Patent Publication Number: US-2022211320-A1

Title: Composite medical treatment apparatus using skin map

Description:
FIELD 
     The present invention relates to a composite medical treatment apparatus. 
     BACKGROUND 
     Compared with surgical operation, the popularity of non-incisional treatment, which has low risk of bleeding, infection, and scarring and allows daily life immediately after treatment, is increasing in recent years. In the non-incisional treatment, for example, a laser, an ultrasound and so on are applied to the skin for treatment. 
     High Intensity Focused Ultrasound (HIFU) is mainly used for non-invasive treatment. HIFU can selectively coagulate, necrotize and kill lesions. In particular, if HIFU is used, non-invasive/non-anesthetic treatment becomes possible, and accurate and repeated treatment of lesions becomes possible. For this reason, it is used in various fields such as tumor treatment (uterine fibroids, liver cancer, breast cancer, etc.), fat and wrinkle removal. 
     Lasers are mainly used to remove lesions by removing tissue or evaporating tissue in place of surgical knives. It is used in various fields such as dermatology, otorhinolaryngology, ophthalmology, and surgery in that microsurgery is possible without bleeding and there is little pain and scarring. 
     HIFU enables treatment by non-invasively applying energy to the inside of the skin (dermis, subcutaneous fat), but may cause side effects when treated near the skin surface (epidermis). On the other hand, although laser is difficult to deliver energy to the inside of the skin, it is excellent at applying energy to the epidermis. For this reason, various treatments for skin diseases and cosmetic treatment using laser have been developed. Therefore, it is necessary to develop a treatment device capable of simultaneously performing ultrasound and laser treatment in that the treatment effect can be improved when ultrasound and laser are combined. 
     SUMMARY 
     The present invention is to provide a composite medical treatment apparatus capable of performing composite treatment using high-intensity focused ultrasound and laser according to a patient&#39;s skin condition. 
     According to one aspect of the present invention, a composite medical treatment apparatus using skin map is provided. The composite medical treatment apparatus may include a handpiece configured for measuring a skin condition associated with a measurement position on a region of interest in a skin map generation step, and configured for measuring a treatment position on the region of interest and applying a treatment medium according to a control parameter corresponding to the treatment position in a treatment step and a main controller configured for associating the measurement position with the skin condition in the skin map generation step, and configured for retrieving the skin condition associated with the measurement position based on the treatment position to generate the control parameter in the treatment step. 
     In one embodiment, the treatment medium is a high-intensity focused ultrasound and a laser, wherein the handpiece may include an ultrasonic transducer configured for generating the high-intensity focused ultrasound and applying to the region of interest, a laser applicator configured for applying the laser generated in the main controller to the region of interest and an optical position sensor configured for generating a measurement position and a treatment position information. 
     In one embodiment, the skin condition is a skin thickness, and the ultrasound transducer is a dual-mode ultrasound transducer configured for applying a low-intensity ultrasound for measuring the skin thickness to the region of interest. 
     In one embodiment, the skin condition is a skin elasticity and the handpiece measures the skin elasticity from time to recover an original state after applying a pressure to the skin on the region of interest. 
     In one embodiment, the handpiece may include a probe being in contact with the skin, a vertical driver configured for applying the pressure to the skin by moving the probe vertically, and removing the pressure when the probe comes into contact with the skin and a sensor configured for measuring a vertical displacement of the probe after the pressure is removed. 
     In one embodiment, the handpiece may include a HIFU-laser generator configured for generating the high-intensity focused ultrasound and the laser, a vertical driver configured for applying the pressure to the skin by moving the HIFU-laser generator vertically, and removing the pressure when the HIFU-laser generator comes into contact with the skin and a sensor configured for measuring a vertical displacement of the HIFU-laser generator after the pressure is removed. 
     In one embodiment, the skin condition in the skin map is associated with the measurement position for each point. 
     In one embodiment, the skin condition in the skin map is associated with a region having the skin condition that is the same or falls within an allowable error range. 
     In one embodiment, the control parameter is a combination of a selection of the treatment medium to be applied to a treatment point corresponding to the treatment location, an intensity of the selected treatment medium, an output time of the selected medium, and an application depth of the selected medium. 
     According to another aspect of the present invention, a method of driving a composite medical treatment apparatus using a skin map is provided. The method may include generating a skin map by measuring a skin condition associated with a measurement position on a region of interest using a handpiece, measuring a treatment position on the region of interest using the handpiece, retrieving the skin condition associated with the measurement position corresponding to the treatment position from the skin map and generating a control parameter for controlling an operation of the composite medical treatment apparatus using the retrieved skin condition. 
     In one embodiment, the generating a skin map by measuring a skin condition associated with a measurement position on a region of interest using a handpiece may include measuring a direction and a distance of movement of the handpiece in contact with the region of interest, measuring the skin condition of the region of interest while moving the handpiece in contact with the region of interest and storing the skin condition associated with the measurement position. 
     In one embodiment, the method may further include adjusting the direction and the distance of movement. 
     In one embodiment, the skin condition may be measured continuously or discontinuously. 
     In one embodiment, the skin condition may include a skin thickness and a skin elasticity of the region of interest. 
     In one embodiment, the skin condition may be associated with the measurement position for each point. 
     In one embodiment, the skin condition is associated with a region having the skin condition that is the same or falls within an allowable error range. 
     In one embodiment, the control parameter is a combination of a selection of the treatment medium to be applied to a treatment point corresponding to the treatment location, an intensity of the selected treatment medium, an output time of the selected medium, and an application depth of the selected medium. 
     According to the present invention, a composite treatment is possible using high-intensity focused ultrasound and laser according to the skin condition of the patient. 
    
    
     
       BRIEF DESCRIPTION OF ACCOMPANYING DRAWINGS 
       Hereinafter, embodiments of the invention will be described with reference to the accompanying drawings. For the purpose of easy understanding of the invention, the same elements will be referred to by the same reference signs. Configurations illustrated in the drawings are examples for describing the invention, and do not restrict the scope of the invention. Particularly, in the drawings, some elements are slightly exaggerated for the purpose of easy understanding of the invention. Since the drawings are used to easily understand the invention, it should be noted that widths, thicknesses, and the like of elements illustrated in the drawings might change at the time of actual implementation thereof. 
         FIG. 1  exemplarily illustrates a skin treatment performed by use of a composite medical treatment apparatus; 
         FIG. 2A ,  FIG. 2B  and  FIG. 2C  exemplarily illustrate the HIFU-laser generator of the composite medical treatment apparatus; 
         FIG. 3A  and  FIG. 3B  exemplarily illustrate configurations of the composite medical treatment apparatus for measuring skin elasticity; 
         FIG. 4  is a flowchart exemplarily illustrating a method of driving the composite medical treatment apparatus using the skin map 
         FIG. 5A  and  FIG. 5B  exemplarily illustrate a process of generating the skin map; and 
         FIG. 6  exemplarily illustrates the skin map and a treatment process using the same. 
     
    
    
     DETAILED DESCRIPTION 
     Embodiments which will be described below with reference to the accompanying drawings can be implemented singly or in combination with other embodiments. But this is not intended to limit the present invention to a certain embodiment, and it should be understood that all changes, modifications, equivalents or replacements within the spirits and scope of the present invention are included. Especially, any of functions, features, and/or embodiments can be implemented independently or jointly with other embodiments. Accordingly, it should be noted that the scope of the invention is not limited to the embodiments illustrated in the accompanying drawings. 
     On the other hand, among terms used in this specification, terms such as “substantially,” “almost,” and “about” are used to take consideration of a margin or an error at the time of actual embodiment. For example, “substantially 90 degrees” should be construed to include angles at which the same advantages as at 90 degrees can be expected. For example, “almost zero” should be construed to include a quantity which is slightly present but is ignorable. 
     In the accompanying drawings, the same or similar elements will be referred to by the same reference numerals. 
       FIG. 1  exemplarily illustrates a skin treatment performed by use of a composite medical treatment apparatus. 
     The composite medical treatment apparatus may include a handpiece  10  and a main controller  20 . The handpiece  10  collects information regarding skin condition, and generates and applies HIFU and/or laser to the skin according to the skin condition of the patient. The main controller  20  drives an ultrasonic source and a laser embedded in the handpiece  10  according to the collected skin condition. 
     The handpiece  10  measures the skin condition of the patient. In addition, the handpiece  10  generates high-intensity focused ultrasound and laser to be applied to the region of interest according to the control parameter determined by the measured skin condition. To this end, the handpiece  10  includes a HIFU-laser generator  100  that generates HIFU and laser, a skin elasticity measuring unit  200  that measures the elasticity of the patient&#39;s skin, and a position measuring unit  300  for measuring the position of the handpiece  10 . Additionally, the handpiece  10  may measure the skin thickness of the region of interest. 
     The HIFU-laser generator  100  may output HIFU and/or laser according to the control parameter. The control parameters are, for example, information regarding a selection of the treatment medium, an intensity of the selected treatment medium, and an output time of the selected treatment medium. The HIFU-laser generator  100  may irradiate HIFU energy to a predetermined depth under the epidermis. In addition, the HIFU-laser generator  100  may irradiate the laser to the epidermis. 
     HIFU can remove the tissue by heating the body tissue to a temperature higher than body temperature (tissue heating) to induce necrosis of cells, or by exposing it to a high temperature for a short time (ablative therapy). Using HIFU, the temperature of a tissue, for example, a skin tissue, can be increased within a few seconds, and a part of the tissue can be necrotic through exposure at a temperature of about 55 degrees or higher for a certain period of time. The heat generated by ultrasonic waves appears differently depending on the energy absorption rate of the body tissue and the rate of heat diffusion and convection. In addition, the rate of increase in temperature varies depending on the frequency and continuity generated by the HIFU-laser generator  100 , the period of the pulse wave, and the voltage between the peaks. By using these differences, the temperature change according to the target can be appropriately adjusted. Various treatments are also being attempted. In addition to the method of directly raising the temperature of the tissue, it also causes cellular changes according to changes in the living environment by changing the temperature by targeting surrounding tissues near the tissue. For example, as the permeability of capillaries increases or the lipid constituting the cell membrane becomes fluid due to the increase in temperature, the sensitivity of the cell to the external environment increases or the structure is destroyed. In addition, HIFU energy can also destroy fat cells. HIFU energy can be converted into thermal energy, and coagulative necrosis may occur in adipose tissue. Due to this, adipose tissue can be destroyed, and collagen can be is also contracted. The destroyed cells may cause a wound healing response, and when macrophages are generated, an inflammatory response may be produced, and macrophages can reduce adipose tissue by processing Lipids and cellular debris in the liver through the lymphatic system. 
     The skin tissue is composed of, for example, an epidermal layer, a dermal layer, and a SMAS layer. The HIFU-laser generator  100  may adjust the focal depth of HIFU energy. For example, when HIFU energy selectively coagulates the tissues in the dermal layer and the SMAS layer, it may cause the regeneration of collagen and elastic fibers in the skin tissue to obtain a skin lifting and/or tightening effect. Since the thickness or elasticity of the skin may be different for each patient and/or each region, and the depth of the target tissue may be different, HIFU energy may be controlled to have a different focal depth for each body part. Conventional HIFU apparatus may include cartridges detachable to the handpiece, each cartridge has a different focal depth. Therefore, the treatment had to be performed while replacing the cartridge according to the skin condition and/or location. 
     The skin elasticity measuring unit  200  measures the skin elasticity of the region of interest. The skin elasticity measurement is associated with the measurement position together with the skin thickness measurement. The skin condition may include the skin elasticity and the skin thickness associated with the measurement position. The skin elasticity measuring unit  200  may measure the skin elasticity of the region of interest in various ways. For example, the skin elasticity may be measured by using the time required for the deformed skin to be recoverd after applying pressure to the skin. The skin may be pressed to a certain depth by pressure or may protrude conversely. 
     The position measuring unit  300  measures a position of the point where the handpiece  10  came into contact with the region of interest for measurement of skin condition (hereinafter, measurement position) and a position of the point where the handpiece  10  comes into contact with the region of interest for treatment (hereinafter, treatment position) to generate two-dimensional or three-dimensional position information. The position measuring unit  300  receives a sensing information from an optical position sensor  310  that measures the distance and direction of movement when the handpiece  10  moves on the skin. In order to adjust the sensing information, the position measuring unit  300  may further include a sensor such as a gyro sensor (not shown) for measuring a posture of the handpiece  10 , for example, rotation, inclination, and so on. Depending on a way of gripping the handpiece  10 , sensing information that fails to accurately indicate the actual movement direction of the handpiece  10  may be generated. 
     The main controller  20  drives the handpiece  10  to collect the skin condition, generates a skin map based on the collected skin condition and measurement position, and generates control parameters to drive HIFU and/or laser according to the treatment position. The main controller  20  may include a storage unit for storing the skin map, a calculation unit for generating control parameters based on the skin condition corresponding to treatment position, a laser generator for generating laser to be applied to the region of interest through the handpiece  10 , and a power supply for supplying power required to drive the composite medical treatment apparatus including the handpiece  10 . The laser is delivered to the handpiece  10  through an optical fiber, and may be applied to the region of interest through a laser applicator in the handpiece  10 . 
       FIG. 2A ,  FIG. 2B  and  FIG. 2C  exemplarily illustrate the HIFU-laser generator of the composite medical treatment apparatus,  FIG. 2A  shows the HIFU-laser generator with an ultrasonic transducer having a fixed focal length,  FIG. 2B  and  FIG. 2C  show the HIFU-laser generator with an ultrasonic transducer having a variable focal length. 
     Referring to  FIG. 2A , the HIFU-laser generator  100  may include the laser applicator  120  and a housing  110  accommodating the ultrasonic transducer  130  therein. The housing  110  may be divided into an upper compartment  112  and a lower compartment  113  by an inner wall  111  extending in the lateral direction. A through hole to which a laser tube  121  is coupled is formed in the inner wall  111 . At least a portion of a bottom of the housing  110  may be formed of an acoustically transparent material through which ultrasonic waves can pass. Meanwhile, at least a portion of the bottom may be formed of an optically transparent material through which the laser can pass. The laser applicator  120  is disposed in the upper compartment  112  to correspond to the through hole to which the laser tube  121  is coupled, and the ultrasonic transducer  130  is disposed in the lower compartment  113 . The laser applicator  120  may be a collimating lens optically coupled to the optical fiber. The laser tube  121  extends in a downward direction from the inner wall  111  to the bottom of the housing  110 . The lower compartment  113  accommodates the ultrasound transducer  130  and an ultrasonic medium that facilitates a transmission of HIFU. The laser tube  121  prevents the laser from being affected by the ultrasonic medium. The lower compartment  113  is isolated from the upper compartment  112  by the inner wall  111  and the laser tube  121 . 
     The ultrasound transducer  130  may be a dual-mode ultrasound transducer. That is, the ultrasound transducer  130  may generate HIFU for the purpose of treatment and a low-intensity ultrasound for the purpose of measuring skin thickness. The ultrasonic transducer  130  may be fixed to an outer surface of the laser tube  121 . The ultrasound transducer  130  may radiate HIFU or the low-intensity ultrasound for skin thickness measurement toward the bottom of the housing  110 . 
     Referring to  FIG. 2B , the HIFU-laser generator  101  may include the first housing  110  for accommodating the laser applicator  120  therein and the second housing  140  for accommodating the ultrasonic transducer  130  therein. The second housing  140  is disposed inside the first housing  110  and may share a bottom. The laser applicator  120  may be disposed on or over the second housing  140 . 
     The second housing  140  may include a lower compartment  141  formed to be isolated from the upper compartment  112  by an upper wall  142  and lateral walls  143 ,  144  and  145 . In the lower compartment  141 , the ultrasonic transducer  130  and the ultrasonic medium are accommodated. The laser tube  150  extends in the downward direction from the upper wall  142  of the second housing  140  to the bottom of the first housing  110 . The upper wall  142  of the second housing  140  includes a through hole through which the laser tube  150  is coupled. The lateral wall of the second housing  140  includes an upper lateral wall  143  extending in the downward direction from the upper wall  142 , a lower lateral wall  144  extending in an upward direction from the bottom of the first housing  110 , and a first stretchable connector  145  for coupling the upper lateral wall  143  and the lower lateral wall  144 . The first stretchable connector  145  may have a bellows structure that may be expanded or contracted in the downward direction by a predetermined length. 
     The laser tube  150  may be also expanded and contracted in the downward direction. The laser tube  150  includes an upper laser tube  151 , a lower laser tube  152 , and a second stretchable connector  153 . The upper laser tube  151  extends in the downward direction from the through hole formed in the upper wall  142  of the second housing  140  to the lower compartment  141 , and the lower laser tube  152  extends in the upward direction from the bottom of the first housing  110  to the lower compartment  141 . The second stretchable connector  153  expanding and contracting in the downward direction by a predetermined length couples the upper laser tube  151  and the lower laser tube  152 . 
     The above-described HIFU-laser generator  100  may move the ultrasonic transducer  130  in the downward direction by a predetermined distance. The downward movement can be implemented by various structures, and  FIG. 2B  illustrates a structure with a rack-pinion. A rack  161  is attached or formed on an outer surface of a vertical extension  154  extending in the downward direction from the through hole formed in the upper wall  142  of the second housing  140  to the laser applicator  120 . A pinion  160  engaged with the rack  161  is rotated clockwise/counterclockwise by a motor to move the ultrasonic transducer  130  in the downward direction by the predetermined distance. The ultrasonic transducer  130  is fixed to an outer surface of the upper laser tube  151 , and the upper laser tube  151  is coupled to the upper wall  142  of the second housing  140 . When the pinion  160  rotates counterclockwise, the ultrasonic transducer  130  coupled to the upper laser tube  151  moves in the downward direction, and on the contrary, when the pinion  160  rotates clockwise, the ultrasonic transducer  130  moves in the upward direction. When moving up and down, the first stretchable connector  145  and the second stretchable connector  153  may be expanded or contracted. 
     Referring to  FIG. 2C , the HIFU-laser generator  102  may include the first housing  110  for accommodating the laser applicator  120  therein and a second housing  170  for accommodating the ultrasonic transducer  130  therein. The second housing  170  is disposed inside the first housing  110  and may share a bottom. The laser applicator  120  may be disposed on or over the second housing  170 . 
     The second housing  170  may include an upper wall  172  that moves up and down, an upper lateral wall  173  extending in the downward direction from an edge of the upper wall, and a lower lateral wall  174  extending in the upward direction from the bottom of the first housing  110 . The upper wall  172 , the upper lateral wall  173 , and the lower lateral wall  174  form a lower compartment  171  that is isolated from the upper compartment  112 . In the lower compartment  171 , the ultrasonic transducer  130  and the ultrasonic medium are accommodated. The laser tube  180  extends in the downward direction from the upper wall  172  of the second housing  170  to the lower compartment  171 . The upper wall  172  of the second housing  170  includes a through hole through which the laser tube  180  is connected. The upper lateral wall  173  of the second housing  170  is disposed to overlap the lower lateral wall  174 . As illustrated in  FIG. 2C , an inner surface of the upper lateral wall  173  may be in contact with an outer surface of the lower lateral wall  174 , or, conversely, the outer surface of the upper lateral wall  173  may be in contact with the inner surface of the lower lateral wall  174 . Although not shown, a member such as O-ring for preventing an outflow of the ultrasonic medium an may be disposed on a location where the upper lateral wall  173  and the lower lateral wall  174  contact each other. 
     The laser tube  180  includes an upper laser tube  181  and a lower laser tube  182 , and the upper laser tube  181  is disposed to overlap the lower laser tube  182 . As illustrated in  FIG. 2C , an inner surface of the upper laser tube  181  is in contact with an outer surface of the lower laser tube  182 , or, conversely, the outer surface of the upper laser tube  181  is in contact with the inner surface of the lower laser tube  182 . Although not shown, a member such as O-ring for preventing an outflow of the ultrasonic medium an may be disposed on a location where the upper laser tube  181  and the lower laser tube  182  contact each other. 
     The above-described HIFU-laser generator  102  may move the ultrasonic transducer  130  in the downward direction by a predetermined distance. The rack  161  is attached or formed on an outer surface of a vertical extension  183  extending in the downward direction from the through hole formed in the upper wall  172  of the second housing  170  to the laser applicator  120 . The pinion  160  engaged with the rack  161  is rotated clockwise/counterclockwise by a motor to move the ultrasonic transducer  130  in the downward direction by the predetermined distance. The ultrasonic transducer  130  is fixed to an outer surface of the upper laser tube  181 , and the upper laser tube  181  is coupled to the upper wall  172  of the second housing  170 . When the pinion  160  rotates counterclockwise, the ultrasonic transducer  130  coupled to the upper laser tube  181  moves in the downward direction, and on the contrary, when the pinion  160  rotates clockwise, the ultrasonic transducer  130  moves in the upward direction. The maximum range of the vertical movement is a range in which the contact of the upper lateral wall  173  and the lower lateral wall  174  is maintained and the contact of the upper laser tube  181  and the lower laser tube  182  is maintained. 
       FIG. 3A  and  FIG. 3B  exemplarily illustrate configurations of the composite medical treatment apparatus for measuring skin elasticity, (a) illustrates one configuration for measuring skin elasticity using a HIFU-laser generator, and (b) illustrates another configuration for measuring skin elasticity using a probe. 
     Skin elasticity may be measured by various ways such as measuring the time it takes for the skin to recover to its original state after it is deformed by applying pressure, measuring the pressure applied to the probe in contact with the pressed skin, or analyzing the moiré image obtained by photographing the skin. The method of measuring skin elasticity using the time taken to recover the original state will be described, but any other methods can be also used. 
     Referring to  FIG. 3A  and  FIG. 3B , the handpiece  10  may measure a time or a physical quantity related to time (for example, an ascent distance within a reference time, a rate at which the skin rises, and so on. Hereinafter, collectively referred to as time) required to recover the original state after the skin is pressed inward by applying a certain pressure to the skin. The skin may be pressed by the HIFU-laser generator ( 100 ,  101 ,  102 ; hereinafter collectively referred to as  100 ) or the probe  221  for measurement. The handpiece  10  includes a vertical driver  210  for moving the HIFU-laser generator  100  or the measuring probe  221  in the downward direction and a displacement sensor  250  for measuring the rising distance. The vertical driver  210  such as an electromagnet generates an electromagnetic force corresponding to the applied electric signal to move the HIFU-laser generator  100  or the probe  221  in the downward direction. In the configuration illustrated in  FIG. 3A , a vertical magnet bar  220  vertically coupled to the upper surface of the HIFU-laser generator  100  is shown to be moved in the downward direction by the vertical driver  210 . However, this is only an example, and when a magnet is attached to a lateral surface of the HIFU-laser generator  100 , the vertical driver  210  may move the HIFU-laser generator  100  directly in the downward direction. Meanwhile, in the configuration illustrated in  FIG. 3B , although one probe  221  is exemplarily illustrated exemplified, but a plurality of probes may be equipped. 
     In an initial position, the HIFU-laser generator  100  or the probe  221  is located inside of the handpiece  10 . In response to one control command input from the handpiece  10  or the main controller  20 , the handpiece  10  applies a certain pressure to the skin. As illustrated, the vertical driver  210  may be moved in the downward direction by the HIFU-laser generator  100  or the probe  221  to press the skin to a preset depth. Thereafter, by another control command input from the handpiece  10  or the main controller  20 , the handpiece  10  removes the pressure applied to the skin. For example, the vertical driver  210  stops pushing the HIFU-laser generator  100  or the probe  221  in the downward direction. Thereby, the skin will rise to its original state. As the skin rises to its original state, the HIFU-laser generator  100  or the measuring probe  221  also moves in the upward direction, and the displacement, that is, the vertical movement distance is measured by the displacement sensor  250 . The measured displacement can be converted into skin elasticity by various conversion formulas. 
       FIG. 4  is a flowchart exemplarily illustrating a method of driving the composite medical treatment apparatus using the skin map,  FIG. 5A  and  FIG. 5B  exemplarily illustrate a process of generating the skin map, and  FIG. 6  exemplarily illustrates the skin map and a treatment process using the same. 
     Referring  FIGS. 4 to 6  together, the skin map is generated using the skin condition measured at the region of interest  400 .  FIG. 5A  exemplarily illustrates a process of measuring skin condition on a patient&#39;s face, and  FIG. 5B  exemplarily illustrates a process of measuring skin thickness and skin elasticity. 
     The measurement position may be generated by the handpiece  10  or by the three-dimensional scanner C 1  or C 2 . The measurement position may be two-dimensional or three-dimensional coordinates for specifying a specific position over the entire region of interest, or a region identifier for specifying a plurality of sub-regions constituting the region of interest. Although there may be some discrepancies, for example, the region identifier may be used to classify and specify the cheeks into four regions  1  to  4  based on statistics on skin thickness. 
     The handpiece  10  may include the optical position sensor  310  and/or the gyro sensor, and may measure a direction and a distance of movement of the handpiece  10  in contact with the region of interest. The information measured by the sensor may be a position in the form of at least two-dimensional coordinates indicating a measurement point, and may be adjusted by information such as tilt and/or rotation measured by the gyro sensor. Additionally, when the handpiece  10  is moved to measure while maintaining a constant angle with the region of interest, the three-dimensional coordinates may be obtained using information such as an inclination measured by the gyro sensor. On the other hand, the three-dimensional scanner C 1 , C 2  may perform a three-dimensional scan on the region of interest to generate three-dimensional coordinates and measure the measurement position of the handpiece  10 . The measurement position generated by the handpiece  10  or the three-dimensional scanners C 1  and C 2  is used to generate the skin map. 
     Referring to  FIG. 5B , the handpiece  10  may measure one or more skin condition while moving in contact with the region of interest. S indicates the position where the handpiece  10  started the measurement, the dotted line indicates a movement path of the handpiece  10 , the arrow indicates the movement direction, d indicates the position where the skin condition is measured, and E indicates the position where the handpiece  10  finished the measurement. The skin condition may be continuously or discontinuously measured according to the characteristics of the corresponding information or the performance of the handpiece  10 . For example, the skin thickness measurement using the ultrasonic transducer  130  may be performed continuously, whereas the skin elasticity measurement using the probe  221  may be performed discontinuously. 
     The skin condition is related to the measurement position. The skin condition may be measured while the handpiece acquires the measurement position. The skin condition may include at least the skin elasticity and the skin thickness related to the measurement position, and additionally include various information such as skin color, size/number of pores, moisture content and so on that can be specified for each patient/position of the region of interest. The skin condition may be stored for each point-by-point or sub-region. The skin condition may be stored in association with each specific point. The sub-region may be defined as a region having skin condition that is substantially the same or falls within an allowable error range in the region of interest, for example, a face. For example, the four regions  1  to  4  may be defined based on statistics on skin thickness, as described above, or may be defined by skin condition measured in the region of interest. In addition, the sub-region may be defined differently for each skin condition. For example, the sub-regions for each of the skin thickness and skin elasticity may be substantially the same, but may be defined at least partially differently. 
     The skin map is a set of one or more skin conditions related to measurement position. Two-dimensional or three-dimensional skin map may be displayed on a display. An example of the completed skin map is shown in  FIG. 6 . In addition to the above-described method of measuring skin condition related to the measurement position using the handpiece  10  or the three-dimensional scanner C 1  or C 2 , the measurement position and the skin condition may be associated with each other in various ways. For example, if a specific position is displayed on the display while an image of the region of interest or a model depicting the region of interest is output to the display, the operator moves the handpiece  10  to the corresponding position to measure skin condition. The generated skin map may be used later in  410  to  430 . 
     In the course of treatment, after the skin map is generated, when the handpiece  10  comes to be in contact with or is moved in contact with the region of interest, the treatment position is measured in  410 . The treatment position may be measured in the same way as the measurement position. 
     One or more skin conditions associated with the treatment position is obtained in  420 . The treatment position measured by the handpiece  10  is retrieved from the skin map stored in the main controller  20  or an external information processing device (e.g., PC or server; hereinafter referred to as the main controller  20  collectively) communicatively connected to the main controller  20 . When the measurement position that matches the treatment position or falls within a predetermined error range is retrieved, one or more skin conditions related thereto may be acquired. If there is no measurement position matching the treatment position, the main controller  20  may calculate an average of one or more of skin conditions associated with measurement positions close to the contact position, or may select one or more skin condition related to the sub-region to which the treatment position belongs. 
     The control parameter is generated using the acquired one or more skin condition in  430 . The control parameter is used to control selection of the treatment medium to be applied to the treatment point, the intensity of the selected treatment medium, an output time of the selected medium, an application depth where the selected medium can reach, and the like, based on one or more skin conditions. The treatment medium is, but is not limited to, HIFU and laser. For example, the main controller  20  may generate a control parameter for adjusting the focal depth of HIFU to be applied (e.g., the application depth of the selected medium) according to the skin thickness. The control parameter may be used to generate a control sequence for controlling two or more treatment mediums to operate simultaneously or sequentially. 
     The above description of the invention is exemplary, and those skilled in the art can understand that the invention can be modified in other forms without changing the technical concept or the essential feature of the invention. Therefore, it should be understood that the above-mentioned embodiments are exemplary in all respects, but are not definitive. 
     The scope of the invention is defined by the appended claims, not by the above detailed description, and it should be construed that all changes or modifications derived from the meanings and scope of the claims and equivalent concepts thereof are included in the scope of the invention.