesn't have a single answer. Although the two technologies seem to serve the same purpose — to rejuvenate the face — they fundamentally target different goals, affect different muscles/tissues, and yield different results. The wrong choice leads to a waste of both time and money; worse, it can cause the patient to shy away from aesthetic treatments with the feeling of "I had it done, but it didn't work."

This guide shares the 4-criterion decision matrix I developed during my 30+ years of medical aesthetic experience as a graduate of Ondokuz Mayıs University Faculty of Medicine. The aim is to provide a clinical framework for you (and your physician) to make the right treatment choice. This article is not a sales pitch — it is a decision tool. By the end, you will have a clear understanding of which treatment might be suitable for you, or why the two treatments are often complementary, not alternatives to each other.

Two Treatments in One Sentence

Before delving into complexity, let's summarize the two technologies in one sentence — this is the brief explanation I use with patients during consultation:

HIFU: A non-surgical facelift method that provides mechanical lifting by precisely heating the SMAS layer and deep dermis beneath the skin with focused ultrasound waves, without touching the surface. Target: sagging.

Gold Microneedling (RFM): A dermal remodeling method that involves inserting 24-karat gold-plated microneedles into the dermis of the skin and delivering radiofrequency energy from the tips of the needles to repair the collagen-elastin structure. Target: skin quality (acne scars, lines, pores, tone, texture).

These two sentences are essentially the core of the comparison. The rest — depth, device differences, protocol details, price — enrich this fundamental distinction. In my clinical experience, the moment a patient understands these two sentences, they are halfway to making the right decision.

HIFU Detailed: Mechanical Lifting, SMAS, Who Is It For?

HIFU — High-Intensity Focused Ultrasound — means focused high-intensity ultrasound. The technology was initially developed for tumor ablation in medicine (especially prostate and liver); in 2009, Ulthera launched the first aesthetic HIFU device and received FDA indication for "non-invasive brow lift." In subsequent years, Korean-made devices such as Doublo (Hironic), Liftera (Classys), and Ultraformer III (Classys) expanded the market.

How Does HIFU Work?

The HIFU transducer focuses ultrasound waves at a specific depth in the skin to a single point via a lens placed on it — much like sunlight burning paper through a magnifying glass. At this focal point, the tissue heats up to 65–75°C, forming a thermal coagulation point (TCP). Each TCP is approximately 1 mm³ in size and selectively heated without damaging the surrounding tissue. The device's transducer (probe) can focus at different depths: typically 1.5 mm (superficial dermis), 3.0 mm (deep dermis), and 4.5 mm (SMAS layer). The 4.5 mm depth transducer is the parameter that reveals the true value of HIFU; because at this depth lies the face's SMAS (Superficial Musculo-Aponeurotic System) layer. The SMAS is the fibrous layer that plastic surgeons lift and secure during a facelift operation.

Bertossi et al. (2021, J Cosmet Dermatol) histopathologically demonstrated the mechanical effect of HIFU at the SMAS level: around the TCPs formed at 4.5 mm depth, SMAS fibers shorten, contract, and this mechanical contraction gradually transforms into a "lifting" appearance. The effect is not instantaneous; minimal contraction is seen in the first week, new collagen production begins with fibroblast activation after 4–6 weeks, and peaks at 3-6 months.

What Problems Is HIFU Effective For?

Primary indications for HIFU:

• Cheek (mid-face) sagging: Downward displacement of the malar fat pad, deepening of the naso-jugal groove.
• Jowl sagging: Loss of clear definition of the jawline, displacement of the "swallowing" line.
• Submental laxity: Sagging of the area under the chin, "double chin" appearance (especially if there is no fat deposit).
• Neck sagging (mild-moderate): In the period before platysma bands become prominent.
• Brow ptosis: With upper face HIFU (1.5 mm + 3.0 mm transducer).
• Upper eyelid hooding: In cases of mild-moderate hooding not suitable for surgery.

Suh and Lee's (2017) multicenter study in the Korean population showed significant improvement in objective sagging scores (NLF — naso-labial fold depth, jowl score) after HIFU. In my clinical practice, I observe similar findings: with proper patient selection, a visible lifting effect is seen in the vast majority of patients 3-6 months after 1 session. The important thing is the definition of "the right patient."

Who Is HIFU Not Suitable For?

The clinical reality of HIFU is this: it is not designed for structural inadequacy. In patients aged 65+ whose facial skeleton has collapsed, skin quality has lost elasticity to a very advanced degree, and jowl fold measures a finger's thickness, HIFU is insufficient. In this case, referring the patient for a plastic surgery consultation is the correct clinical approach. Furthermore, in patients with very poor facial fullness and a dominant "skeletal" appearance, HIFU may further reduce fullness; in these patients, volume is first restored with hyaluronic acid or biostimulators (Profhilo, Sculptra), and then HIFU is planned if necessary.

For more detailed information, you can refer to the dictionary pages /sozluk/hifu and /sozluk/smas.

Gold Microneedling Detailed: Dermis Quality, Collagen, Who Is It For?

Gold microneedling — scientifically known as fractional radiofrequency microneedling (RFM) — uses 24-karat gold-plated, insulated microneedles. The needles penetrate the skin at programmable depths from 0.5 mm to 3.5 mm; bipolar radiofrequency energy is emitted from the distal tips of the needles (the part where the insulation is open), creating thermal coagulation zones of 65–75°C in the reticular dermis. Hantash et al. (2009, Lasers in Surgery and Medicine) was the first study to demonstrate the histopathological basis of this technology.

How Does Gold Microneedling Work?

Three simultaneous mechanisms come into play:

1. Mechanical micro-injury: Microchannels are formed in the papillary and reticular dermis as 36 to 64 needles penetrate the dermis. This triggers fibroblast activation.

2. Thermal coagulation (RF): Radiofrequency energy emitted from the needle tip denatures collagen fibers in the dermis in a controlled manner, initiating both immediate collagen contraction and delayed neocollagenesis (new collagen production).

3. Molecular cascade: TGF-β, HSP47, and HSP70 signals are activated; type-I/III collagen synthesis begins to increase from day 14 and peaks at 6 months. Park et al. (2020) reported a 20-35% increase in dermal thickness.

What Problems Is Gold Microneedling Effective For?

• Atrophic acne scars (Goodman-Baron score 3-4): Undisputedly the strongest indication for gold microneedling.
• Striae (stretch marks): Including striae rubra (red, fresh) and striae alba (white, old).
• Enlarged pores: Especially in the T-zone, forehead, and around the nose.
• Fine lines and superficial wrinkles: Around the eyes, mouth, upper lip.
• Uneven skin texture: "Orange peel" surface appearance.
• Mild-moderate sagging (onset of jowl, anterior neck): Dermis-derived laxity not reaching the SMAS level.
• Neck wrinkles: Period before superficial platysma laxity.
• Postpartum abdominal laxity: Can be evaluated 9+ months after childbirth.

Who Is Gold Microneedling Not Suitable For?

Gold microneedling cannot reach the SMAS level. This means that for significant jowl sagging, deep facial contour loss, or advanced facial sagging, gold microneedling will be insufficient. This mismatch in expectations is a frequent source of disappointment in my clinic. Gold microneedling increases dermal thickness, improves tissue tone/structure, but does not cause SMAS contraction. If sagging is the primary complaint, gold microneedling is not the primary treatment.

For detailed information on gold microneedling, you can read the gold microneedling radiofrequency guide page. For the basic mechanism of radiofrequency, the /sozluk/radyofrekans dictionary entry is useful.

4-Criterion Decision Matrix: Which Treatment Is Right For You?

In my clinical practice, I evaluate every patient based on four fundamental criteria. These criteria are complementary; looking at only one is misleading. The matrix below is distilled from my consultation notes over the last 8 years.

Criterion 1 — Problem Type: Sagging, Quality, or Both?

The answer to this question determines more than 50% of the treatment. During the initial examination with the patient, I ask three questions in front of a mirror:

1. "Does your face look better when you hold your chin up?" → If the answer is "yes," there is sagging, the primary target is HIFU.
2. "Does the surface of your skin (pores, texture, fine lines) bother you?" → If the answer is "yes," there is a quality issue, the primary target is Gold Microneedling.
3. "Do both bother you?" → If "yes," a layered protocol is needed (my Pillar A guide).

Criterion 2 — Age and Skin Condition

• 30s (preventive phase): Generally, laxity is minimal. Primary goal is to support collagen production and preserve dermis quality — gold microneedling light protocol or Profhilo. HIFU is too early at this age; the concept of "preventive HIFU" is marketing.
• 40s (early intervention): Laxity has begun but is still moderate. Both HIFU and gold microneedling may be candidates; the decision is made based on other criteria.
• 50s (peak intervention): SMAS laxity is prominent. HIFU is primary; gold microneedling is considered additionally for quality. A layered protocol is suitable for most patients.
• 60+ years: When structural changes deepen, HIFU may be insufficient. We recommend surgical consultation; gold microneedling can still be done additionally for quality.

Criterion 3 — Downtime Tolerance

HIFU's biggest advantage is its practical lack of downtime: after the session, the patient can apply makeup and go to work. Gold microneedling, however, causes visible redness, scabbing, and mild edema for 3-7 days. The patient's schedule (meetings, weddings, holidays) determines downtime tolerance. For a patient with an urgent social event, postponing Gold Microneedling until after the event is the correct clinical approach.

Criterion 4 — Expectation Type

• Lifting expectation: "I want my face to be lifted" → HIFU.
• Repair expectation: "I want my skin to be smoother, more even, fresher" → Gold Microneedling.
• Both: "I want both lifting and skin repair" → Layered protocol (HIFU → Gold Microneedling 4-6 weeks later).
• Only prevention: "I want to start young" → Gold microneedling light protocol + Profhilo optional for 30s.

Your Problem	Recommended Primary Treatment	Secondary Add-on
Cheek/jowl sagging, moderate-good skin quality	HIFU	—
Acne scars, pores, fine lines, low skin quality	Gold Microneedling (RFM)	—
Sagging + low skin quality (both)	HIFU → Gold Microneedling 4-6 weeks later	Pillar A (layered protocol)
Only preventive (skin protection, under 35)	Gold Microneedling light protocol	Profhilo optional
Advanced sagging (60+, very loose skin)	Surgical option evaluation	HIFU insufficient, gold microneedling for quality add-on
Only acne scars (no sagging)	Gold Microneedling	Subcision, TCA CROSS optional
Only brow ptosis (lower face normal)	HIFU upper face protocol	Botox brow lift optional

10-Dimension Comparison Table

The table below summarizes the key clinical differences between HIFU and Gold Microneedling across 10 dimensions. This table is a customized version of the reference chart I use during patient consultations.

Dimension	HIFU	Gold Microneedling (RFM)
1. Primary target layer	SMAS (4.5 mm), deep dermis (3.0 mm)	Reticular dermis (1.0–3.5 mm)
2. Energy type	Focused ultrasound	Bipolar radiofrequency (from needle tip)
3. Needle / skin contact	None (applied superficially)	Yes (microneedle penetrates skin)
4. Primary indication	Sagging, SMAS laxity	Skin quality, acne scars, lines, pores
5. Typical number of sessions	1 (annual repeat)	3-6 (4-6 weeks apart)
6. Session duration	45-90 min	45-75 min
7. Anesthesia	Topical cream only (sufficient for most patients)	Topical cream + sometimes block
8. Downtime	Practically none (mild redness, edema 1-2 days)	3-7 days (redness, microcrusts)
9. First visible result	4-6 weeks (collagen contraction)	2-4 weeks ("early glow")
10. Peak result	3-6 months	3-6 months

Each row of the table affects the clinical decision. For example, the downtime row might be critical for a parent (child's school schedule), while it might be insignificant for a retired patient. The needle/skin contact row might be decisive for patients with needle phobia; in that case, HIFU offers an advantage. Therefore, the table is not static information — it is a dynamic decision tool used with the patient, asking the question, "Which row is critical for you?"

Which Complaint → Which Treatment? (Decision Matrix)

A more practical view: primary/secondary treatment recommendations based on the patient's stated complaint. In my clinical practice, I proceed by mapping patient statements to this matrix.

Patient Statement	Primary	Secondary/Alternative
"My jowls are sagging"	HIFU (SMAS protocol)	Surgical consultation in advanced cases
"My cheeks are dropping"	HIFU mid-face	Filler for mid-face support optional
"I have acne scars"	Gold Microneedling (RFM)	Subcision, TCA CROSS, fractional laser
"My pores are too large"	Gold Microneedling	Continued topical retinoid
"My skin isn't bright, it's dull"	Gold Microneedling (light protocol)	Skinbooster, Profhilo
"My facial oval shape is distorted"	HIFU mid-face + jowl	Filler chin & jaw definition
"I have a double chin"	HIFU submental + (if present) cryolipolysis	Surgical liposuction
"Fine lines on my neck"	Gold Microneedling superficial protocol	Botox platysmal bands
"Neck sagging + bands"	HIFU + Botox platysma	Surgery in advanced cases
"I generally don't want to age"	30s: Gold microneedling preventive; 40+: evaluation	Skin longevity program (/skin-longevity/)

Recommendation by Age: 30s / 40s / 50s

Age alone is not a treatment selection criterion, but age-related changes in skin biology influence recommendations. The following framework is a general approach; individual results vary depending on the person, skin structure, genetic factors, and lifestyle.

30s (Preventive Phase)

In this age range, SMAS laxity has not yet begun; collagen production starts to decrease by ~1% annually (Sasaki, 2018). Primary goal: support collagen production, preserve dermis quality. Recommended: Gold microneedling light protocol (3.0 mm, low energy, 6-month to annual repeat), Profhilo or skinbooster optional. HIFU is unnecessary at this age; the "preventive HIFU" concept is a marketing slogan with weak scientific basis.

40s (Early Intervention)

The first signs of laxity begin to appear: slight jowl formation, deepening of NLF (naso-labial fold), "tired" facial expression. The decision matrix is applied individually based on the four criteria. In most cases, gold microneedling is considered for quality, and HIFU for sagging if necessary, in combination. In my clinical experience, the "layered protocol" is the most frequently recommended approach for this age group.

50s (Peak Intervention)

SMAS laxity becomes prominent, and skin elasticity loss can be objectively measured. HIFU gains primary indication in this age group. Gold microneedling is planned in combination for quality restoration. General rule: first HIFU, then gold microneedling 4-6 weeks later (layered protocol, Pillar A guide). Individual results vary; a special protocol is designed for each patient during clinical consultation.

60+ Years (Advanced / Surgical Limit)

In this age group, when structural changes deepen, the limits of non-invasive treatments become apparent. HIFU can be clinically effective but does not provide surgical-level results. It is essential to speak clearly with the patient: "HIFU would have been very effective for you 5-7 years ago; now it will be effective but not at a surgical level." This conversation correctly calibrates patient expectations and increases satisfaction.

"Which One Is Not Suitable for Me?" — Contraindications

HIFU Contraindications

• Pregnancy and breastfeeding period
• Active skin infection (herpes simplex, impetigo) in the treatment area
• Metallic implant in the treatment area (pacemaker, cochlear implant, jawbone plate/screw)
• Very advanced sagging (surgical candidate)
• Uncontrolled autoimmune disease
• Keloid tendency (in the treatment area)
• Active isotretinoin (Roaccutane) treatment within the last 6 months
• Very thin face, patient with dominant "skeletal" appearance — HIFU may reduce volume perceptually even if it doesn't cause fat ablation

Gold Microneedling (RFM) Contraindications

• Pregnancy and breastfeeding period
• Active acne, herpes, impetigo in the treatment area
• Active isotretinoin (last 6 months)
• Keloid / hypertrophic scar tendency
• Uncontrolled autoimmune disease or uncontrolled diabetes
• Metallic implant in the treatment area (pacemaker, defibrillator → absolute contraindication)
• Bleeding disorder, anticoagulant therapy (relative)
• Tattoo in the treatment area (ink may be affected by needles) — alternative area evaluated
• Fitzpatrick V-VI skin types with sub-standard parameters (PIH risk)

During clinical consultation, each patient's medical history, medication list, allergies, and previous aesthetic procedures are thoroughly questioned. "Being on the approved treatment list" does not mean it is safe; individual risk profile is always evaluated.

3 Case Scenarios in My Clinical Practice

The following three cases are presented to connect the theoretical framework in this guide with practical clinical decisions. Patient information has been anonymized.

The second case is a classic "layered protocol" candidate frequently encountered in clinical experience:

Case 2: 52 years old, female, retired teacher. Complaint: "My face looks tired, my jowls have become prominent, and my skin isn't like it used to be." Clinical evaluation: Prominent jowl, mid-face descent, deepened NLF; skin quality moderate-low, enlarged pores, fine lines. SMAS laxity present on pinch test. Decision: Classic layered protocol candidate. First HIFU (mid-face + jowl + submental), with a 4-6 week interval, then Gold Microneedling 3 sessions, 4-6 weeks apart. Objective improvement in both sagging and quality parameters was observed at the 6-month check-up. For details of this protocol, see my Pillar A guide.

Side-by-Side Price-Value Analysis (TTB-Safe Framework)

In Turkey, medical aesthetic pricing is framed by certain rules according to the Turkish Medical Association (TTB) and legislation; specific TL amounts are not shared within the guide. However, we can discuss the price-value relationship through the cost structure of the two treatments.

HIFU cost structure: Typically has a higher initial cost for a single session; however, since 1 session per year is sufficient, the total annual cost is predictable. SMAS-cartridge (device head) cost is reflected in the session price; there are significant brand premium differences between Ulthera/Doublo/Liftera.

Gold microneedling cost structure: A single session may be lower than HIFU, but the protocol requires 3-6 sessions. The total annual treatment cost can approach or exceed HIFU depending on the number of sessions. Needle cartridge (single-use) cost is reflected in the session price.

Layered protocol (HIFU + Gold Microneedling): Calculated as the total cost of the two treatments; however, the synergistic effect of the two treatments provides results across a wider range of indications compared to performing them individually. "Value" is not just the TL amount — it is the probability of achieving the desired outcome.

An individual plan is created during consultation; pricing varies according to the number of sessions, device type, and protocol complexity. The patient is given a written treatment plan, and all options are transparently shared from a financial and clinical perspective. You can refer to the /fiyatlar page for a general framework.

Is Device Selection Important? (Doublo, Ulthera, Genius RF, Sylfirm X)

A frequently heard question in marketing: "Doctor, which device do you use?" The device brand is important but not the sole determinant. The trio of device × protocol × experience each affects the outcome. Below is a brief comparison:

HIFU Devices

• Ulthera (Merz, USA): First FDA-approved HIFU. The "Original" reference. Transducers 1.5/3.0/4.5 mm.
• Doublo (Hironic, Korea): Leader in the Korean market; widespread use, reasonable cost.
• Liftera A2 (Classys, Korea): Common in Turkey; "Liftera lifting" brand is known.
• Ultraformer III (Classys): Has both MMFU (macro-focused) and superficial transducers; wide range of protocols.

Gold Microneedling (RFM) Devices

• Genius RF (Lutronic, Korea): Pin-by-pin energy control, "smart pulse" technology.
• Vivace (Aesthetics Biomedical, USA): 36 needles, LED integrated, popular US market.
• Sylfirm X (Viol, Korea): "Pulsed wave" and "continuous wave" dual mode, stands out with melasma indication.
• Secret RF (Cutera): One of the first generation RFM devices, extensive clinical data.
• Morpheus8 (InMode): Non-insulated category; technologically different; reaches deeper (4 mm) but is not insulated.

In clinical practice, using more than one device means being able to choose the most suitable technology for each patient's needs. Device discussion is meaningful for clinical decision, not for the customer. Dr. Hamza Gemici's clinic uses HIFU and RFM device inventory in a way that changes according to need; the claim that a single device is a "universal solution" is a false reduction.

7 Common Mistakes in Treatment Selection

In my 30+ years of medical aesthetic experience, the most common erroneous approaches I hear from patients are:

1. The "It worked for my friend, it will work for me too" fallacy. When skin structure, age, and problem type are different, the same treatment yields different results. A friend's result is not a reference for you, only a conversation starter.
2. The "More expensive = better" fallacy. Device brand determines price, but clinical results are determined by the formula of physician experience × protocol × patient selection. The highest-priced device may not be right for you.
3. The "Everything will be solved in one session" expectation. Clinical reality: most treatments require multiple sessions or, even if done in a single session, results develop gradually (3-6 months).
4. The "Let's do everything at once" approach. Under budget and time pressure, "HIFU + gold microneedling + filler in one day" is requested; this is not the correct clinical approach in terms of tissue healing and energy load. The layered protocol is planned with 4-6 week intervals.
5. The "If the internet says so, it's true" approach. "Before-and-after" visuals on social media often change with filters, lighting, and angles. Clinical decisions are based on examination, not visuals.
6. The "Price selection, not physician selection" mistake. The same device is applied in different clinics with different protocols and hygiene standards. Certification, experience, and approved institution information should be questioned.
7. The "I'm not happy with the result, let me do another treatment immediately" reflex. Post-treatment results are evaluated at least 3-6 months later. Early evaluation leads to wrong decisions; adding other treatments creates protocol complications.

Post-Treatment Care: Comparison for HIFU and Gold Microneedling

The post-treatment care protocol is an important parameter that distinguishes the two treatments. The practical absence of downtime after HIFU also lightens the post-treatment care burden. Gold microneedling requires a careful care regimen for 7-14 days.

After HIFU

• First 24 hours: Mild edema, sensation of heat is normal; cold application can be done.
• 1-7 days: Intense massage, sauna, Turkish bath, high-intensity exercise are not recommended.
• Sun protection: SPF 50+ continues.
• Makeup: Can be applied the same day or the next day.
• General: Normal social life continues without interruption.

After Gold Microneedling

• First 24 hours: Minimal contact with water; gentle cleansing with warm physiological saline.
• 2-3 days: Active ingredients (retinol, AHA/BHA, Vitamin C) are stopped; moisturizer + ceramide barrier support.
• 4-7 days: Microcrusts fall off naturally; never pick them off.
• Sun protection: SPF 50+ mandatory; avoid direct sun for at least 4 weeks.
• Makeup: Mineralized, non-comedogenic makeup after 48-72 hours.
• Monitoring during active phase: Report unexpected edema, pain, leakage to the clinic.

At Dr. Hamza Gemici's clinic, every patient is given a written post-treatment protocol. Adherence to the care protocol accounts for approximately 20-30% of the success of the result — meaning that even if the technique is perfect, lack of care can negatively affect the outcome.

Conclusion: When Is Combination Recommended?

At the end of this guide, let's return to the initial question: "HIFU or Gold Microneedling?" The answer varies according to the result of the four-criterion decision matrix:

• If your complaint is only sagging: HIFU.
• If your complaint is only skin quality: Gold Microneedling.
• If both bother you: Layered protocol — HIFU followed by Gold Microneedling 4-6 weeks later.
• If you want a preventive approach (30s): Gold Microneedling light protocol.
• If there is advanced age + advanced structural change: Plastic surgery consultation.

One of the common misconceptions I encounter is the idea that "the two treatments are alternatives to each other." The clinical reality is this: for most patients, the two treatments are complementary, not alternatives. If you have both sagging + quality complaints, both are planned; a layered facial rejuvenation strategy is formed. For detailed science and protocol planning of this approach, you can read the guide "HIFU + Gold Microneedling Combination: Layered Facial Rejuvenation" (Pillar A).

For a holistic framework of skin aging science, the Skin Longevity Guide is a useful reference. Additionally, the dictionary entries /sozluk/kolajen and /sozluk/fraksiyon support the conceptual background. For individual consultation, you can make an appointment via the /iletisim page or reach out via WhatsApp.

References

• Hantash BM, Ubeid AA, Chang H, Kafi R, Renton B. Bipolar fractional radiofrequency treatment induces neoelastogenesis and neocollagenesis. Lasers Surg Med. 2009;41(1):1-9.
• Suh DH, Lee SJ. Update on high-intensity focused ultrasound for facial rejuvenation. Dermatol Surg. 2017;43(Suppl 1):S106-S114.
• Bertossi D, Botti G, Gualdi A, et al. Effectiveness, longevity, and complications of facelift using high-intensity focused ultrasound. J Cosmet Dermatol. 2021;20(8):2398-2407.
• Park JY, Lee EG, Yoon MS, Lee HJ. Efficacy and safety of fractional microneedle radiofrequency device in the treatment of cutaneous laxity. Ann Dermatol. 2020;32(5):417-424.
• Sasaki GH. Quantification of human abdominal tissue tightening and contraction after fractional bipolar radiofrequency: clinical applications and a treatment selection algorithm. Aesthet Plast Surg. 2018;42(4):986-995.
• Calderhead RG, Goo BL, Lauro F, Gursoy D, Savant SS, Wronski A. The clinical efficacy of microneedle radiofrequency: a temperature-dependent insulated needle system. Lasers Med Sci. 2018;33(7):1495-1503.

About the Author

This guide was written by Dr. Hamza Gemici. Dr. Hamza Gemici is a graduate of Ondokuz Mayıs University Faculty of Medicine; he has 30+ years of medical aesthetic experience. He has thousands of case experiences in HIFU and gold microneedling protocols over the last eight years. ORCID ID: 0009-0007-8058-2774. For contact and consultation, you can reach him via the /iletisim page. My clinical philosophy: the most suitable treatment for the patient is not the popular one — it is the one that most appropriate fits the individual and their problem.