Monopolar radiofrequency treatment for facial laxity: Histometric analysis

Treatment with synchronized radiofrequency and facial muscle stimulation: Histologic analysis of human skin for changes in collagen and elastin fibers

BACKGROUND

Skin's exposure to intrinsic and extrinsic factors causes age-related changes, leading to a lower amount of dermal collagen and elastin.

AIM

This study investigated the effects of a novel facial muscle stimulation technology combined with radiofrequency (RF) heating on dermal collagen and elastin content for the treatment of facial wrinkles and skin laxity.

METHODS

The active group subjects (N = 6) received four 20-min facial treatments with simultaneous RF and facial muscle stimulation, once weekly. The control subject (N = 1) was untreated. Skin biopsies obtained at baseline, 1-month and 3-month follow-up were evaluated histologically to determine collagen and elastin fibers content. A group of independent aestheticians evaluated facial skin appearance and wrinkle severity. Patient safety was followed.

RESULTS

In the active group, collagen-occupied area reached 11.91 ± 1.80 × 106 μm2 (+25.32%, p < 0.05) and 12.35 ± 1.44 × 105 μm2 (+30.00%, p < 0.05) at 1-month and 3-month follow-up visits. Elastin-occupied area at 1-month and 3-month follow-up was 1.64 ± 0.14 × 105 μm2 (+67.23%, p < 0.05), and 1.99 ± 0.21 × 105 μm2 (+102.80%, p < 0.05). In the control group, there was no significant difference (p > 0.05) in collagen and elastin fibers. Active group wrinkle scores decreased from 5 (moderate, class II) to 3 (mild, class I). All subjects, except the control, improved in appearance posttreatment. No adverse events or side effects occurred.

CONCLUSION

Decreased dermal collagen and elastin levels contributes to a gradual decline in skin elasticity, leading to facial wrinkles and unfirm skin. Study results showed noticeable improvement in facial appearance and increased dermal collagen and elastin content subsequent to simultaneous, noninvasive RF, and facial muscle stimulation treatments.

Development of Home Beauty Devices for Facial Rejuvenation: Establishment of Efficacy Evaluation System

Background

Home beauty devices for facial rejuvenation utilizing technologies such as radiofrequency, microcurrent, and light emitting diode have gained widespread attention due to their claimed ability to improve skin tightness and elasticity, making them popular among consumers. However, there is controversy within the industry regarding the effectiveness and safety of these devices.

Objective

This study aims to verify the safety and effectiveness of these home beauty devices in treating skin aging based on relevant efficacy evaluation indicators.

Methods

A systematic search of PubMed and web of science was conducted to include original research literature on the efficacy of home beauty devices for facial rejuvenation over the past two decades. The selected literature was processed and analyzed based on efficacy evaluation indicators such as sample size, follow-up period, experimental results, adverse reactions, and others.

Results

After screening, a total of 18 clinical studies were included. A comprehensive analysis of the experimental results and adverse reaction indicators from existing literature revealed that home beauty devices for facial rejuvenation can improve skin aging to a certain extent. Apart from transient redness and swelling, no other adverse reactions were observed.

Conclusion

Despite the variety of home beauty devices for facial rejuvenation available in the market, corresponding research reports are limited. Existing studies suffer from issues such as small sample sizes and short follow-up periods, highlighting the need for a more comprehensive efficacy evaluation system. Furthermore, the physical stimulation of meridian acupoints by home beauty devices for facial rejuvenation may meet the multi-dimensional anti-aging needs of patients, suggesting a potential direction for future research.

Achieving the minimum pain experience by buccal nerve and superficial cervical plexus blocks in radiofrequency treatment

BACKGROUND

Thermage is a monopolar radiofrequency (RF). It has become an indispensable part of facial and body youthful methods. Although the current device is constantly improving in epidermal cooling techniques and even automatically measures the local impedance value, applying surface anesthesia can take some of the pain away caused by thermage, and the patient's severe pain in the jaw and neck areas is still difficult to resolve.

METHODS

The author describes how he uses the combination of the buccal nerve block (BNB) and the superficial cervical plexus block (SCPB) to improve the comfort of the patient's face and neck treatment of patients. It can improve the quality, elasticity, and texture of the skin.

RESULTS

According to the author's knowledge of oral and maxillofacial surgery, the combination of BNB and SCPB is applied to the neck and facial analgesia. Combining the BNB and SCPB effectively provides facial and neck anesthesia. The BNB in this technique provides pain relief to the facial skin in the mandibular area and SCPB offers pain relief to the skin of the neck. RF facial rejuvenation treatment often involves the junction of the face and neck to improve the contour of the mandibular margin. Therefore, Whether the RF treatment is aimed at the face or neck, or the treatment is performed simultaneously, we advocate the block both of the buccal nerve and the superficial cervical plexus nerves to achieve perfect analgesia. Still, the dosage of anesthetic medication for the nerve block can be adjusted according to the treatment area.

CONCLUSION

We applied these two nerve blocks and their combination to improve skin laxity with RF therapy for the first time.

Nonablative monopolar radiofrequency for the reduction of facial pores and sebum excretion in Thai patients: A novel approach

BACKGROUND

Enlarged facial pores are visible topographic features of the skin that have been associated with cutaneous photoaging and increased sebum production. It has remained a common dermatologic concern, gaining a significant number of in-clinic consults. Available treatment modalities often operate on a single mode of action, consequently offering limited and short-term outcomes.

OBJECTIVE

This study aimed to evaluate the long-term efficacy and safety of a nonablative monopolar radiofrequency (NMRF) for pore tightening and sebum output reduction in Thai patients.

METHODS

Nineteen patients with enlarged pores underwent two sessions of NMRF treatments at 4-week intervals. The measurements of pore volume, skin texture, average pore size, sebum production, and skin elasticity were quantified using Antera® 3D imaging system, dermoscopic image analysis with ImageJ software, Sebumeter® and Cutometer®. Clinical evaluation by two dermatologists was done using blinded clinical photographs. All objective and subjective assessments were done at the baseline, a month after the first treatment, and during follow-up visits 1, 3, and 6 months after the last treatment. Adverse effects were also recorded during each visit.

RESULTS

Seventeen out of the 19 subjects completed the study protocol. The mean pore volume significantly reduced by 24% from the baseline at 1 month after the first treatment (p < 0.016). The pore volume continued to decrease by 34% and 38% a month (p < 0.001) and 6 months (p < 0.001) following the final treatment, respectively. Sebum excretion likewise significantly decreased from baseline by 39% (p = 0.002) and 36% (p < 0.001), 3 and 6 months after the second treatment, respectively. Skin texture and elasticity also significantly improved following two NMRF sessions. The objective assessments of the pore appearance corresponded to subjective clinical evaluations. The treatment was well-tolerated without significant side effects, such as dyspigmentation, textural alteration, and scarring.

CONCLUSION

NMRF appears to be effective and safe for the reduction of pore size and sebum production, with therapeutic outcomes persisting up to 6 months after two treatment sessions.

The effect of combined hyaluronic acid filler injection and radiofrequency treatment: A clinic histological analysis

BACKGROUND

Hyaluronic acid (HA) filler injections have increased in popularity. They are usually performed in combination with other treatment modalities, including lasers and energy-based devices, to enhance cosmetic results. Theoretically, HA and other filler injections should be performed after laser- or energy-based device treatments. In some instances, however, practitioners are asked to administer laser- or energy-based device treatment after HA dermal filler injection. There is a concerning possibility of HA filler degradation as a result of bulk heating generated by lasers or energy-based devices, especially radiofrequency (RF).

AIM

To evaluate the effect of RF treatment at different time points on HA degradation in vivo, using clinicohistological analysis.

PATIENTS/METHODS

Fourteen volunteers were recruited and received intradermal HA filler injections in four sites on the abdomen. One site served as the control, and the other three sites were treated with monopolar RF on the same day after injection, at 14 and 28 days post-injection. Skin biopsies were performed at baseline and 56 days after HA injection. Histopathological sections were reviewed for residual filler in the tissue.

RESULTS

The results showed that HA grading scores decreased in five (35.71%), one (7.14%), and one (7.14%) participants when RF was performed immediately, 14 and 28 days after injection, respectively.

CONCLUSION

In conclusion, RF treatment after HA filler injection may affect the integrity of the HA filler in the tissue, especially if RF treatment was performed on the same day after HA injection.

Efficacy of microneedle radiofrequency therapy in the treatment of senile purpura: A prospective study

BACKGROUND

Radiofrequency (RF) devices have been used for skin rejuvenation and treating skin laxity. It may also be effective for senile purpura (SP) based on its action of promoting neocollagenesis with minimal epidermal damage. This study aimed to evaluate the efficacy and safety of microneedle RF for treating SP of the forearms in elderly.

MATERIAL AND METHODS

In this prospective study, 23 patients who underwent a single session of microneedle RF device (GENIUS, Lutronic Co., Korea) therapy for SP were enrolled. Histopathological features were assessed 1 week before and 8 weeks after therapy. The total amount of collagen and elastic fibers were measured using the computer vision method, and epidermal thickness and the number of blood vessels were analyzed using ImageJ. The clinical improvements were evaluated by blinded evaluators and the patients using investigator global assessment (IGA) and patient global assessment (PGA), respectively. Data regarding the number of purpuric lesions and the size of the largest lesion were collected via a telephone survey.

RESULTS

The total amount of collagen and elastic fibers, and mean epidermal thickness tended to improve after RF treatments, although they did not reach statistical significance. The locally estimated scatterplot smoothing curve showed decreasing tendency in both size and number of purpuras as weeks progressed. PGA showed very satisfied in 65% of patients and IGA showed 39% near-total improvement and 43% marked improvement. There were no serious adverse events.

CONCLUSIONS

Microneedle RF therapy induces remodeling of dermal circumstances with minimal epidermal impairment. It may be a promising therapeutic option for SP.

Objective assessment of facial laxity changes after monopolar radiofrequency treatment by using moiré topography

Radiofrequency (RF) has been widely used as a noninvasive technique for skin tightening and rejuvenation. Moiré is a type of interference pattern corresponding to the shape of the face. We aimed to objectively evaluate the effect of RF on facial skin laxity using moiré. Ten subjects participated and were treated with a monopolar RF on the face. Clinical photographs and moiré images were obtained at the baseline and after treatment. The periorbital angle from the upper third of the face, zygomatic length ratio (L1/L2), angle from the middle third, perioral perpendicular length, and angle from the lower third were analyzed. After one session of RF treatment, the mean zygomatic length ratio (L1/L2) from the middle third of the face significantly increased in the 4th week (by 49.68%, P = .047). The L1/L2 ratio increased to nearly one, which were not significant after 8 weeks. The mean perioral perpendicular length decreased to 282.25 ± 84.069 pixels (px) after 4 weeks, and to 281.38 ± 76.03 px after 24 weeks; these differences were statistically significant. The parameters of zygomatic length ratio and perioral perpendicular length extracted from illuminated moiré images can be useful for objectively assessing various facial tightening treatments in clinical settings.

Monopolar radiofrequency for reposing drooping fat planes and facial rejuvenation: A prospective study on 30 subjects towards true antiaging

BACKGROUND

Monopolar radiofrequency (MRF) for facial rejuvenation works by diffusely heating the dermis and subdermal fibro-septal network. Immediate collagen contraction and long-term neo-collagenesis produce antiaging effects.

AIM

To lift and repose drooping fat planes along their vectors of descent to restore natural, youthful contours using MRF and to objectively measure, quantify, and analyze the antiaging effects of MRF on the backdrop of functional facial anatomy.

METHODS

This was a prospective study on 30 subjects aged 25-65 years who underwent three sessions of MRF (Exilis, BTL Aesthetics) with a modified protocol at weekly intervals. Clinical evaluation at baseline and 4 weeks after the final session was done according to the global drooping and wrinkles classification and scoring system (GDWCSS) and statistically evaluated. Two patients were analyzed with Ultrasound and Vectra-H1 imaging for change in subcutaneous fat depth and volume over different facial areas, respectively.

RESULTS

There was improvement in all parameters (volume alteration and wrinkles) of the GDWCSS, of which improvement in cases that had baseline severe (grade-4) temporal fat loss, malar fat loss, periorbital hollowing, and puffiness was statistically significant. The results of imaging supported the clinical findings.

CONCLUSION

Monopolar radiofrequency targets facial collagen as deep as the facial fat, thereby achieving "reversal" of the grooves and bulges of aging with volume re-distribution and favorable "remolding" of fat pads. The result is simultaneous skin tightening, lifting and contouring in manner that is natural, regenerative, and corrective. Given its versatility, efficacy, safety, and tolerability, it is emerging as a power-player in the dermatologist's antiaging armamentarium.