HIFU in Tokyo: devices, prices and English-speaking clinics

HIFU stands for high-intensity focused ultrasound. The handpiece focuses ultrasound energy at a set depth beneath the skin, typically 1.5 mm, 3.0 mm or 4.5 mm, heating tiny points of tissue so that the skin and the layer beneath it tighten as they heal. It is a non-surgical treatment with little or no downtime, used for sagging jawline and cheeks, under the chin and on the neck.

Ultherapy (Merz) is the original ultrasound lifting device. It shows the physician an ultrasound image of the tissue during treatment, which is the main reason it costs two to three times as much as other HIFU devices in Tokyo. Clinics in Japan often refer to it as Ulthera or ウルセラ. Most Tokyo clinics have Korean-made HIFU devices: ULTRAcel Zi and ULTRAcel Q+ (Jeisys), Ultraformer III (Classys), Doublo Gold and New Doublo (Hironic), Liftera and others. Sofwave is a different ultrasound technology (clinics list it as SUPERB) and is priced closer to Ultherapy.

Not every device has been approved under Japan's Pharmaceuticals and Medical Devices Act. Clinics are required to disclose when a device has been imported individually; Ledian Clinic, for example, notes this on its price list for ULTRAcel Zi. This is routine in Japanese aesthetic medicine, but you can ask the clinic what approval status applies to the device it uses.

HIFU prices listed on Tokyo clinic websites are typically per session and include Japan's 10% consumption tax. The cost depends on several factors, including the type of device used, the treatment area (full face, full face and under the chin, or face and neck), the number of shots or lines delivered, and whether the procedure is performed by a nurse or a doctor. Some clinics offer separate pricing depending on who performs the treatment, with doctor-administered procedures generally costing more. For example, Elm Clinic charges approximately ¥30,000 extra for its Doctor HIFU treatment, while Art Lounge Clinic charges an additional ¥100,000 for a fully customized HIFU treatment performed by a doctor.

Among the clinics in this guide, a standard full-face HIFU session ranges from ¥59,400 (Ledian Clinic, ULTRAcel Zi, 600 shots) to ¥199,600 (Art Lounge Clinic, New Doublo Premium plan). Full-face Ultherapy ranges from ¥252,560 (Matsurika Clinic, 348 shots) to ¥462,000 (Shirono Clinic, full face plus under the chin).

Extras to ask about: anesthetic cream is usually ¥3,300 and not included; some clinics charge a one-time initial consultation fee (¥3,300 at Rejuva and Art Lounge, ¥11,000 for an Ultherapy consultation at Matsurika); return-visit and multi-session prices are lower; and some clinics keep a separate, higher price list for patients who need an interpreter. Art Lounge Clinic states that Japanese and English speakers pay the standard prices and that only patients who need an interpreter pay separate prices.

"English OK" has different definitions at different clinics. At Omotesando Rejuva Medical Clinic, three doctors offer consultations in English. At Art Lounge Clinic, the director offers consultations in English but also performs treatments throughout the day, so book ahead and ask for an English consultation. Matsurika Clinic states "English available"; BIANCA Clinic says care in English is standard at its Tokyo clinic; KAI Clinic Tokyo and Ledian Clinic arrange English-speaking staff on request. Elm Clinic's English pages are machine-translated, and the clinic itself says its staff speak only Japanese.

• Which device will be used, and whether a doctor or a nurse will perform the treatment.
• How many shots or lines are included for the area you want, and what add-ons cost.
• Whether the quoted price includes tax, and whether anesthetic cream or a consultation fee is extra.
• Whether an English consultation is available on the day and at the time you book.
• Whether foreign-issued credit cards are accepted. Rejuva accepts credit cards, WeChat Pay and Alipay; Art Lounge accepts Visa, Mastercard, JCB, American Express, Diners Club, Discover and UnionPay.

Some HIFU menus are designed to reduce fat rather than tightening the skin: BIANCA Clinic lists a "Lipo HIFU" for the jawline and under the chin, and Kumiko Clinic lists a "Deep Shower" for reducing fat in the cheeks and double chin. If you want a lift without losing volume in your cheeks, say so at the consultation and ask the doctor how the depths and shot counts will be planned around the volume you have. Art Lounge Clinic describes planning each treatment around facial structure, fat volume and existing volume for this reason, and gives four to six months as the usual interval between sessions.