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2.05: Comparison of Portable Ultrasound Devices

First, a brief conflict of interest statement

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As of January 2024, the primary portable devices approved for use in the USA and Canada, which also possess a frequency high enough to effectively resolve facial anatomy for aesthetic practice, are as follows:

Clarius L20

Clarius L20

  • Frequency Range - 8-20 MHz
  • Max Penetration Depth - 4 cm
  • Wight - 290 g
  • Footprint Size - 2.2 cm
  • Cost -approx. $6000 USD**
Recommended*
Clarius L15

Clarius L15

  • Frequency Range - 5-15 MHz
  • Max Penetration Depth - 7 cm
  • Wight - 290 g
  • Footprint Size - 5 cm
  • Cost -approx. $4000 USD**
Recommended*
Philips Lumify L12-4

Philips Lumify L12-4

  • Frequency Range - 4-12 MHz
  • Max Penetration Depth - 12 cm
  • Wight - 136 g
  • Footprint Size - 3.5 cm
  • Cost -approx. $5000 USD**
GE VScan Air SL

GE VScan Air SL

Linear Array (Also comes with Phase Array)
  • Frequency Range - 3-12 MHz
  • Max Penetration Depth - 8 cm
  • Wight - 218 g
  • Footprint Size - 2.2 cm
  • Cost -approx. $5000 USD**

*Learn the Face recommends the Clarius L20 for its specific design catering to aesthetic practices. No other portable device is designed specifically with this in mind. This device also boasts the highest frequency among portable devices which allows for the highest resolution of facial anatomy possible in a mobile scanner.

Additionally, the Clarius L15 is advised due to its combination of high-frequency range paired with its cost-effectiveness.

It’s important to note that while all these portable devices listed can image facial anatomy, the Clarius L20 is capable of discerning finer structures that may not be visible with other devices, including the Clarius L15.

**The prices listed were sourced directly from quotations provided by Clarius, Phillips, and GE. It’s important to note that these prices are subject to change over time and may vary when purchasing from third-party sellers. Additionally, refurbished or used devices can sometimes be found at a discounted rate compared to the quoted prices.

Recommendations from Learn the Face Education for purchasing

Recommendations from Learn the Face Education for purchasing: Audio automatically transcribed by Sonix

Recommendations from Learn the Face Education for purchasing: this m4a audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

All right. So I have been asked, not infrequently, to give my personal opinion on which probe is best to buy for a medical aesthetics practice. So here I'm going to give you my opinion and take that as you will.

Before I do so, however, there's two things I want to preface this by: One being that is very challenging to give advice in terms of which probe you should buy without knowing the specifics of what you're trying to achieve for your clinic when introducing this technology. So you need to think about what you're trying to achieve, and for the most part, that will guide you towards which device you should buy. The second thing I want to preface this by is a conflict of interest statement. As of the time of recording this talk in January of 2024, I have received no compensation, nor have any relationship with any medical device manufacturer or anyone that manufactures an ultrasound machine or device. So I have no conflict of interests. You're getting my opinion solely based on my experience using all these different types of ultrasound machines at the bedside.

Okay, so the first thing that's worthwhile looking at is, is a non-portable or portable device best for your clinic. Now I think for the vast majority of medical aesthetics clinics, a portable device is going to be the most cost effective way to go when introducing this technology to your practice. The clinics or clinicians that may want to consider a non-portable device will generally have the following goals:

One, you're going to be potentially interested in using this technology to create images that you're going to publish, or you're interested in actually doing research with the ultrasound machine. The reason why you may want a non-portable device if you're interested in such goals, is that generally a non-portable device will create a higher-quality image, compared to what is available with a portable device. And this is assuming you acquire the correct probe for non-portable device. So for non-portable devices you buy the machine, and then you have a whole host of different probes you can attach to it. So, a lot of it's going to come down to which probes you buy as well. The second reason why you may want a non-portable machine is that in your clinical practice, you are interested in imaging structures beyond superficial anatomy of the face. So you're looking elsewhere over the body with ultrasound, and you may be imaging structures which are deeper and don't require the high resolution that facial ultrasonography requires. To do that, you will need some other different types of probes, and having a non-portable device as mentioned previously, allows you to swap in and out different probes with greater ease, and once you once you start acquiring a whole bunch of different types of probes, the cost benefits of having a portable device no longer makes sense, and the reason for that is that a portable device doesn't allow you to swap in and out different probes very easily. The exception with this being the GE probe, which allows you to switch between a phase array and a linear probe. But even then, you only have those two options. So if you're looking at acquiring more than, say, two probes for your ultrasound machine, a non-portable device is likely to save you some money.

Now, most aesthetics clinics are not going to fall into this category, so if you don't have those specific goals, my recommendation would be a portable ultrasound device. And really, the introduction of these portable ultrasound devices has allowed this technology to be accessible and to make sense within aesthetic practices. Regardless of portable versus non-portable device, I just want to reiterate one more time, we've said this several times in this course, but the bare minimum requirements for any ultrasound machine is that you have the ability to have a linear probe, and you can generate high frequency. So you need a probe that can ideally has a range of between 15 to 20MHz, with a bare minimum being 12MHz. Regardless of what type of machine you buy, if it is not a linear probe and generates below 12MHz, then you just aren't going to have the resolution to image the face with any utility.

So let's consider portable devices now. So, in my opinion, the best all-around performing device when we factor in cost is the Clarius L15. The L15 probe is going to be likely the most cost-effective probe you will find on the market. That's certainly the case as of the time of recording this talk, and it also has the ability to generate up to 15MHz. It should be noted when comparing the two clarius devices; So there's the higher end Clarius L20, which generates up to 20MHz, versus the L15 probe, which I mentioned previously - when you image beyond two centimeters of depth, the actual frequency being used by these probes automatically adjusts as you go deeper, and so the frequency will be the same for the most part beyond two centimeters. So that means the resolution of the image that you're acquiring between the L15 and the L20 is essentially going to be the same beyond two centimeters. Now, with that said, many structures in the face that you are imaging are going to be superficial and under two centimeters of depth, and in that case, the L20 will allow you to visualize anatomical structures that the L15 may not be able to see specifically small vasculature. But outside of this, the L15 performs very well for facial anatomy, and in fact, this was the probe I first acquired when I was learning how to do facial ultrasonography.

The biggest downside to the L15 is its large footprint, which can make imaging around the lips and the nose somewhat more challenging. The L15, sorry, the L20. The L20 has a smaller footprint, which will allow you to image around the lips and the nose and smaller structures of the face with greater ease, and I elaborated upon this in our footprint specific talk within this course. So if you haven't seen that already, go take a look.

When considering the Clarius devices. One downside that they have is the weight. Now, these are the heaviest probes that you're going to find out of all our recommendations. And the reason why weight may matter for you, is your dexterity, so your ability to manipulate the probe on the face becomes a little bit more challenging as the probe gets heavier. If you are used to using non-portable ultrasound devices with their wired probes, which are, you know, quite light, usually they're about 100g. The Clarius probes are more than two times as heavy, so it takes a little bit of adjustment to your ergonomics when using the Clarius probe if you're used to the other the other lighter weight probes. That said, for me personally, I got used to the heavier weight. You know, after a couple of days of imaging, it doesn't really impact how I use the device. I am obviously a man. I have larger hands. When teaching a female clinicians who have just their physically smaller in terms of their hand size, they have, they have often complained a little bit more about the weight. I think it has a bigger impact if you just have a smaller hand. So something to consider.

The benefits of the Clarius L20 device is that it also has been designed specifically for medical aesthetic use, which is, as far as I'm aware, it's the only portable ultrasound probe which has been specifically developed with medical aesthetics in mind. It has some extra settings and features which can be handy, but are by no means essential for acquiring good facial anatomy images.

The other benefit of the portable devices is that they are generally wireless, with the exception of the Philips Lumify device. So the Clarius and GE devices, they connect via Wi-Fi to a tablet or a cell phone, a smartphone, and they integrate easily with both Android and the iOS, so the Apple operating system on these devices. The Philips device is portable, but it plugs in with a physical cable into a tablet, essentially into the charging port. So you still have that physical connection between the screen and the probe itself. Now at Learn the Face, myself and our instructors use both the Clarius L15 and L20 in our practice daily. We tend to use both these probes for specific purposes, and generally we use a smaller footprint probe, so the L 20 when we are screening for facial anatomy, or if we are imaging around the lips and the nose and the chin, so smaller anatomical structures, or if someone just physically has a smaller face, the smaller footprint is handy on the L20 we generally reach for the L15 when we are doing ultrasound guided injections, and the reason being is the larger footprint allows us to more easily visualize our needle entering through the skin and then going towards the target that we are looking to inject in. So having the ability to image more of the face all at once, with the larger footprint on the L15 tends to be useful for injecting under ultrasound.

With all that said, the L15 and L20 in our experience can get the job done very well. Like I said previously, I started learning on the L15 and then acquired the L20 later on. There are times in my own clinical practice when the ultrasound machine may be being used by another clinician in the clinic, and I only have one available. So it's the L15 and the L20 is being used - I'll reach for whatever is available. You can you can achieve the goals you want to achieve with either probe. Having more than one is somewhat of a luxury, but it is nice to have in terms of being able to image certain areas of the face with greater ease and so on, but it's it's not necessary.

If you're looking for a portable option, in my opinion, as a bottom line, I think you would likely be happy with both the Clarius L15 or L20.

Let me take a moment just to mention some of the other devices which do have the ability to image the face and are portable. So one of the devices that I used early on as well was the Philips Lumify 12-4. In my experience with using the Philips Lumify, the images acquired by it are visibly fuzzier, part of this is likely due to the lower frequency, and when I say visibly fuzzier, visibly fuzzier when compared to the Clarius L15 and L20, and this is specifically true for the Philips Lumify device when imaging anatomy under two centimetres. The footprint on the Phillips Lumify device is also larger, so you run into the same struggles that you can find you have with the L15 device. The one area where I found the Phillips Lumify device really shined nicely was when using Doppler mode. For whatever reason, the Doppler mode seemed to be a little bit more visually superior then the Clarius device, specifically the Clarius L15. But the visual differences between the Clarius Doppler mode and the Philips Lumify Doppler mode was pretty small. We're splitting hairs here, but if I was to say one area where the Philips Lumify device seemed to perform more optimally compared to the Clarius device, it was the Doppler mode.

So if ultimately in your clinical practice, you're looking at introducing ultrasound because you want to be able to screen for the major arteries of the face and potentially have this technology available if a complication occurs, the Philips Lumify definitely can - you can definitely visualize the major facial arteries with this device, and the Clarius, both L15 and L20 certainly have the ability to offer you this advantage, they can definitely visualize those major arteries and the significant anatomy of the face with ease, if you know what you're looking for and know how to position the probe.

One of the things to keep in mind, and this is aside from the actual ultrasound probes themselves, is the portable device, oo the tablet computer, that you will be using for acquiring these images. You will see significant performance differences between tablet computers. In my clinical practice, I use the latest generation iPad. And if you use an earlier generation iPad, so as of recording this talk it's 2024, if I use an iPad, say, from the year 2020, you will notice visible lag when using both the Philips Lumify or the Clarius device. And that's because of the processing capacity of the tablet. And when there's visible lag, it's quite frustrating, it's quite frustrating, and I'd say it's almost impossible to inject under ultrasound guidance if there is any lag. So you want to acquire a tablet computer, which is of the most recent generation - that has the most processing power for you have real time imaging without any lag. And that has nothing to do with the probe itself. You have to remember that the probe is sending out the ultrasound waves, and then it is picking them back up when they echo back. But the information ultimately has to be processed by a computer. So the images that you acquire is going to be, to a large extent, also dependent on the computer processing capacity. So when thinking about acquiring an ultrasound device, think about also factoring in the cost of a new generation tablet computer. One other thing I will mention is yes, you can technically use a smartphone for any of these portable devices. I personally would not recommend it. The reason being is that all your settings and how you set up your probe is controlled by touch screen and when using a small phone and you're also manipulating a probe on someone's face, the ergonomics of that is a little bit awkward. And it's also nice just to have a physically larger image on your screen to look at. So definitely, I would recommend getting a tablet computer, and not to rely upon a cell phone for your main computing capacity when using these portable devices in your clinic.

All right, so there you have it - my advice. So for the vast majority of clinics, I would look at getting the L15, and if you want to acquire the best possible images that you can acquire with a portable device, then the Clarius L20 would be where I would invest my money.

And then you may find that you can get good deals on used devices and also from third party sellers. So if you can acquire one of the non-Clarius portable devices, say the Philips Lumify or the GE VScan, and you are looking at just having a device around that can visualize the major anatomy and improve the safety in your clinic. Those other devices certainly can also get you to where you want to go.

So there you have it - my recommendations. If you have any questions, please do leave a comment down below and we would be happy to get back to you.

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