Embodiments of a dermatological cosmetic treatment and imaging system and method can include use of transducer and a reflective surface to simultaneously produce multiple cosmetic treatment zones in tissue. The system can include a hand wand, a removable transducer module, a control module, a graphical user interface and / or a parabolic reflector. In some embodiments, the cosmetic treatment system may be used in cosmetic procedures, including brow lifts, fat reduction, sweat reduction, and treatment of the décolletage. Skin tightening, lifting and amelioration of wrinkles and stretch marks are provided.