Consensus Recommendations for 4th Generation Non-Microneedling Monopolar Radiofrequency for Skin Tightening: A Delphi Consensus Panel

January 2020 | Volume 19 | Issue 1 | Original Article | 20 | Copyright © January 2020

Published online December 13, 2019

Anne Chapas , Brian S. Biesman , Henry Hin Lee Chan , Michael S. Kaminer , Suzanne L. Kilmer , Mary P. Lupo , Ellen Marmur , Susan Van Dyke

aUnion Square Laser Dermatology, New York, NY bBrian S. Biesman PLLC, Nashville, TN cHong Kong Dermatology and Laser Center, Hong Kong dSkin Care Physicians, Chestnut Hill, MA eLaser & Skin Surgery Center of Northern California, Sacramento, CA fLupo Center for Aesthetic & General Dermatology LLC, New Orleans, LA gMarmur Medical, New York, NY hVan Dyke Aesthetics, Paradise Valley, AZ

en over the course of the rounds because overall feedback is given to each participant. Second, the lack of face-to-face collaboration, coupled with the increased potential for participant burnout as the number of rounds increases.

Finally, although these Consensus Statements provide clinicians with recommendations, further work is necessary to generate the data that would be needed to develop evidence-based guidelines. We encourage the manufacturer to support the development of a patient registry that would allow prospective collection of outcomes data from both patients and treatment data from clinicians.


All authors were financially compensated by Solta Medical, a division of Bausch Health, for their work on the development, editing, review, approval and decision to submit the manuscript for publication, their participation in the consensus statement process and analysis and interpretation of the data.

Solta Medical had no role in the design or conduct of the study nor collection, management, analysis or interpretation of the data; nor in the preparation, review, or approval of the manuscript.


Dr. Anne Chapas had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

The authors would like to thank Jeffrey S. Dover MD, FRCPC, (SkinCare Physicians, Chestnut Hill, MA), for his expert review of the manuscript and Judi Miller (SRxA, McLean, VA) for assistance with consensus statement methodology research, questionnaire design and interpretation and manuscript preparation. Ms. Miller’s work was financially supported by Solta Medical.


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Anne Chapas MD