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Gao Y, Che Q, He Q, Wang W, Luo W, Tong Y, Liu L, Tang Q, Xie Y, Zhou Z, Wa Q. Treatment of periorbital aging with negative pressure fractional microneedle radiofrequency: A self-controlled clinical trial. J Cosmet Dermatol 2023. [PMID: 38013586 DOI: 10.1111/jocd.16091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/28/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Several treatment modalities are used for the treatment of periorbital rejuvenation with variable results. Recent studies showed that fractional radiofrequency may be an effective treatment modality for periorbital aging. This study aims to determine the efficacy and safety of negative pressure fractional microneedle radiofrequency (NPFMR) as a treatment for periorbital aging. METHODS Twenty-five patients with periorbital aging were involved in this study. They were treated two times with an interval of 1 month. The patients were evaluated before treatment and 1, 3, and 6 months after the final treatment. RESULTS The research findings suggest that periorbital wrinkles of the patients were significantly improved by VISIA system (p < 0.05). Physiological indicators detected by MPA10 system showed that compared with before treatment, the hydration increased (p < 0.05) and trans epidermal water loss (TEWL) decreased (p < 0.05) at 3 and 6 months after treatment. The glossiness increased at 1 month after treatment compared to pre-treatment (p < 0.05) and returned to the baseline level at 3 and 6 months after treatment. There was no significant change in melanin content (p > 0.05). Periorbital dermal thickness of the patients significantly increased at 1, 3, and 6 months after treatment according to skin ultrasound (p < 0.05). A periorbital skin biopsy revealed that the collagen fibers in the dermis were significantly thicker and more orderly after treatment, and the expression of type I collagen fibers and elastic fibers was increased compared with that before treatment. One patient developed post-inflammatory hyperpigmentation (PIH) at 1 month after the first treatment, which improved after active treatment. No other adverse reactions were observed. CONCLUSIONS NPMFR could be an effective and safe treatment modality for the treatment of periorbital aging.
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Affiliation(s)
- Yulian Gao
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Qilei Che
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Qiang He
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Wenju Wang
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - Wangsha Luo
- Department of Dermatology, Chengdu Fifth People's Hospital, Chengdu, China
| | - Yao Tong
- Department of Dermatology, Chengdu First People's Hospital, Chengdu, China
| | - Lufeng Liu
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Qiuyue Tang
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Yuhong Xie
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Zixuan Zhou
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
| | - Qingbiao Wa
- Medical Cosmetic Center, Chengdu Second People's Hospital, Chengdu, China
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Choi M, Lee HS, Cho SB. Effect of Pulse Widths and Cycles on Invasive, Bipolar, and Gated Radiofrequency-Induced Thermal Reactions in ex vivo Bovine Liver Tissue. Clin Cosmet Investig Dermatol 2023; 16:87-97. [PMID: 36660189 PMCID: PMC9844106 DOI: 10.2147/ccid.s395072] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
Background Radiofrequency (RF) oscillations generate thermal tissue reactions, the patterns of which vary depending on the mode and efficiency of energy delivery. The aim of our study was to analyze patterns of RF-induced thermal tissue reactions according to the modes of RF delivery, including continuous and gated modes, using an alternating current, invasive bipolar RF device. Methods RF energies at frequencies of 1 and 2 MHz were delivered at respective experimental settings into ex vivo bovine liver tissue at a 0.5-mm microneedle penetration depth. The tissue samples were then evaluated thermometrically. A histologic study was performed to evaluate RF-induced thermal tissue reactions at a 3.0-mm microneedle penetration depth. Results Thermal imaging study revealed homogenous, well-demarcated, square-shaped zones of RF-induced thermal reactivity on the treated area. Multivariate linear regression analysis revealed that higher temperature elevations immediately after RF treatment (∆T1) were positively associated with RF frequency, power, conduction time/pulse pack, and off-time between pulse packs and negatively associated with total off time. In the 1-MHz experimental setting, higher ∆T1 showed a positive association with power, conduction time/pulse pack, and off-time between pulse packs and a negative association with the number of pulse packs. In the 2-MHz setting, however, higher ∆T1 was positively associated with only total treatment time. Conclusion Thermometric effects during bipolar and gated RF treatments are significantly associated with the frequency, power, and pulse widths and cycles of pulse packs.
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Affiliation(s)
- Min Choi
- R&D Center, Shenb Co., Ltd, Seoul, Korea
| | - Hye Sun Lee
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Bin Cho
- Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea,Correspondence: Sung Bin Cho, Yonsei Seran Dermatology and Laser Clinic, Geumcheon REMAIN CITY 6F, 224 Siheung-daero, Geumcheon-gu, Seoul, 08628, Korea, Tel +82.2-2135-1375, Fax +82.70-8250-1375, Email
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Bzovey B, Ngo W. Eyelid Warming Devices: Safety, Efficacy, and Place in Therapy. CLINICAL OPTOMETRY 2022; 14:133-147. [PMID: 35959466 PMCID: PMC9362510 DOI: 10.2147/opto.s350186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Meibomian gland dysfunction (MGD) is characterized by the obstruction and/or inflammation of the meibomian glands that result in decreased and altered meibum secretion. This results in deficiencies in the tear film lipid layer which contributes to increased evaporation and destabilization of the tear film. One of the mainstay therapies for MGD is medical devices that apply heat and/or pressure to the eyelids and promote the liquification and outflow of meibum into the tear film. Over the past two decades, there have been a surge of interest in diagnosing and managing MGD. As a result, numerous medical devices have been developed and each have their own unique approach to treating MGD. This narrative review was conducted to summarize the current state of knowledge on eyelid warming devices, specifically warm eye coverings, devices that direct heat and/or pressure to the eyelids, moisture chamber goggles, and light-based therapy. This review summarized 58 human clinical studies and found that most eyelid warming devices were efficacious in improving signs and symptoms in a wide range of MGD severities and were generally safe to use.
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Affiliation(s)
- Brandon Bzovey
- Centre for Ocular Research & Education, School of Optometry & Vision Science University of Waterloo, Waterloo, Ontario, Canada
| | - William Ngo
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research (CEVR), Hong Kong, People’s Republic of China
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Chawvavanich P, Singthong S, Intarachaieua K. The effectiveness and side effects of bipolar radiofrequency to treat submental laxity. J Cosmet Dermatol 2022; 21:4392-4397. [PMID: 35255190 DOI: 10.1111/jocd.14898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/09/2022] [Accepted: 02/25/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Submental skin laxity becomes a common cosmetic problem with age. Bipolar radiofrequency is a new, non-invasive procedure. Unlike the LASER, the radiofrequency (RF) device has no specific chromophore absorption. Thus, the device can be used on any skin type. OBJECTIVE To evaluate the effectiveness and adverse effects of the bipolar RF for treatment of submental laxity and skin tightening. MATERIAL AND METHODS Twenty-two patients with submental laxity were treated with FormaTM on both sides of the submental area. The patients underwent four sessions every two weeks for one and half months. Two blinded dermatologists evaluated the pre-treatment and post-treatment photographs every visit. The three-dimensional photographs were recorded by Vectra® camera and determined the association. RESULTS All 22 patients completed all the treatment sessions. The degree of improvement was statically significant after the third session based on the physical assessment scale and after the second session in terms of the submental laxity score. The fat volume reduction was statically significant from one week to six months from baseline. Almost all subjects developed transient erythema immediately after the treatment. No serious side effects were noted. CONCLUSIONS The bipolar RF device is another potential choice for skin tightening due to its efficacy and safety profile. It can be used with any skin type and has few side effects.
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Austin GK, Struble SL, Quatela VC. Evaluating the effectiveness and safety of radiofrequency for face and neck rejuvenation: A systematic review. Lasers Surg Med 2021; 54:27-45. [PMID: 34923652 DOI: 10.1002/lsm.23506] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/04/2021] [Accepted: 11/25/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Radiofrequency technology has emerged as a treatment for aesthetic rejuvenation. OBJECTIVE To examine radiofrequency for facial and neck rejuvenation, clinical studies were assessed on effectiveness and safety of radiofrequency for acne, acne scars, and facial aging by subjective and objective measures. METHODS A systematic literature review was performed. Eligibility criteria included articles in English, primary literature, clinical or ex vivo studies, use of radiofrequency, and face or neck treatment. Ablative techniques, home-use devices, combined modalities, and studies unrelated to rejuvenation were excluded. All studies were appraised for quality and biases. RESULTS We identified 121 articles. Radiofrequency effectively treated acne by reducing sebum levels and lesion count and improving acne scars. Radiofrequency demonstrated a volumetric reduction in facial fat, and improved skin laxity, elasticity, and global skin aesthetic. Patient satisfaction was higher for those desiring modest rejuvenation. There were histological changes consistent with repair response, neocollagenesis, and neoelastinogenesis. Radiofrequency was safe apart from one patient who developed a neck fistula. CONCLUSION Most studies demonstrated radiofrequency treatment of acne, scars, or facial rhytids had positive subjective improvement ratings. Objective studies demonstrated reduction of acne, decreased scarring, lifting effect, improvement in elasticity and collagen, volumetric fat changes, and wrinkle reduction.
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Affiliation(s)
- Grace K Austin
- Quatela Center for Plastic Surgery, Rochester, New York, USA.,Grace Kim Austin, MD, Inc, Glendale, California, USA.,Department of Surgery, Facey Medical Group, Valencia, California, USA
| | - Sarah L Struble
- School of Medicine, California University of Science and Medicine, Colton, California, USA
| | - Vito C Quatela
- Quatela Center for Plastic Surgery, Rochester, New York, USA
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Turer DM, James IB, DiBernardo BE. Temperature-Controlled Monopolar Radiofrequency in the Treatment of Submental Skin Laxity: A Prospective Study. Aesthet Surg J 2021; 41:NP1647-NP1656. [PMID: 33693518 DOI: 10.1093/asj/sjab107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Laxity of the submental area is a common cosmetic complaint of the aging population. OBJECTIVES The aim of this study was to determine the safety and effectiveness of a temperature-controlled, minimally invasive percutaneous monopolar radiofrequency device to improve dermal laxity and achieve lift. METHODS A total of 72 subjects (35-65 years old) with mild to moderate skin laxity in the submental area were included in this single-center prospective study. All subjects received 1 treatment at baseline with an average subdermal temperature of 63°C. The primary endpoint was the proportion of subjects with at least a 20-mm2 decrease in surface area at Day 90 based on 3-dimensional photography. Secondary endpoints included skin elasticity measured by Cutometer, assessment by a blinded physician panel from 2-dimensional photographs, and physician- and subject-reported outcomes. RESULTS At Day 90, 72.1% (95% CI: 62.2%-84.0%; P < 0.001) of subjects achieved at least a 20-mm2 lift of the submental area. All Cutometer-measured skin elasticity values (R2, R5, R7) showed significant improvement by 180 days. The independent panel graded 74.2% of subjects as "improved" at 90 days (95% CI: 62.0%-84.2%; P < 0.001). The treatment was well tolerated, and only 1 possibly related serious adverse event was reported (pharyngeal inflammation). CONCLUSIONS Treatment with temperature-controlled monopolar radiofrequency alone is a safe and effective treatment to achieve submental lift for at least 6 months. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- David M Turer
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Isaac B James
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Harrison LM, Shapiro R, Johnson RM. Tissue Modification in Nonsurgical Facelift Options. Facial Plast Surg 2020; 36:688-695. [PMID: 33368123 DOI: 10.1055/s-0040-1721115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nonsurgical facelifts are a term for a heterogeneous group of procedures used by physicians to improve facial rejuvenation without the use of operative techniques. Patients demand these services due to the reduced recovery time and generally lower risk. However, nonsurgical techniques, to be effective, must induce conformational change in the cells and tissues of the face. Therefore, these techniques are significant procedures that have associated risks. Understanding the tissue modifications and mechanisms of action of these techniques is vital to their safe and effective use. The purpose of this article is to provide a background of tissue modification in nonsurgical facelift options.
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Affiliation(s)
- Lucas M Harrison
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - Ryan Shapiro
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - R Michael Johnson
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
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Lee C, Gold MH. Updates on radiofrequency devices for skin tightening and body contouring. ACTA ACUST UNITED AC 2020. [DOI: 10.1002/der2.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
| | - Michael H. Gold
- Gold Skin Care Center Nashville Tennessee USA
- Tennessee Clinical Research Center Nashville Tennessee USA
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Kinney BM, Kanakov D, Yonkova P. Histological examination of skin tissue in the porcine animal model after simultaneous and consecutive application of monopolar radiofrequency and targeted pressure energy. J Cosmet Dermatol 2020; 19:93-101. [PMID: 31794139 PMCID: PMC7004092 DOI: 10.1111/jocd.13235] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The cosmetic appearance of skin is substantially influenced by the organization of connective fibers and underlying subcutaneous tissue. It has been previously documented that radiofrequency and pressure energies alone are able to improve skin appearance; however, detailed histological evaluation should be done to determine their synergistic effect. AIMS This histological study investigates the difference between simultaneous and consecutive application of monopolar radiofrequency with targeted pressure energy on porcine skin. METHODS In a total of four weekly abdominal treatments, simultaneous emission of the energies was applied to two pigs (12 minutes per session); additionally, two pigs were treated consecutively (12 + 12 minutes per session). The 5th pig served as a control subject. Biopsies were obtained at baseline, after the 4th treatment, and at 1-month follow-up. Primary outcomes were to document changes of dermal and hypodermal tissues. RESULTS In the treated subjects, the amount of collagen and elastin fibers increased significantly (P < .001). At follow-up, simultaneous application showed a significantly higher increase in collagen and elastin fibers (by 59% and 64%, respectively), when compared to consecutive. Thickness of the dermis increased more in the pigs treated simultaneously (+848.8 µm/50.17%; P < .001). Treated tissue also showed the upper part of dermis to be rich in blood vessels and better organized interlobular septa in hypodermis. No significant change was observed in the control subject. CONCLUSION Simultaneous application produces significantly more profound changes, when compared to consecutive treatment. Further research is needed but our findings represent a new potential treatment of various skin conditions like cellulite or laxity.
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Affiliation(s)
- Brian M. Kinney
- Division of Plastic SurgeryThe University of Southern California Keck School of MedicineBeverly HillsCAUSA
| | - Dian Kanakov
- Department of Internal Noninfectious DiseasesFaculty of Veterinary MedicineTrakia UniversityStara ZagoraBulgaria
| | - Penka Yonkova
- Department of Veterinary Anatomy, Histology and EmbryologyFaculty of Veterinary MedicineTrakia UniversityStara ZagoraBulgaria
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Gorgu M, Gökkaya A, Karabekmez FE, Aytar O, Kızılkan J, Karanfil E, Astarcı HM. Effects of device variables to radiofrequency (RF) applications. J COSMET LASER THER 2019; 21:364-371. [PMID: 31495230 DOI: 10.1080/14764172.2019.1661491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
RF devices have frequency, power and duration setting options, it is important to make sure that the device meets the targeted values at the head output. This study was made to evaluate the RF device output value accuracy and the effects of different frequencies on the tissue heat levels. RF was applied to invitro tissues obtained from surgical operations, and invivo tissues during operations. Heat differences and depth were measured by laser/IR thermometer and thermal infrared camera. First, the output frequency and power values provided by the device were approved. Then, three three heads (monopolar, bipolar and tripolar) with three different frequencies (1,7, 20 MHz) were used. Depth of heat increase was evaluated in millimeters. The results showed that temperature increase varied between 10°C and 30°C at different depths using different frequencies. Heating of the skin with a radiofrequency device in a therapeutic dose is possible if the appropriate frequency and adequate power values are applied. Because the therapeutic temperature is close to the complication limit, the practitioner should be an expert using the device, well-knowledgeable about the regional skin structure and thickness, as well as be able to properly adjust the application doses in order to get therapeutic results.
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Affiliation(s)
- Metin Gorgu
- Department of Plastic Reconstructive Surgery, Abant İzzet Baysal University , Bolu , Turkey
| | - Ali Gökkaya
- Department of Plastic Reconstructive Surgery, Abant İzzet Baysal University , Bolu , Turkey
| | - Furkan Erol Karabekmez
- Department of Plastic Reconstructive Surgery, Abant İzzet Baysal University , Bolu , Turkey
| | - Oktay Aytar
- Department of Electrical & Electronics Engineering Dept, Abant İzzet Baysal University , Bolu , Turkey
| | - Jehat Kızılkan
- Department of Plastic Reconstructive Surgery, Abant İzzet Baysal University , Bolu , Turkey
| | - Ertuğrul Karanfil
- Department of Plastic Reconstructive Surgery, Abant İzzet Baysal University , Bolu , Turkey
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Shin JW, Kwon SH, Choi JY, Na JI, Huh CH, Choi HR, Park KC. Molecular Mechanisms of Dermal Aging and Antiaging Approaches. Int J Mol Sci 2019; 20:ijms20092126. [PMID: 31036793 PMCID: PMC6540032 DOI: 10.3390/ijms20092126] [Citation(s) in RCA: 322] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 04/22/2019] [Accepted: 04/28/2019] [Indexed: 01/08/2023] Open
Abstract
The dermis is primarily composed of the extracellular matrix (ECM) and fibroblasts. During the aging process, the dermis undergoes significant changes. Collagen, which is a major component of ECM, becomes fragmented and coarsely distributed, and its total amount decreases. This is mainly due to increased activity of matrix metalloproteinases, and impaired transforming growth factor-β signaling induced by reactive oxygen species generated during aging. The reduction in the amount of collagen hinders the mechanical interaction between fibroblasts and the ECM, and consequently leads to the deterioration of fibroblast function and further decrease in the amount of dermal collagen. Other ECM components, including elastic fibers, glycosaminglycans (GAGs), and proteoglycans (PGs), also change during aging, ultimately leading to a reduction in the amount of functional components. Elastic fibers decrease in intrinsically aged skin, but accumulate abnormally in photoaged skin. The changes in the levels of GAGs and PGs are highly diverse, and previous studies have reported conflicting results. A reduction in the levels of functional dermal components results in the emergence of clinical aging features, such as wrinkles and reduced elasticity. Various antiaging approaches, including topicals, energy-based procedures, and dermal fillers, can restore the molecular features of dermal aging with clinical efficacy. This review summarizes the current understanding of skin aging at the molecular level, and associated treatments, to put some of the new antiaging technology that has emerged in this rapidly expanding field into molecular context.
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Affiliation(s)
- Jung-Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Soon-Hyo Kwon
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Ji-Young Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- Department of Dermatology, Seoul National University College of Medicine, Seoul 03080, Korea.
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Hye-Ryung Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Kyung-Chan Park
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- Department of Dermatology, Seoul National University College of Medicine, Seoul 03080, Korea.
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