Advances in Energy-based Nonsurgical Tissue Lifting:  Historical Perspectives, Practical Applications, and Clinical Pearls
Release Date: December 15, 2014
Last Reviewed:  November 24, 2014
Expiration Date: December 15, 2017
Time to Complete Activity:   2.0 hours

*This activity expired for credit on December 15, 2017 and is no longer available for credit

This activity is provided by Paradigm Medical Communications, LLC.          
Sabrina G. Fabi, MD, FAAD, FAACS
Volunteer Assistant Clinical Professor
Department of Medicine/Dermatology
University of California, San Diego
Goldman Butterwick Fitzpatrick Groff and Fabi Cosmetic Laser Dermatology
San Diego, CA
Julius W. Few Jr, MD
Director, The Few Institute for Aesthetic Plastic Surgery
Clinical Professor, The University of Chicago
Clinician, Northwestern University
Chicago, IL
Target Audience
This activity has been designed to address the educational needs of dermatologists, dermatologic surgeons, plastic surgeons, facial plastic surgeons, nurse practitioners, physician assistants, and other healthcare providers who are involved in aesthetic medicine.
Statement of Need
The armamentarium for facilitating a younger and healthier appearance continues to grow. Historically limited to surgical interventions, more recent approaches have focused on interventions that afford short-duration enhancements to specific facial targets—such as through injectable soft tissue fillers and neuromodulators. Additionally, lasers and radiofrequency technologies facilitate collagen remodeling, ultimately effecting tissue tightening, and can also address problems with skin irregularities or scarring to afford longer-duration benefits. New devices using micro-focused ultrasonic (MFUS) energy are able to penetrate the deep skin and foundational layers, providing both lifting and tightening, with benefits persisting for long durations—of more than a few years. Each energy-based approach has a unique set of indications, benefits, and drawbacks. This program will educate participants about energy-based tissue lifting techniques, where they “fit” within the rejuvenation continuum, and how to select appropriate patients.
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Describe the causes, processes, and sites of skin and tissue laxity in the face, neck, and upper body, as well as other hard-to-treat areas.
  • Differentiate nonsurgical energy-based approaches for tissue lifting based on their mechanism of action, efficacy, and safety.
  • Identify specific patient factors and characteristics that influence treatment selection.
Accreditation Statement
Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation Statement
Paradigm Medical Communications, LLC designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician Assistant Continuing Education
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 2.0 hours of Category 1 credit for completing this program.
Nurse Practitioner Continuing Education
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.
Disclosure of Commercial Support
This activity is supported by an educational grant from Ulthera, Inc.
Instructions for Participation
To receive a CME certificate of participation, participants should:
  • Follow instructions to register or log in with your professional information and complete the pretest
  • View the online activity in its entirety.
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit. You will have unlimited opportunities to successfully complete the posttest.
  • A certificate of participation willbe available for download/printing immediately following your successful completion of the posttest and evaluation.
There is no fee required for participation in this activity.

Hardware/Software Requirements
This certified CME activity is designed as a self-running Flash presentation. In the event that you need this plug-in, a link to download the required Flash Player has been provided below.
Flash Player 10 or later required–download at
For your convenience, a control bar is located at the bottom of the screen that provides buttons to move forward and backward through the deck. 
Supported Browsers:
For Windows: Internet Explorer 7 or higher, Firefox 4.0, Safari 3, Google Chrome, Opera 9.5
For Mac: Safari 3, Firefox 4.0, Google Chrome
Linux: Firefox 4.0
Technical Support: If you have any technical problems or playback issues, please click on the Technical Support button on the left of the screen or call 845-398-5100.
In accordance with Accreditation Council for Continuing Medical Education requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below.
Steering Committee
Sabrina G. Fabi, MD, FAAD, FAACS
Grant/Research Support: Allergan Inc; Kythera Biopharmaceuticals, Inc; Revance Therapeutics, Inc; Ulthera, Inc
Consultant: Allergan Inc; Biopelle, Inc; Lumenis; Ulthera, Inc; Valeant Pharmaceuticals International Inc.
Speakers Bureau: Allergan Inc; Biopelle Inc; Lumenis; Medicis Pharmaceutical Corp; Ulthera, Inc; Valeant Pharmaceuticals International Inc; Zeltiq Aesthetics, Inc
Julius W. Few Jr, MD, FACS
Retained Consultant: Allergan, Inc; Medicis Pharmaceutical Corp; Ulthera, Inc
William P. Werschler, MD,FAAD, FAACS
Advisory Board: Allergan, Inc; Dermik Laboratories; Johnson & Johnson Services, Inc; Merz Aesthetics, Inc; Pacific Bioscience Laboratories, Inc; Suneva Medical, Inc
Consultant: Allergan, Inc; Dermik Laboratories; Fibrocell Science, Inc; Nordson Micromedics; Pacific Bioscience Laboratories, Inc; SkinMedica; Ulthera, Inc
Grant/Research Support: Allergan, Inc; Amgen, Inc; Dermik Laboratories; Galderma Laboratories; Genentech, Inc; Johnson & Johnson Services, Inc
Honoraria: Allergan, Inc; Dermik Laboratories; Johnson & Johnson Services, Inc; Medicis Pharmaceutical Corp; Merz Aesthetics, Inc; SkinMedica
Ownership Interest: Allergan, Inc; Medicis Pharmaceutical Corp
Speakers Bureau: Allergan, Inc; Cynosure, Inc; Dermik Laboratories; Johnson & Johnson Services, Inc; LEO Pharma, Inc;Medicis Pharmaceutical Corp; Merz Aesthetics, Inc; SkinMedica; Valeant Pharmaceuticals International, Inc
Paradigm Medical Communications, LLC staff members have no financial conflicts to disclose.
Independent peer reviewer has no financial conflicts to disclose.
Resolution of Conflict of Interest
Paradigm Medical Communications, LLC has implemented a system to resolve conflicts of interest for each CME activity to help ensure content objectivity, independence, fair balance, and that the content is aligned with the interest of the public. Conflicts, if any, are resolved through one or more processes. All CME content in this activity was independently reviewed to ensure that it is free of commercial bias, scientifically rigorous, aligned with the public interest, and compliant with all regulatory guidance and the ACCME’s Standards for Commercial Support of Continuing Medical Education.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA.
This CME activity represents the views and opinions of the individual faculty, and does not constitute the opinion or endorsement of, or promotion by, Paradigm Medical Communications, LLC.  Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.
Signed statements of informed consent granting permission for publication have been obtained for all photographs and videos in which an individual can be identified.
Terms of Use and Privacy Policy
The materials provided for this activity are for informational purposes only, and should not be used for diagnosis or treatment of a health problem without consulting a licensed medical professional. Any views or opinions presented are solely those of the Faculty, and do not necessarily represent those of Paradigm Medical Communications, LLC. References to any entity, product, service, or source of information on this website should not be considered an endorsement, either direct or implied, by Paradigm. Paradigm accepts no liability for the content referenced in this activity.
Privacy policy
Paradigm iscommitted to protecting the privacy of those who participate in the activities (herein referred to as "website") located at The information below describes the security of the website for safeguarding personal information and the rationale for collection and use of personal information.
Security/safeguarding personal information
This website has physical and procedural safeguards in place to prevent unauthorized access to personal information used to access this website.
Collection and use of your personal information
The submission of certain personally identifiable information is necessary to award and track the credits participants may earn after completing the program. Required items include first name, last name, degree, and email address. These items are necessary. Participants are also required to complete an evaluation of the CME activity. All evaluative information submitted is collected and retained, and used by Paradigm to continuously improve the learning experience.
Paradigm Medical Communications, LLC does not transfer, sell, or share personal information with outside parties. Paradigm will not otherwise disclose personal information unless required to in a legal process. Paradigm staff members review individual test results to the extent necessary to record and track participants’ credits.
Contact Us
If you have any questions or comments, please email us at
© 2014 Paradigm Medical Communications, LLC, except where noted. Content may not be reproduced in whole or part without the express written permission of Paradigm Medical Communications, LLC.