Prospective Clinical Trial of the Latest Generation of Noninvasive Monopolar Radiofrequency for the Treatment of Facial and Upper Neck Skin Laxity

Efficacy and safety of a novel monopolar radiofrequency device with a continuous water-cooling system in patients with age-related facial volume loss

BACKGROUND

Esthetic radiofrequency (RF) technology has much attracted public attention with the increasing demand for skin rejuvenation. A continuous water cooling-based monopolar RF (MRF) device was designed for the first time to protect the epidermis and maximize clinical outcomes.

OBJECTIVE

Assess the efficacy and safety of the proposed MRF device in patients with mild-to-moderate sunken cheeks and jawline laxity.

METHODS

Twenty-one patients underwent a single session of MRF treatment. Quantitative analysis was performed using a 3D imaging technique. Postprocedural clinical improvements were assessed with the Merz Scale. Regarding safety, adverse events (AEs), thermal sensation (TS) and pain intensity were explored. Patient satisfaction was surveyed with the Self-Assessment Questionnaire (SAQ).

RESULTS

The follow-up investigation demonstrated that facial volume increased across the cheek and jawline, with lifting effects throughout the treatment area. The Merz Scale assessment revealed that sunken cheeks, sagging jawlines and wrinkles were markedly improved. In addition, there were transient AEs, mild TS and moderate pain. In SAQ, 81% patients were satisfied with the procedure.

CONCLUSIONS

This study provided quantitative evidence for postprocedural volumetric increases along with enhanced lifting effects, strongly implying that the proposed MRF device can be an attractive option for improving facial skin volume loss and laxity.

Facial tightening using a novel vacuum-assisted microneedle fractional radiofrequency system: A prospective, randomized, split-face study

BACKGROUND

The microneedle fractional radiofrequency system (MFRS) is able to rejuvenate facial appearance by heating and coagulating certain depth of skin tissue.

OBJECTIVE

To evaluate the safety and efficacy of a novel vacuum-assisted MFRS for facial contour tightening.

METHODS

This prospective, randomized, split-face study included 21 patients who underwent three treatments with a vacuum-assisted MFRS at 1-month intervals. Half of the face was treated with the MFRS; the other half was untreated (control). Facial volume changes and wrinkles were objectively measured using a three-dimensional imaging system and VISIA-CR.

RESULTS

Volume changes of the treated midface were -0.24 ± 0.75, -0.59 ± 0.92, and -0.55 ± 0.65 mL at 1, 3, 6 months follow-up; however, measurements of the control side were 0.08 ± 0.70, -0.08 ± 0.53, and - 0.10 ± 0.86 mL, indicating significant reductions (p < 0.05). The number of facial wrinkles on the treated side was significantly reduced to 12.44 ± 4.85 at 3 months and sustained at 6 months (11.11 ± 4.100) compared to the control side (14.89 ± 5.26 and 13.22 ± 4.44, respectively; p < 0.05). No long-term side effects occurred.

CONCLUSION

The vacuum-assisted MFRS is safe and effective and is recommended for improving facial tightening and reducing wrinkles. This technology is sufficient to ensure the insertion depth, thus helping to improve the treatment accuracy and safety. The MFRS provides sustained effects for at least 6 months.

Radiofrequency and Radiofrequency Microneedling in Skin of Color: A Review of Usage, Safety, and Efficacy

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.

Dermal Micro-coring for the Treatment of Moderate to Severe Facial Wrinkles

Micro-coring technology (MCT) removes cores of skin without formation of scars, thereby tightening skin and reducing skin wrinkling. The purpose of this study was to evaluate the safety and efficacy of MCT with the dermal micro-coring device for the treatment of facial wrinkles.

METHODS

This prospective, multicenter clinical trial included fifty-one subjects who underwent MCT treatments of the mid to lower face. The primary study endpoint was change in the Lemperle Wrinkle Severity Scale. Secondary study endpoints were change in Global Aesthetic Improvement Scale (GAIS), participant satisfaction, and evaluation of treatment outcome by an independent review panel. All study endpoints were evaluated at 1, 7, 30, 60, and 150 or 180 days after treatment. Procedure bleeding, pain, and early healing profile were also captured.

RESULTS

The mean Lemperle Wrinkle Severity Scale change was 1.3 grades. Improvement in the GAIS was reported for 89.7% (87/97) of treated sites, and average improvement of GAIS was 1.5. Participants reported satisfaction with 85.6% of treatment sites. The independent review panel correctly identified 84.2% of the post-treatment photographs as post-treatment. Procedure bleeding and pain was mild with good healing responses and patient-reported average down time of 3 days.

CONCLUSIONS

The results of this study demonstrate the safety and efficacy of MCT with the dermal micro-coring device for the treatment of moderate to severe facial wrinkles. MCT led to significant improvement of facial wrinkles with high patient satisfaction and fast recovery time and should be considered in patients who are seeking minimally invasive treatment for wrinkles of the face.

Efficacy and Safety of Monopolar Radiofrequency for Treatment of Lower Facial Laxity in Asians

INTRODUCTION

Monopolar radiofrequency (MRF) is a valuable modality for tightening and contouring mild-to-moderate facial skin laxity. Few studies have evaluated new-generation MRF devices for lower facial laxity in Asians. This study aims to evaluate the efficacy and safety of MRF for treating lower facial laxity in Asians.

METHODS

This prospective cohort study enrolled 30 volunteers with Fitzpatrick Skin Types III-V and mild-to-moderate skin laxity. Subjects received a single MRF treatment. Self-assessments and adverse events were recorded. Two blinded dermatologists graded improvements (6-point scale) after treatment and 1, 3, and 6 months later.

RESULTS

All subjects completed the study. Treatment energy levels ranged from 2 to 4. The average number of shots was 412 ± 49, delivered in 3-4 passes with 15-30% overlap. All patients reported improvement in lower facial laxity immediately after treatment. Most patients had mild-to-moderate improvement over the 6-month follow-up. Continuous improvement was observed at the 1-, 3-, and 6-month follow-ups (P < 0.01). Significant improvement was seen at the 6-month follow-up compared with the 1-month follow-up (P < 0.01). Subjects tolerated the procedure well: the average pain score was 3.13 out of 10, and no serious adverse events were observed.

CONCLUSIONS

The new-generation MRF device we tested was effective and safe for mild-to-moderate lower facial laxity in Asian skin. The latest MRF technology offers improved safety to prevent complications. Appropriate patient selection, setting, and protocols are mandatory to achieve optimal clinical outcomes.

THE TRIAL REGISTRATION NUMBER

TCTR20210326002.