Evaluation of Facial and Neck Skin Laxity With SofWave Treatment in Adults Initiating Tirzepatide for Weight Loss

1. Healthy female subjects between the ages 30-50.

2. Eligible to start on Tirzepatide treatment for weight loss.

3. Non-diabetic.

4. BMI>30.

5. Non-Smoker.

6. Desire to lift facial and neck skin laxity, and/or desire to lift the eyebrow area and/or improve facial wrinkles.

7. Able and willing to comply with all visits, treatments and evaluation schedules and requirements.

8. Able to understand and provide written Informed Consent.

9. Women of child-bearing age are required to be using a reliable method of birth control at least 3 months prior to study enrollment.

10. Subject agrees not to undergo any other facial cosmetic treatment during the study course.

1. Pregnant or planning to become pregnant, having given birth less than 3 months ago, and/or breast feeding.

2. BMI < 30

3. Currently a smoker or has a history of heavy smoking (25 cigarettes per day or more) in the past 10 years.

4. Melanoma, active non-cutaneous malignancy, or history of non-cutaneous malignancy in the past 5 years.

5. History of any other non-melanoma skin cancers in the past 5 years within the treatment area (head and neck).

6. Previous chemotherapy treatments.

7. Suffering from significant concurrent illness, such as cardiac disorders, diabetes (type I or II), lupus, porphyria, or pertinent neurological disorders (i.e. any disease state that in the opinion of the investigator may interfere with the anesthesia, treatment, or the healing process).

8. History of chronic drug or alcohol abuse.

9. History of epileptic seizures.

10. History of immunosuppression/immune deficiency disorders (including HIV infection or AIDS) or currently using immunosuppressive medications.

11. Suffering from hormonal imbalance, whether related to thyroid, pituitary, or androgens.

12. History of significant lymphatic drainage problems within the facial areas.

13. History of epidermal or dermal disorders (particularly involving collagen or microvascularity), including collagen deposition disorders, vascular disease, scleroderma, or vasculitic disorders.

14. Medical disorder that may hinder the wound healing or immune response (such as blood disorder, inflammatory disease, etc.)

15. Known allergy to Lidocaine, Tetracaine, Xylocaine, Epinephrine or antibiotics.

16. Taking Isotretinoin or other oral retinoid within the past 6 months; taking anti-platelet or anti-coagulant within the past 2 weeks.

17. Severe solar elastosis in the intended to treat area.

18. Tattoo or former tattoo at or near treatment area.

19. Tendency for melasma.

20. Significant scarring, atrophic scars in the area to be treated, or has a history of atrophic scars or keloids or prone to bruising.

21. Surgical or traumatic scar in the intended to treat area.

22. Presence of a metal stent or implant in the facial area (e.g. braces; dental implants are not excluded).

23. History of cosmetic treatments in the facial area to be treated, including facial skin-tightening procedure within the past 6 months; injectable (Botox or fillers) of any type within the past 6 months; ablative or non-ablative resurfacing/rejuvenation laser treatment or light treatment within the past 6 months, dermabrasion or deep facial peels within the past 12 months; facelift, blepharoplasty, or brow lift (including contour threads) within the past 12 months.

24. Presence of any active systemic or local infections.

25. Severe or cystic facial acne, and/or Accutane use during past 6 months.

26. Undergo any kind of facial surgery over the last 12 months.

27. Inability to understand the protocol or to provide a signed informed consent.

28. As per the investigator's discretion, any physical or mental condition which might make it unsafe for the subject to participate in this study.