Sofwave™Frequently Asked Questions

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“Sofwave™” is a revolutionary ultrasound device that uses Synchronous Ultrasound Parallel BeamTM Technology SUPERB™ to deliver consistent facial tightening in ALL SKIN TYPES.  It is FDA approved to treat facial lines and wrinkles, lax skin of upper arms, lifting of brows, submentum, and neck tissue, for the treatment of acne scars, and for the improvement of the appearance of cellulite.  

Most patients report that the treatment is tolerable. During treatment, on occasion, you may feel a sharp burst of heat into the skin for one second as the energy is delivered, but there is no persistent pain or tenderness afterward. Most patients report a warm sensation on their skin as the ultrasound energy is delivered. Following treatment, you may feel a tightening sensation around the jawline, cheeks, or wherever Sofwave treatment was used. There is no need to apply special care to the skin and patients may resume their daily activities immediately post-treatment.

We will rarely apply numbing creams prior to treatment because you will likely not need it. Often, it simply increases procedure risks. Dr. Nandedkar and Jessica Beliveau PA-C are experts at minimizing pain or discomfort during all procedures. Both Dr. Nandedkar and Jessica Beliveau PA-C have had the treatment and know how to deliver the treatment with the least pain possible. 

The best way to understand the differences is to use the analogy of a bed with a frame, a box spring, mattress, mattress topper, sheets and bedspread. If the bed frame is falling and not able to support the bed, then rebuilding the frame is the best option. A facelift is like rebuilding the frame. It pulls the underlying support structures tight. It does not do anything for the box spring, the mattress, sheets or bed spread. Fillers add support when placed deeper in the skin. The hyaluronic acid in the filler is like “firming up a boxspring mattress.”  They help build collagen and add support to the deep dermis where Sofwave cannot penetrate. They support the lips and give volume, which Sofwave cannot do. Sofwave is like working on the mattress itself. Sofwave provides controlled heating of the mid dermis to make the cells lay down more collagen and elastin. Sofwave is like taking a mattress that has become soft over time and making it firm again. That’s why it is good for both facial laxity and cellulite. 

Skin Pen Microneedling works on the epidermis and upper dermis to smooth the skin and help reduce the appearance of fine lines, wrinkles, abnormal pigmentation and acne scars. It’s like replacing a soft mattress topper with a firmer mattress topper and replacing wrinkled sheets with crisply ironed ones on your bed. It doesn’t help the mattress or the box spring or the frame. It works only on the topper and sheets.  A peel works only on the bedspread. If you have dyspigmentation, pre-cancers and sun damage then Sofwave is not going to correct that for you. Chemical Peels will repair surface skin cells that have become damaged from the sun, but it will not fix the underlying structure. Only Sofwave, Fillers or a Facelift can do that. Microneedling is like a mattress topper and sheets so if the underlying structure is poor, the topper can only do so much to correct a sagging bed. Microneedling is really good in conjunction with Sofwave for acne scars. It takes numerous treatments but works well. Sometimes combining treatments is the best way to maximize results but you do NOT need everything. Some treatments will be beneficial and others may be overdoing it or worse, ineffective. We want you to look like a refreshed YOU! Dr. Nandedkar and Jessica Beliveau PA-C will guide you to the treatments that are best for your skin type, degree of sun damage and needs. Realistic expectations are essential.  

Yes. You can resume your normal activities immediately following your Sofwave

appointment. There is no bruising, and you can apply makeup immediately. Some patientsexperience mild redness or swelling that subsides within a few hours. However for some people following treatment, there may be some redness and/or swelling in the treatment areas that may last for a few hours, disappear and then return intermittently over the next few days; there should be no pain when the procedure is complete, while post-procedure discomfort, “tired feeling,” slight fever or tenderness is possible. This is all normal. 

Some people say they see initial improvement immediately and then it seems to subside around day 4. This is normal and expected because the heated tissue under the skin is weakest around day 3-4 as collagen is remodeling. A fine collagen mesh is forming and remodeling, but the real structural collagen fibers have not yet formed. Some people say they see results within one week, but this is not the norm. The norm is that gradually over the next 10-12 weeks, your skin naturally produces new structural collagen, elastin, and re-forms more durable hyaluronic acid between the fibers in the mid-dermis. While clinical studies show results can last up to a year or more, we know from seeing results that most people will need at least two treatments spaced 3-6 months apart. The first treatment should be the most intensive and extensive then the second treatment should focus on the areas of need such as nasolabial folds or jawline or neck. Our trusted team of board-certified providers will guide you. 

We recommend that you eat the rainbow every day! Lots of antioxidant fruits like blueberries, oranges and tomatoes, coupled with vegetables like red cabbage, white cabbage, broccoli, cauliflower, greens, and butternut squash or sweet potato help heal tissue. You can’t find those good antioxidants in a pill. We also recommend muscle work in the treated area. Sofwave cannot correct underlying structural deficiencies, but you may make a difference with muscle work. Strength and conditioning training are proven to reduce laxity and the appearance of cellulite on the surface of the skin. We will show you exercises to help strengthen the tissue under the dermis, which is like tightening the bed frame. Muscle work three times a week with an antioxidant diet may help. 

The first treatment covers the most surface area, so it is the most expensive but the second or third treatment is usually much less expensive. You will be in maintenance treatment mode. To give perspective, a maintenance treatment is roughly the cost of two syringes of filler and lasts as long but treats different parts of the dermis. Fillers provide volume replacement and Sofwave smooths and tightens the surface appearance. Together they are like a padded bra.  Both of those are significantly less expensive than a facelift, which can cost anywhere from 50 to 100 thousand dollars, and provide a more natural look. Our treatments are more subtle and give a soft appearance. Again, the goal is to simply create a refreshed you. If that is what you are looking for then we are the right place for you. If you are looking for a different you, then Sofwave is not the right treatment for you. 

Sofwave™ is a non-invasive treatment for skin tightening. Clinical trials submitted to the FDA for approval of the device have shown the technology to be effective and safe in the right hands. It is designed to be used by board-certified providers trained in the technology and who have had extensive experience in other technologies such as lasers, microneedling, fillers, neurotoxins and peels. We integrated Sofwave into our practice because it has an exceptional safety profile. Indeed, both of our board-certified providers have had the treatment. Sofwave utilizes an integrated cooling mechanism called Sofcool™. This ensures the uppermost skin layer is protected from burning while the ultrasound energy heats the underlying tissue. There is real-time skin temperature monitoring with controlled heating but no damage to underlying structures and no fat loss. Sofwave works directly on the mid dermal collagen, forcing hyaluronic acid and elastin deposition to give “lift” to the face or to smooth cellulite dimpling. There were no device-related adverse events reported in multi-center clinical studies. Some patients experience mild redness or swelling that subsides within a few hours. However for some people following treatment, there may be some redness and/or swelling in the treatment areas that may last for a few hours, disappear and then come intermittently over the next few days; there should be no pain when the procedure is complete, while post-procedure discomfort, “tired feeling,” slight fever or tenderness is possible. This is all normal. In the multi-center clinical studies submitted to the FDA, no device-related adverse events were reported. Indeed, none of the patients experienced persistent pain or tenderness that would delay a return to normal activities. 

The Sofwave treatment protocol typically calls for 1-2 treatments, depending on the patient’s skin condition. However, we feel that realistically 1 initial treatment followed by one to two “touch up” treatments over 1-2 years will be more in line with our patients needs. Most of our patients who want Sofwave are 50-70 years old. The Sofwave studies were done in ages 22-65. The results were impressive. However, as medical providers with over twenty years of collective experience, we know that older skin is less likely to rejuvenate on a time schedule dictated by protocols designed for younger age groups. Also, there is not a “one size fits all” approach to skin rejuvenation. Therefore, factors such as degree of sun damage, degree of laxity, previous filler use, current GLP-1 induced active progressive weight loss all play a role in success with Sofwave. We will use a set “treat to total energy protocol” that has been well studied by Sofwave to ensure that we give consistent treatments.  

The good news is Sofwave™ is designed to minimize downtime and optimize patient convenience so you will see slow and steady results over 12 weeks, and no one will know you had a treatment. Also, because no penetration of the skin is required you will heal gradually and naturally under the surface skin. However, be advised that although you may see great results in one treatment, more than one will likely be needed to ensure all the vectors that pull our face down or cause cellulite to dimple will be treated.  

Because the Sofwave time slot is so long, we will respectively request a 50% non-refundable deposit to book your appointment. We usually do the initial treatment on Fridays and touchups are usually done on Thursdays. There is a charge for touch ups, which should be done several months after the initial treatment. 

We would like to see you at one month, 3 months and 6 months after your treatment. We will take pictures and review your progress. Please call us if you have any adverse effects before these times. We have described what to expect in FAQs so anything beyond redness for 1-4 days, 1-2 days of tiredness, slight fever day of procedure or a tight feeling we must be informed. We want you to have great results and want you to be happy you had the procedure. If you have had a true adverse effect, we will report it to both Sofwave and the FDA via their MedWatch Program