INTRODUCTION
As individuals age, collagen, which comprises the majority
of dermal proteins, can become disorganized leading to atrophy of the epidermis.1 Evidence of this degeneration includes flattening of the dermal-epidermal junction;
loss of rete processes; reduced number of fibroblasts; and decreased levels of overall collagen. Regardless of the underlying
etiology, most aesthetic skin complaints related to aging have traditionally been treated with plastic surgery.2
Within the last decade, interest in minimally invasive or non-invasive techniques for cosmetic facial rejuvenation, with little to no down time for recovery, has grown substantially. Historically,
dermatological concerns of the face, such as rhytides, striae, skin laxity or texture irregularities, have been treated with either surgical intervention or ablative dermal resurfacing techniques.3 The majority of these procedures work by destroying
the epidermis and inducing dermal injury. As the skin heals, dermal collagen is then reorganized, leading to several desired secondary effects, such as skin tightening and improvement in rhytides.4 Examples of these techniques include chemical peels, dermabrasion, char-free pulsed carbon dioxide (CO2), and erbium-doped yttrium aluminum garnet (Er: YAG) lasers.5,6
More recently, efforts have increased to develop a technique
that provides effective treatment for dermatological
conditions affecting the face, while also minimizing both post-treatment recovery time and the potential risk for infection,
scarring, and hyperpigmentation. As such, attention has been given to the use of thermal energy for inducing dermal injury while preserving the integrity of the epidermal layer. Several techniques have been developed that utilize thermal energy, including both light-based systems and noninvasive lasers. Evidence from clinical evaluations of these procedures
has provided support for their effectiveness in treating facial rhytides.7,8
Unlike techniques developed from light-based non-ablative resurfacing, treatment using radiofrequency (RF) energy causes thermal energy in the skin, initiating dermal injury. The thermal energy generated from RF is created by an oscillating
electrical current, which causes charged molecules and ions to collide against one another to generate heat energy
in the tissue. Depending on the intensity, this thermal energy can be used to stimulate or ablate targeted tissue within the body.9
The potential clinical applications of RF energy are widely varied
and depend on the depth of the targeted tissue, the specific frequency used during treatment and the method which the energy is delivered to the tissue,10 though RF energy is most
