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Alizadeh Z, Halabchi F, Bodaghabadi Z, Zarandi MM, Abolhasani M, Seifi V, Khazaei R, Ghanadi S, Mazaheri R, Tabesh MR. Non-invasive Body Contouring Technologies: An Updated Narrative Review. Aesthetic Plast Surg 2024; 48:659-679. [PMID: 37749418 DOI: 10.1007/s00266-023-03647-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION Nowadays, a lot of body contouring devices and methods are introduced all over the world. The object of the present narrative review was to update and classify existing evidence on these methods and devices. METHODS We searched databases including PubMed, Cochrane, and Google Scholar for 11 essential keywords, including cryolipolysis, high-intensity focused ultrasound (HIFU), shock wave, low-level laser therapy (LLLT), radiofrequency (RF), capacitive resistive electrical transfer (TECAR), high-intensity focused electromagnetic (HIFEM), electromyostimulation (EMS), carboxytherapy, mesotherapy, and acupuncture and their abbreviations, in addition to obesity, overweight, cellulite, subcutaneous fat, and body contouring. RESULTS Totally 193 references were used in 11 main topics. CONCLUSION In order to help physicians with finding the best evidence in different methods, the data were summarised in 11 topics. Furthermore, FDA-approved devices, side effects and common protocols were described in each section. LEVEL OF EVIDENCE I This journal requires that authors 39 assign a level of evidence to each article. For a full 40 description of these Evidence-Based Medicine ratings, 41 please refer to the Table of Contents or the online 42 Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Zahra Alizadeh
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farzin Halabchi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Bodaghabadi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Abolhasani
- Cardiovascular Diseases Research Centre, Cardiac primary prevention research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Seifi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Khazaei
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Ghanadi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mazaheri
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mastaneh Rajabian Tabesh
- Cardiac Primary Prevention Research Center (CPPRC), Heart Centre Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Alexiades M. Radiofrequency Microneedling. Facial Plast Surg Clin North Am 2023; 31:495-502. [PMID: 37806682 DOI: 10.1016/j.fsc.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Radiofrequency microneedling is a technique that allows energy to be delivered to specified target depths in the skin via needle electrodes and measures temperature and impedance within the tissue. This method of delivery and real-time feedback has increased safety and efficacy, providing clinically significant improvements in skin laxity, rhytids, and cellulite.
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Affiliation(s)
- Macrene Alexiades
- Yale University School of Medicine, New Haven, CT, USA; Dermatology & Laser Surgery Center of New York, NY, USA.
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LaTowsky B, Jacob C, Hibler BP, Lorenc PZ, Petraki C, Palm M. Cellulite: Current Treatments, New Technology, and Clinical Management. Dermatol Surg 2023; 49:S8-S14. [PMID: 37000913 DOI: 10.1097/dss.0000000000003747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
BACKGROUND Cellulite is a well-known concern for many women; however, treatment can prove challenging because of the complexities of cellulite etiology, the various factors contributing to its appearance, and the multitude of therapies and procedures available. OBJECTIVE To discuss current cellulite treatment options and effective clinical management. METHODS A roundtable meeting was convened to discuss and share views on current cellulite treatment options, new technologies, and clinical management. The participants' views helped guide a narrative review on this topic. RESULTS Advanced interventions for cellulite treatment-such as physical and acoustic subcision, radiofrequency, and injectable biostimulators-are gradually being established, with accumulating evidence showing efficacy, patient satisfaction, and potentially long-lasting outcomes. Cellulite severity rating scales are necessary for assessing treatment outcomes, but these can be complex to use in clinical practice, and the majority do not include patient or clinician perspectives. CONCLUSION With the advent of new treatments and technologies, cosmetic surgeons and dermatologists will need to tailor their approach to each patient's needs and manage patient expectations because multimodal methods are likely to be required to address the various factors underlying cellulite appearance.
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Shridharani SM, Tisch GM, Kennedy ML. Injection Adipocytolysis for Body and Jawline Contouring: Real-World Experience and Treatment Considerations. Aesthet Surg J 2023; 43:470-483. [PMID: 36326562 PMCID: PMC10016034 DOI: 10.1093/asj/sjac285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The role of ATX-101 in submental fat reduction has been well documented; however, its applicability across multiple anatomic areas is to be explored. OBJECTIVES The authors sought to describe the experience with ATX-101 subcutaneous injections for body and jawline contouring and evaluate its safety. METHODS This single-arm, single-center observational study included 201 patients who underwent injection adipocytolysis with ATX-101 (area-adjusted dose of 2 mg/cm2) in the jowl, abdomen (upper/lower), thigh (inner/outer/banana roll), arm, anterior periaxillary fat, back (lower/upper/nape/lipoma), knee (anterior/medial), chest, and/or neck. The number of treatment sessions, treatment volumes, doses, injections required for each anatomic area, and associated adverse events were recorded. RESULTS The mean number of treatment sessions conducted was 1.8. Multiple sessions were common for the jowl (mean: 2.0 and mean volume administered varied significantly between persons receiving 1 or multiple sessions [P = 0.005]). The mean volume and mean number of injections per session were highest in the chest (84.7 mL and 423.5, respectively) and lowest in the jowl (0.8 mL and 4.6, respectively). The chest (0.2 mL) and nape (0.2 mL) received the highest mean ATX-101 dose per injection site per session, whereas the inner thigh (0.11 mL) and upper back (0.11 mL) received the least. Adverse events observed were localized to the injection site. All patients experienced edema after each session, whereas numbness, tenderness, bruising, and paresis were experienced by 99.6%, 94.2%, 33.1%, and 2.6% of patients, respectively. Alopecia was not observed. CONCLUSIONS ATX-101 was well tolerated for body and jawline contouring. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Sachin M Shridharani
- Corresponding Author: Dr Sachin M. Shridharani, Washington University—St. Louis, School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110-1010, USA. E-mail: ; Instagram: @sachinshridharanimd
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Radiofrequency and Radiofrequency Microneedling in Skin of Color: A Review of Usage, Safety, and Efficacy. Dermatol Surg 2023; 49:489-493. [PMID: 36826381 DOI: 10.1097/dss.0000000000003733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Radiofrequency (RF) and radiofrequency microneedling (RFM) for rhytides, scarring, and skin rejuvenation are believed to have a lower risk of postprocedural dyspigmentation in darker skin types. OBJECTIVE To explore the safety and efficacy of RF and RFM in Fitzpatrick skin Types III to VI. METHODS AND MATERIALS A systematic review of PubMed/MEDLINE databases from 2000 to 2021 using combinations of the terms radiofrequency, microneedling, skin of color, and Fitzpatrick was performed. Exclusion criteria included non-Fitzpatrick skin Types III-VI patient population, nonprimary articles, nonskin radiofrequency, and nonhuman studies. RESULTS Thirty-five articles addressing the use of RF or RFM in skin of color were identified-22 for skin rejuvenation, 7 for acne scars, 4 for nonacne scars, 1 for hyperpigmentation, and 1 for acne treatment. Seven studies noted transient postinflammatory hyperpigmentation, 1 observed mild prolonged hyperpigmentation, and only 1 study reported permanent scarring. CONCLUSION Radiofrequency and RFM seem to have a low risk of scarring or hyperpigmentation in skin of color. This review demonstrates that these procedures have been successfully used primarily for rhytides, acne scarring, and skin rejuvenation. However, a large proportion of the studies lack strong quality evidence.
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Suh DH, Cho M, Kim HS, Lee SJ, Song KY, Kim HS. Clinical and histological evaluation of microneedle fractional radiofrequency treatment on facial fine lines and skin laxity in Koreans. J Cosmet Dermatol 2023; 22:1507-1512. [PMID: 36718800 DOI: 10.1111/jocd.15614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/02/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Facial wrinkles and sagging are the most visible signs of aging and can cause profound distress. Microneedle fractional radiofrequency (MFR) is a minimally invasive procedure, which utilizes both microneedling and radiofrequency energy to rejuvenate the skin. OBJECTIVE To describe the safety and efficacy of a temperature-controlled MFR device on facial fine lines and laxity. PATIENTS AND METHODS A retrospective chart & histology review was performed on individuals who received bipolar MFR for facial rejuvenation. A total of 15 Koreans with a median age of 46 years were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the participants' satisfaction scores. Histologic changes before, immediately after MFR and at 4 months follow-up was examined. Complications were also recorded. RESULTS Partially denatured collagen fibers and dermal shrinkage was observed immediately after MFR whereas an increase in elastin and collagen was noted at 4 months follow-up. 86.7% of recipients considered the results satisfactory. Consensus ratings by two independent dermatologists on the objective outcomes at 4-month follow-up were very much improved (53.3%), much improved (26.7%) and improved (20%). Treatment was well tolerated and did not cause any significant long-lasting discomfort. CONCLUSION Temperature-controlled bipolar MFR is a minimally invasive treatment option to consider for facial fine lines and laxity via neo-collagenesis and neo-elastogenesis. The procedure was safe and clinically effective.
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Affiliation(s)
- Dong Hye Suh
- Arumdaun Nara Dermatology Clinic, Seoul, South Korea
| | - Minah Cho
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | - Sang Jun Lee
- Arumdaun Nara Dermatology Clinic, Seoul, South Korea
| | - Kye Yong Song
- Department of Pathology, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Lin F, Song J, Huang Y, Zhai Y, Yao X, Yang B. Successful treatment of microneedle fractional radiofrequency for refractory depressed scars in buttocks: A case report. J Cosmet Dermatol 2022; 21:3629-3630. [PMID: 35398944 DOI: 10.1111/jocd.14979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/07/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Feiyan Lin
- Dermatology Hospital of Southern Medical University No.2 Lujing Road Yuexiu District, Guangzhou 510091 Guangdong China
- Department of Laser Therapy the Fifth People’s Hospital of Hainan Province No.33 South Longkun Road Haikou 570206 Hainan China
| | - Jinru Song
- Dermatology Hospital of Southern Medical University No.2 Lujing Road Yuexiu District, Guangzhou 510091 Guangdong China
| | - Yuren Huang
- Department of Laser Therapy the Fifth People’s Hospital of Hainan Province No.33 South Longkun Road Haikou 570206 Hainan China
| | - Yabin Zhai
- Department of Laser Therapy the Fifth People’s Hospital of Hainan Province No.33 South Longkun Road Haikou 570206 Hainan China
| | - Xiaojuan Yao
- Department of Laser Therapy the Fifth People’s Hospital of Hainan Province No.33 South Longkun Road Haikou 570206 Hainan China
| | - Bin Yang
- Dermatology Hospital of Southern Medical University No.2 Lujing Road Yuexiu District, Guangzhou 510091 Guangdong China
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Benítez-Roig V, Trelles MA. Procedure and results on lower face and neck rejuvenation using a temperature-controlled bipolar fractional radiofrequency microneedling device. Lasers Surg Med 2022; 54:639-647. [PMID: 35060650 DOI: 10.1002/lsm.23517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/03/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Radiofrequency (RF) devices which are under ongoing technological development, are being increasingly used for minimally invasive rejuvenation procedures. The objective is to evaluate the efficacy and safety of a procedure that uses bipolar RF microneedles for rejuvenation of the lower face and neck. STUDY DESIGN AND METHODS A prospective clinical and histological study, with a blind evaluation of the results by independent evaluators. Twenty-four women over 40 years of age were evaluated, who were treated with bipolar RF equipment (Profound™; Candela Medical) during a single session. Biopsy samples were taken from 12 patients. Microscopy images related to the immediate effects of RF and the changes observed 4 months after treatment were examined. The clinical results were established through questionnaires and by comparing before and after photographs. Mean (m), range (R), and percentage (%) values were calculated. RESULTS Immediate lysis of adipocytes in submental fat was observed, as well as an increase in the density and compaction of elastin and collagen fibers 4 months later. The average percentage of reduction in fine lines, wrinkles, furrows, and folds was around 30%, while the average improvement of the neck silhouette was around 20%. Photographic signs of aging improved significantly, both in the face (p = 0.0007) and the neck (p = 0.002). Patient and therapist satisfaction with the results was 8.3/10 (R = 3-10) and 9.3/10 (R = 8-10), respectively. The adverse effects were mild and temporary and no complications were observed. CONCLUSION The procedure is safe, clinically effective, and satisfactory for patients.
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Affiliation(s)
- Virginia Benítez-Roig
- Laser and Aesthetic Medicine Department, Helicópteros Sanitarios Hospital, Marbella, Málaga, Spain
| | - Mario A Trelles
- Plastic Surgery Department, Vilafortuny Laser Centre, Dubai, UAE
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