Open-label, Prospective Evaluation of the Ulthera® System for Lifting Submental (Under the Chin) and Neck Tissue in Chinese Patients

Inclusion criteria

• Both parents of full Chinese decent.
• Mild to moderate skin laxity of the submental (under the chin) and neck tissue as determined by the physician and trained assessors.
• Adequate menton area to allow for quantitative analysis, as confirmed by photography images.
• Willingness and ability to comply with protocol requirements, including returning for follow-up visit and abstaining from any other procedures in the areas to be treated through the follow-up period.
• Subjects of childbearing potential must have a negative urine pregnancy test result and must not be lactating at the Screening Visit and be willing and able to use an acceptable method of birth control (e.g. barrier methods used with a spermicidal agent, hormonal methods, IUD, surgical sterilization, abstinence) during the study. Women will not be considered of childbearing potential if one of the following conditions is documented on the medical history:

• Postmenopausal with last menstrual bleeding at least 12 months prior to study; and
• Without a uterus and/or both ovaries.
• Willing to take 600mg Ibuprofen as pre-treatment medication, at least 60 minutes but not more than two hours prior to study treatment.
• Willingness and ability to provide written consent for study-required photography and adherence to photography procedures (i.e., removal of jewelry and makeup).
• Willingness and ability to provide written informed consent prior to performance of any study-related procedure.

Exclusion criteria

• Presence of an active systemic or local skin disease that may affect wound healing.
• Presence of any hemorrhagic disorder or hemostatic dysfunction, herpes simplex, diabetes, epilepsy, bell's palsy or any physical or psychological condition that is deemed unacceptable by the investigator for participation in this study.
• Severe solar elastosis.
• Excessive subcutaneous fat in the area(s) to be treated.
• Excessive skin laxity on the area(s) to be treated.
• Significant scarring in the area(s) to be treated that would interfere with assessing results.
• Open wounds or lesions in the area(s) to be treated.
• Severe or cystic acne on the area(s) to be treated.
• Active implants (e.g., pacemakers or defibrillators), or metallic implants in the treatment areas (dental implants not included.)
• Inability to understand the protocol or to give informed consent.
• Allergy or sensitivity to pre-treatment medication (ibuprofen).
• Microdermabrasion, or prescription level glycolic acid treatment to the treatment area(s) within four weeks prior to study participation or during the study.
• Marked asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, or thick sebaceous skin in the area(s) to be treated.
• BMI greater than or equal to 30.
• History of chronic drug or alcohol abuse.
• More than 2-3 doses of any NSAID in any 2-week period prior to and throughout study.
• History of autoimmune disease.
• Concurrent therapy that, in the investigator's opinion, would interfere with the evaluation of the safety or efficacy of the study device.
• Subjects who anticipate the need for inpatient surgery or overnight hospitalization during the study.
• Subjects who, in the investigator's opinion, have a history of poor cooperation, noncompliance with medical treatment, or unreliability.
• Concurrent enrollment or enrollment in any study involving the use of investigational devices or drugs within the past three months.
• Current smoker as defined by

• Having smoked one or more cigarettes per day on a daily basis within the past year; or
• Smoke cessation within the past 6 months.
• Current user of any nicotine-containing products, e.g., e-cigarettes, Nicorette gum, nicotine patches, etc.
• History of the following cosmetic treatments in the area(s) to be treated:

• Skin tightening procedure within the past year;
• Injectable filler of any type within the past: i) 9 months for Hyaluronic acid fillers (e.g. Restylane); ii) 24 months for Ca Hydroxyapatite fillers (e.g. Radiesse); iii) 12 months for Long-lasting Hyaluronic acid (Juvéderm Voluma); iv) 24 months for Poly-L-Lactic acid fillers (e.g. Sculptra); v) Ever for permanent fillers (e.g. Silicone, Artecoll)
• Neurotoxins within the past three months;
• Ablative resurfacing laser treatment;
• Nonablative, rejuvenative laser or light treatment within the past six months;
• Surgical dermabrasion or deep facial peels;
• Facelifts within the past year; or
• Any history of contour threads.
• History (in the prior year) or current use of the following prescription medications:

• Accutane or other systemic retinoids within the past six months;
• Topical Retinoids within the past two weeks;
• Antiplatelet agents/Anticoagulants (Coumadin, Heparin, Plavix);
• Psychiatric drugs that in the investigators opinion would impair the subject from understanding the protocol requirements or understanding and signing the informed consent.