Novel Nonablative Radio-Frequency Rejuvenation Device Applied to the Neck and Jowls: Clinical Evaluation and 3-Dimensional Image Analysis
November 2013 | Volume 12 | Issue 11 | Original Article | 1215 | Copyright © 2013
Lisa K. Chipps MD MS,a,b,c Jason Bentow MD,c Heidi B. Prather MD,d Jeffrey J. So MS PA-C,a
Jonathan M. Schouest BS,a and David M. Ozog MD,a,e Ronald L. Moy MDa,b
aMoy-Fincher-Chipps Medical Group, Beverly Hills, CA
bDavid Geffen School of Medicine at UCLA, Los Angeles, CA
cDivision of Dermatology, Harbor-UCLA Medical Center, Torrance, CA
dUniversity of Pittsburgh, Department of Dermatology, Pittsburgh, PA
eHenry Ford Hospital, Department of Dermatology, Detroit, MI
OBJECTIVE: To use 3D photography to evaluate the clinical efficacy of a novel radiofrequency delivery device used to improve the appearance
of rhytids and laxity of the face and neck.
STUDY DESIGN: Forty-nine subjects received a total of two radio-frequency treatments to the face and neck one-month apart. The novel radio-frequency delivery device was used to heat the dermis between 41-43°C for five heat cycles. Primary outcome measures were clinical efficacy quantified by the Global Assessment Improvement Scale (GAIS) and a patient survey that assessed treatment satisfaction.
RESULTS: Assessments of 3D photographs revealed an overall improvement in 74% of study subjects. 85% of patients noted an overall improvement in the appearance of their skin. 81% of patients rated their post-treatment skin laxity as improved, 85% rated their skin smoothness as improved and 62% rated their skin brightness as improved.
CONCLUSION: Subjects in this study demonstrated an overall improvement in face and neck appearance with regard to skin tightening, wrinkles, and skin texture suggested by overall patient satisfaction (85%) and physician-rated GAIS improvement (74%). This study suggests that radiofrequency applied with a continuous thermal treatment device is a safe and efficacious way to improve the overall appearance of aging facial skin.
J Drugs Dermatol. 2013;12(11):1215-1218.
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There are multiple manifestations of the aging face, which are influenced by internal and external factors. Rhytids develop around the eyes, forehead, mouth, and lower jaw. Skin laxity increases noticeably in the jowls and neck. As a means to correct these changes, patients seek out various treatment options including surgical intervention, photorejuvenation, radio-frequency devices, chemical ablation, retinoids, fillers and neurotoxins. Non-invasive and nonablative procedures have increased in popularity because they have little to no recovery time and minimal side effects. Of the non-ablative procedures, radio-frequency devices have been shown to decrease skin laxity and improve the appearance of rhytids.1 It has been suggested that results are achieved by the thermal effect: electrically generated radiowaves produce heat in the skin as determined by the formula: Energy (J) = I2 × R × T (I = Current, R = Impedance of the tissue, T = time of application).2 At the frequencies used by these devices, the greater impedance of the dermis relative to the epidermis leads to heat production in the dermis with sparing of the epidermis. Thus, dermal collagen fibrils are selectively targeted, resulting in collagen fibril shortening3. The heat produced also induces an inflammatory response leading to collagen neogenesis.4 In this study we describe a novel application of monopolar radio- frequency (RF) to generate continuous heat in the dermis resulting in skin tightening and an overall improved cosmesis.5 Clinical data evaluating the efficacy of this procedure was limited. To address this deficiency, we designed a prospective clinical study to evaluate overall patient satisfaction and investigator assessed clinical efficacy of this novel monopolar radio-frequency device.