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Somenek M. Minimally Invasive Male Facial Rejuvenation: Energy-Based Devices. Facial Plast Surg Clin North Am 2024; 32:437-445. [PMID: 38937001 DOI: 10.1016/j.fsc.2024.03.001] [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: 06/29/2024]
Abstract
The development of minimally invasive, non-surgical, and office-based procedures that have minimal downtime has stimulated an interest among men who may seek cosmetic treatments to increase competitiveness and appear youthful in the workplace. There has also been greater media attention on the male appearance and grooming along with increasing acceptance of cosmetic procedures within society. Achieving a successful cosmetic treatment in a male patient requires the physician to recognize the gender differences that exist. These include anatomy, skin aging, and skin biology, as well as behavioral patterns that exist in this population.
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Affiliation(s)
- Michael Somenek
- Somenek+Pittman MD, Advanced Plastic Surgery, 2440 M Street NW, Suite 507, Washington, DC 20037, USA.
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Shauly O, Marxen T, Menon A, Gould DJ, Miller LB, Losken A. Radiofrequency Microneedling: Technology, Devices, and Indications in the Modern Plastic Surgery Practice. Aesthet Surg J Open Forum 2023; 5:ojad100. [PMID: 38887534 PMCID: PMC11181949 DOI: 10.1093/asjof/ojad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024] Open
Abstract
Background Since the initial invention of microneedling, advancements have been made to improve the desired effects. The addition of radiofrequency to microneedling devices was developed within the past decade as a way to induce thermal injury and increase dermal heating to enhance the dermal wound healing cascade. Objectives With an overabundance of literature and mainstream media focused on microneedling and radiofrequency microneedling, this review aims to focus on the available high-quality evidence. Methods A comprehensive review of the literature was performed across PubMed (National Institutes of Health, Bethesda, MD) and Embase (Elsevier, Amsterdam, the Netherlands) databases. Attention was focused on manuscripts that provided objective data with respect to clinical application, innovation, anatomy, and physiology. Results Optimal outcomes are achieved when needle depth is targeted to the reticular dermis. Needle depth should reflect the relative differences in epidermal and dermal thickness throughout the face. A depth of at least 1.5 mm should be used for the forehead and temporal skin, 1.0 mm for the malar region, 2.0 mm (maximum depth for radiofrequency microneedling) for the nasal side walls, 0.5 mm for the perioral skin, and 1.5 mm for the neck. Deeper settings can be used with care to provide some fat reduction in the submentum. Conclusions The authors find herein that radiofrequency microneedling is a safe adjunctive tool to surgical aesthetic procedures. The addition of radiofrequency poses an advance over traditional microneedling devices for skin tightening, with improvements in both safety and efficacy over time. Level of Evidence 5
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Affiliation(s)
- Orr Shauly
- Corresponding Author: Dr Orr Shauly, Division of Plastic Surgery, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA. E-mail: ; Instagram: @orrshaulymd
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Ahn GR, Jang YN, Lee SY, Kim WJ, Han HS, Yoo KH, Bae TH, Barn J, Seok J, Kim BJ. Full-thickness skin rejuvenation by a novel dual-length microneedle radiofrequency device: A proof-of-concept study using human skin. Lasers Surg Med 2023; 55:758-768. [PMID: 37548075 DOI: 10.1002/lsm.23707] [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: 04/10/2023] [Revised: 06/05/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND A novel dual-length microneedle radiofrequency (DLMR) device has been developed to achieve full-thickness skin rejuvenation by stimulating the papillary and reticular dermis simultaneously. This device's dual-level targeting concept need to be validated on human skin, although its clinical efficacy has been demonstrated in a previous study. OBJECTIVES This study evaluated the dual-depth targeting capability and the ability to induce rejuvenation in each layer of vertical skin anatomy, that is, the epidermis, papillary dermis, and reticular dermis, using full-thickness human facial skin samples. METHODS Human facial skin samples were obtained from 13 Asian patients who had facelift surgery. To validate the dual-depth targeting concept, DMLR-treated skin samples were analyzed using a digital microscope, thermal imaging, and hematoloxylin and eosin (H&E) staining immediately after DLMR application. On samples stained with H&E, Masson's tricrome, and Verhoeff-Van Gieson, histological observation and morphometric analysis were performed. Total collagen assay (TCA) and quantitative real-time polymerase chain reaction (qPCR) were used to assess changes in total collagen content and mRNA expression levels of collagen types I/III and vimentin, respectively. RESULTS The DLMR device successfully induced thermal stimulation in the papillary and reticular dermis. The thickness, stacks, and dermal-epidermal junction convolution of the epidermis treated with DLMR were significantly increased. Collagen bundles in the dermis treated with DLMR exhibited a notable increase in thickness, density, and horizontal alignment. Dermal collagen levels were significantly higher in the morphometric and TCA data, as well as in the qPCR data for dermal matrix proteins. CONCLUSIONS Our DLMR device independently and precisely targeted the papillary and reticular dermis, and it appears to be an effective modality for implementing full-thickness rejuvenation.
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Affiliation(s)
- Ga Ram Ahn
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, South Korea
- Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea
| | - You Na Jang
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, South Korea
| | - So Young Lee
- Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea
| | - Woo Ju Kim
- Department of Plastic Surgery, Chung-Ang University Gwangmyeong Hospital, Seoul, South Korea
| | - Hye Sung Han
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Seoul, South Korea
| | - Kwang Ho Yoo
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Seoul, South Korea
| | - Tae Hui Bae
- Department of Plastic Surgery, Chung-Ang University Gwangmyeong Hospital, Seoul, South Korea
| | | | - Joon Seok
- Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea
| | - Beom Joon Kim
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, South Korea
- Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea
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Magro I, Kochhar A, Arnaoutakis D, Karimi K. Transcutaneous Radiofrequency Microneedling in the Facial Plastic Surgeon's Practice: A Review. Facial Plast Surg Aesthet Med 2022; 24:S3-S10. [DOI: 10.1089/fpsam.2022.0226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabelle Magro
- Department of Otolaryngology, Head and Neck Surgery, Keck Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Amit Kochhar
- Pacific Neuroscience Institute, Providence St. Johns Medical Center, Santa Monica, California, USA
| | - Demetri Arnaoutakis
- Department of Otolaryngology, Division of Facial Plastic Surgery, University of South Florida, Tampa, Florida, USA
| | - Kian Karimi
- Rejuva Medical Aesthetics, Los Angeles, California, USA
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Efficacy and Safety of Using Noninsulated Microneedle Radiofrequency Alone versus in Combination with Polynucleotides for Treatment of Periorbital Wrinkles. Dermatol Ther (Heidelb) 2022; 12:1133-1145. [PMID: 35501660 PMCID: PMC9110589 DOI: 10.1007/s13555-022-00729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction A few studies have evaluated the efficacy and safety of noninsulated radiofrequency microneedling (RFMN) to treat periorbital wrinkles in Asian patients. Recently, wound healing accelerators, polynucleotides (PNs), have received attention in wound management. However, their efficacy and safety have not been fully elucidated following RFNM. This study aimed to evaluate the efficacy and safety of noninsulated RFMN for periorbital wrinkles and the synergistic effect of PNs after RFMN. Methods Thirty subjects with Fitzpatrick skin types III to V and facial wrinkles (Fitzpatrick grades I and II) were enrolled. All volunteers were treated over the entire face with noninsulated RFMN for three sessions at 2-week intervals. The left and right sides of each patient’s face were randomly assigned to receive PNs (treatment group) or normal saline solution (control group). The indentation and maximum depth of wrinkles were objectively measured using Antera 3D. Subjective self-evaluations were obtained at baseline, 2 weeks after the third treatment, and at 1, 2, 3, and 6 months after the final treatment. In addition, pain scores, immediate reactions, and other adverse effects were evaluated. Results Twenty-nine subjects completed the treatment protocol. Most presented with grade II wrinkling (69%). At 2-month follow-up, Antera 3D image analysis revealed faster improvement for the treatment group. At 6-month follow-up, the majority of subjects reported an improvement of 25–75% in their periorbital wrinkles. The average pain score was 2.2 out of 10. No serious adverse events (infection, pigmentary alteration, persistent erythema, or scarring) were observed. Conclusions Noninsulated RFMN is safe and effective for treating periorbital wrinkles and can be used as a modality for transdermal drug delivery. Topical polynucleotides as an adjunctive treatment provide additional benefits for periorbital wrinkle treatment. Trial Registration Number TCTR20201105007.
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Saghati S, Khoshfetrat AB, Tayefi Nasrabadi H, Roshangar L, Rahbarghazi R. Fabrication of alginate-based hydrogel cross-linked via horseradish peroxidase for articular cartilage engineering. BMC Res Notes 2021; 14:384. [PMID: 34583753 PMCID: PMC8480019 DOI: 10.1186/s13104-021-05795-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/20/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE We aimed to detect the effect of a couple of parameters including Alg, H2O2, and HRP concentrations on the gelation time of Alg-based hydrogels using an enzymatic cross-linked procedure. RESULTS NMR, UV-Vis, and ATR-FTIR analyses confirmed the conjugation of Ph to the Alg backbone. Data showed gelation time was delayed with the increase and reduction of H2O2 and HRP, respectively. We noted that hydrogel consisted of 1.2% (w/v) Alg, 5 U HRP, and 100 mM H2O2 yielded an appropriate gelation time with appropriate mechanical properties. The addition of 0.5% (v/v) Col developed hydrogel increased the gelation time. The data showed that Alg, HRP, and H2O2 with the ratio of 1:0.54:0.54 had proper physicochemical features for cartilage engineering.
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Affiliation(s)
- Sepideh Saghati
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hamid Tayefi Nasrabadi
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Rahbarghazi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, 5154853431, Tabriz, Iran.
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Holcomb JD. Helium plasma dermal resurfacing: VISIA CR assessment of facial spots, pores, and wrinkles-Preliminary findings. J Cosmet Dermatol 2021; 20:1668-1678. [PMID: 33773028 PMCID: PMC8251577 DOI: 10.1111/jocd.14106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022]
Abstract
Objectives Effects of low energy, single‐pass helium plasma dermal resurfacing (PDR) treatment on brown spots, enlarged pores, and wrinkles—preliminary findings. Methods Twenty two subjects (64.6 ± 6.6 years) with Fitzpatrick Wrinkle and Elastosis Scale score (FWS) of ≤2 and seeking improvement of facial appearance were included in this subanalysis. All subjects received a single, one‐pass, full face, and low power helium PDR treatment. Standard digital images were collected using the VISIA‐CR (Canfield Scientific Inc.) at baseline and 3 months after treatment with images assessed for improvement in FWS and for improvements in brown spots, enlarged pores, and wrinkles by proprietary automated image processing algorithms. Results Nearly all subjects demonstrated ≥1‐point improvement in FWS and also reported improvement per modified Global Aesthetic Improvement Scale query. The numbers of brown spots and enlarged pores decreased by 45.1% and 28.3%, respectively. Stratification of brown spots data by presence or absence of post‐inflammatory hyperpigmentation revealed paradoxically conflicting data. The improvement detected in wrinkle area and mean wrinkle thickness was less pronounced with overall reductions of 13.4% and 4.8%, respectively. 37 Non‐serious adverse events (AEs) in 22 subjects were reported with most resolving within 14 days or less, and no serious AEs were observed. Conclusions While longer‐term follow‐up is needed, these early study results show that one single‐pass, low energy helium PDR treatment improves facial skin appearance both qualitatively and quantitatively. Studies evaluating higher energy levels and multiple treatment passes are ongoing.
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Sawant O, Khan T. Management of periorbital hyperpigmentation: An overview of nature-based agents and alternative approaches. Dermatol Ther 2020; 33:e13717. [PMID: 32472659 DOI: 10.1111/dth.13717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/17/2020] [Accepted: 05/23/2020] [Indexed: 11/30/2022]
Abstract
Periorbital hyperpigmentation (POH) is a common dermatological condition that presents as dark periorbital area beneath the lower eyelids, and it is commonly found in females belonging to the age group of 16 to 45 years. The data presented in this review include studies conducted on patients with a clinical/histological diagnosis of POH or melasma. Many diverse topical depigmenting agents comprising an array of naturally obtained actives such as arabinoxylans, α-arbutin, asiaticoside, azelaic acid, beta-carotene, boswellic acid, caffeine, chrysin, curcumin, cyanidin-3-glucoside, d-glucoronic acid, dihydrochalcone, dipalmitoyl-hydroxyprolene, fucoxanthin, genistein, glabridin, b-glucogallin, hyaluronic acid, lactic acid, lycopene, niacinamide, pycnogenol, retinol, salidroside, and xymenynic acid demonstrated significant benefits in the management of POH. An exhaustive literature search revealed that other techniques such as blepharoplasty, carboxytherapy, calcium hydroxylapatite fillers, tear trough implant, Q-switched ruby laser, medicated tattoo, fat transfer, micro-needling, chemical peels, nitrogen plasma skin regeneration, intense pulsed light, and radiofrequency have been evaluated and reported to be beneficial in the treatment of POH. The use of topical depigmenting agents is the most widely reported method in the clinical management of POH. Of these, α-arbutin, caffeine, cyanidin-3-glucoside, and dihydrochalcone are reported to exhibit significant benefits. Combination products containing a blend of actives are reported to be better than single active containing products. This review aims to provide a comprehensive perspective on the role of several topical actives in the modulation of melanin and tyrosinase biosynthesis pathway involved in the complex pathophysiology of POH. It also presents the advantages of combination products and other alternative therapies used in the management of POH.
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Affiliation(s)
- Omkar Sawant
- Department of Quality Assurance, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
| | - Tabassum Khan
- Department of Pharmaceutical Chemistry and Quality Assurance, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
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