Split-face comparison of radiofrequency versus long-pulse Nd-YAG treatment of facial laxity.

BACKGROUND AND OBJECTIVE: To improve photoaging skin with laser treatment, multiple sessions have been considered necessary to achieve results comparable with one radiofrequency (RF) treatment. We compared single-treatment improvements obtained by the long-pulse 1064 nm Nd:YAG laser and RF device. STUDY DESIGN/MATERIALS AND METHODS: In a split-face study, patients with sagging skin were treated once with laser (left side) and once with RF (right side) energy. RESULTS: Improvement judged by six blinded observers was greater for wrinkles and laxity (30% median) on the laser-treated side and essentially the same with both modalities (15% median) for texture, pores, and pigmentation. Improvement was maintained for at least 2-6 months on both facial sides without adverse effects. CONCLUSION: With a single treatment, both the long-pulse 1064 nm Nd:YAG laser and ThermaCool RF device provide a modest degree of improvement in both wrinkles and laxity of facial skin and similar improvement in texture, pores, and pigmentation.     

Cellulite treatment using a novel combination radiofrequency, infrared light, and mechanical tissue manipulation device.

BACKGROUND: Most post-pubertal women exhibit cellulite, particularly in the thigh and buttock regions. The prevalence of cellulite has led to many attempts at treatment, including a variety of topical solutions, massage-based therapies, and surgical techniques--most with suboptimal clinical effects. The purpose of this controlled study was to evaluate a novel combination device involving radiofrequency, infrared light, and mechanical tissue manipulation for the treatment of cellulite. METHODS: Twenty adult women (ages 25-57 years) of various skin phototypes (I-V), and with moderate bilateral thigh and buttock cellulite, received eight biweekly treatments to a randomly selected side (the contralateral side serving as a non-treated control). A combined bipolar radiofrequency, infrared light, and mechanical suction-based massage device was applied at 20 watts RF, 20 watts IR (700-1500 nm) light, and 200 millibar vacuum (750 mmHg negative pressure). Patients were evaluated using standardized digital photography and circumferential leg measurements at baseline, prior to each treatment session, and at one, three, and six months after the final treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = or < 25%, 1 = 25%-50%, 2 = 51%-75%, 3 = or >75% improvement) were made independently by two masked medical assessors after the series of treatments. Final post-treatment body weight and patients' subjective evaluations were recorded. RESULTS: Ninety per cent (18/20) of patients noticed overall clinical improvement, and 17 of these 18 patients reported that they would pursue treatment of the contralateral thigh. Side effects were limited to transient erythema in most patients, and bruising was observed in 2/20 patients after the first couple of treatment sessions, but not as the treatment series progressed. Clinical improvement scores averaged 1.82 (corresponding to approximately 50% improvement) after the series of treatments. Circumferential thigh measurements were reduced by 0.8 cm on the treatment side. CONCLUSIONS: Cellulite can be significantly and safely reduced with the use of a noninvasive device that combines bipolar RF, infrared light, and mechanical massage. The effects of treatment appear to be prolonged, but maintenance treatments may be necessary to further enhance the clinical results achieved.     

Combination radiofrequency and diode laser for treatment of facial rhytides and skin laxity.

PURPOSE: As the demand for noninvasive procedures to address cutaneous aging issues has increased, novel nonablative lasers and radiofrequency (RF) devices have recently emerged. The objective of this study was to evaluate the safety and efficacy of a combination RF/diode laser device designed to target both skin laxity and facial rhytides.Materials and methods. Twenty patients (skin phototypes I-III) with mild to moderate rhytides and skin laxity received three treatments at 3-week intervals with a combined radiofrequency and diode laser system (Polaris WR(TM), Syneron Medical Ltd, Israel). Clinical improvement was determined through masked assessments by the treating investigator and two independent assessors after each treatment session, and at 3 and 6 months after the final treatment using a quartile grading scale (1<25%; 2 = 25-50%; 3 = 51-75%; 4>75% improvement). Patient satisfaction surveys were also obtained at end-study. RESULTS: Modest improvement in facial rhytides was observed in the majority of patients as evidenced by investigator and independent assessor evaluations. Patient satisfaction surveys reflected the clinical improvements observed. Side effects were mild and limited to transient erythema and edema. No scarring or pigmentary alteration was seen. CONCLUSIONS: The Polaris WR(TM), which sequentially delivers radiofrequency and diode laser energy, is safe and effective for treatment of mild to moderate facial rhytides and skin laxity. Multiple treatment sessions and laser passes were well tolerated by patients due to the minimization of individual optical and radiofrequency energies used.     

A home-based eyebrows lifting effect using a novel device that emits electrostatic pulses containing RF energy,resulting in high frequency,low level transdermal microcurrent pulsations: Double blind,randomized clinical study of efficacy and safety

Background: As the appearance of the face is a primary concern of many people, ways in which to tighten the skin are increasingly in demand. In recent years, radiofrequency (RF) has become a promising nonablative, non-invasive, technique for facial rejuvenation. Objective: To assess the safety and the efficacy of a unipolar RF-based device for home use in increasing skin tightness (lifting effect) in the eyebrows area. Methods: Subjects (N = 50) aged between 30 and 70 years old showing skin wrinkledness all over the face and skin laxity in the eyebrows area were enrolled. The primary endpoint was the assessment of the eyebrow to hairline distance by means of a morphometric digital image analysis technique. Results: The eyebrows to hairline distance was statistically significant (both vs. basal condition and placebo) decreased by 1.338 ± 0.170 cm in the treated eyebrow. Conclusion: The obtained results confirm the safety and the efficacy of the tested device in decreasing skin laxity in the eyebrows area. The treatment is not time-consuming (about 6 minutes) and can be done at home. The device seems to be then a useful tool to delay skin laxity or to prolong the time to the first surgical facial lift.     

Nonablative lasers and nonlaser systems in dermatology: current status

Nonablative lasers and nonlaser systems are newer systems used for skin rejuvenation, tightening, body sculpting, and scar remodeling. DEVICES: Different technologies such as lasers, Intense Pulsed Light (IPL), and radiofrequency have been introduced. Most nonablative laser systems emit light within the infrared portion of the electromagnetic spectrum (1000-1500 nm). At these wavelengths, absorption by superficial water containing tissue is relatively weak, thereby effecting deeper tissue penetration. A detailed understanding of the device being used is recommended. INDICATIONS: Nonablative technology have been used for several indications such as skin tightening, periorbital tissue tightening, treatment of nasolabial lines and jowl, body sculpting/remodeling, cellulite reduction, scar revision and remodeling and for the treatment of photodamaged skin. FACILITY: Nonablative laser and light modalities can be carried out in a physician treatment room or hospital setting or a nursing home with a small operation theater. PREOPERATIVE COUNSELING AND INFORMED CONSENT: The dermatologic consultation should include detailed assessment of the patient's skin condition and skin type. An informed consent is mandatory to protect the rights of the patient as well as the practitioner. All patients must have carefully taken preoperative and postoperative pictures. CHOICE OF THE DEVICE AND PARAMETERS: Depends on the indication, the area to be treated, the acceptable downtime for the desired correction, and to an extent the skin color. ANESTHESIA: These lasers are mostly pain-free and tolerated well by patients but may require topical anesthesia. In most cases, topical cooling and numbing using icepacks is sufficient, even in an apprehensive patient. POSTOPERATIVE CARE: The nonablative lasers, light sources and radiofrequency systems are safe, even in darker skin types, and postoperative care is minimal. Proper postoperative care is important in avoiding complications. Post-treatment edema and redness settle in a few hours to a few days. Postoperative sun avoidance and use of sunscreen is mandatory.     

Complementary clinical effects of topical tightening treatment in conjunction with a radiofrequency procedure

Abstract

Background: Skin laxity and cellulite on the buttocks and thighs are two common cosmetic concerns. Skin tightening with radiofrequency (RF) devices has become increasingly popular. Objective: The purpose of this study is to evaluate the efficacy and safety of a topical skin laxity tightening agent when used in combination with an RF device. Methods: A double-blinded, randomized clinical trial enrolled twenty females with mild-to-moderate skin laxity on the posterior thighs/buttocks. Each subject underwent two monthly treatments with an RF source (Alma Accent) to both legs. Subjects were then randomized to apply a topical agent (Skinceuticals Body Tightening Concentrate) twice daily to only one designated thigh/buttock throughout the eight-week duration of the study. All subjects were evaluated for improvement in lifting, skin tone, radiance, firmness/tightness, skin texture, and overall appearance based on photographic evaluation by blinded investigators at 12 weeks following the final RF treatment. Results: A statistically significant improvement was found in the overall appearance on both sides treated with the RF device when compared to baseline. However, the area treated with the topical agent showed a statistically significantly greater degree of improvement than the side where no topical agent was applied. No adverse effects were reported. Conclusion: The use of a novel skin tightening agent used after RF procedures is both safe and effective for treatment of skin laxity on the buttocks and thighs. Combined therapy leads to a better result.     

A pilot study of the efficacy of the POLARGEN® ultrahigh-frequency electric field (40.68 MHz) radiofrequency device in the treatment of facial contouring

Background: Various radiofrequency (RF) devices are used to treat skin laxity and face contouring, but few studies have examined ultrahigh-frequency (UHF) electric field (40.68 MHz) RF devices. Objective: To evaluate the efficacy and safety of a UHF electric field (40.68 MHz) RF device for skin tightening and face contouring. Methods: Ten patients each underwent four sessions of UHF electric field RF device treatment at 2-week intervals. Clinical improvement was evaluated with the patient satisfaction score using a six-point scale, and clinical photographs taken at every visit and 2 months after the RF treatment were assessed. Skin biopsies were obtained from one patient before the first treatment and immediately after the last treatment. Adverse reactions were recorded at every follow-up visit. Results: All patients were women with a mean age of 51.7 ± 7.2 years. The mean satisfaction score was 4.5 ± 0.9 immediately after the last treatment session. Cheek, jawline, and neck enhancement and tightening were apparent in all patients. Side effects were minimal, and there were no burns or major complications. Conclusions: The UHF electric field RF device was effective for skin tightening and facial contouring, without significant adverse reactions.     

Thermage: the nonablative radiofrequency for rejuvenation

Thermage is a noninvasive nonablative device that uses monopolar radiofrequency energy to bulk heat underlying skin while protecting the epidermis to produce skin tightening. It is used for the treatment of rhytids on the face including the periorbital region and lower face, and more recently, for off-face applications. Studies have shown that it can impart mild tightening of periorbital mid, and lower facial laxity. Other radiofrequency devices have also shown objective improvements in cellulite of the buttocks and thigh regions. Thermage is an efficacious and safe nonsurgical alternative for treating mild skin laxity.     

Radiofrequency for the treatment of skin laxity: mith or truth

The nonablative radiofrequency is a procedure commonly used for the treatment of skin laxity from an increase in tissue temperature. The goal is to induce thermal damage to thus stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue. However, many of these devices haven''t been tested and their parameters are still not accepted by the scientific community. Because of this, it is necessary to review the literature regarding the physiological effects and parameters for application of radiofrequency and methodological quality and level of evidence of studies. A literature search was performed in MEDLINE, PEDro, SciELO, PubMed, LILACS and CAPES and experimental studies in humans, which used radiofrequency devices as treatment for facial or body laxity, were selected. The results showed that the main physiological effect is to stimulate collagen synthesis. There was no homogeneity between studies in relation to most of the parameters used and the methodological quality of studies and level of evidence for using radiofrequency are low. This fact complicates the determination of effective parameters for clinical use of this device in the treatment of skin laxity. The analyzed studies suggest that radiofrequency is effective, however the physiological mechanisms and the required parameters are not clear in the literature.     

Kinetics of the superficial perfusion and temperature in connection with photodynamic therapy of basal cell carcinomas using esterified and non-esterified 5-aminolaevulinic acid

BACKGROUND: Photodynamic therapy (PDT) is a local treatment modality with increasing indications for various malignant and non malignant diseases. The treatment parameters have not yet been optimized as there is a need for a better understanding of the process. The skin is an important target and serves as a good model for monitoring and evaluating the interaction of light with biological tissue. OBJECTIVES: The tissue perfusion and the temperature of basal cell carcinomas were measured in connection with PDT in order to investigate the biological mechanisms involved. METHODS: An infrared camera was used during the treatment to measure skin temperature and a laser Doppler perfusion imaging device was used to image the superficial perfusion before and after treatment. Six hours after topical application of 5-aminolaevulinic acid (ALA) or methyl esterified ALA (ALA-ME), 38 basal cell carcinomas were treated using light from a diode laser at 633 nm. RESULTS: In the lesions, the perfusion immediately after PDT was similar to that before PDT. One hour after the treatment the perfusion in the lesion was increased 50% compared with before PDT. However, in the skin surrounding the lesions the perfusion was doubled immediately after PDT and was still increasing 1 h after treatment. A temperature increase in the lesions of about 1-3 degrees C was observed for light fluence rates of 100-150 mW cm-2. In all patients treated, a diffuse temperature increase was visible outside the lesions. In some of the patients, the outlines of the blood vessels surrounding the treated lesions became visible in the thermal images. Measurements of temperature on healthy volunteers not administered photosensitizer, but illuminated with light of the same fluence rate, showed a similar increase in temperature in the illuminated spots. However, no temperature increase was observed outside the illuminated area. No statistically significant differences were found between the measurements on patients treated with ALA and ALA-ME. CONCLUSIONS: The increased perfusion in the area surrounding the lesions after PDT, as seen by perfusion and temperature measurements, is the result of an inflammatory reaction to the PDT process. However, directly after PDT the perfusion in the lesions was the same as before irradiation. The combination of these observations suggests the presence of local blood stasis during and immediately after the treatment. The temperature measurements showed that the increased temperature was well below the temperature limit of hyperthermal damage. Furthermore, the measurements indicate that the increase in temperature was primarily a consequence of the heat absorbed in the tissue.     

Clinical evaluation of non-ablative radiofrequency facial rejuvenation.

OBJECTIVE: To evaluate the clinical efficacy of non-ablative cutaneous radiofrequency (RF) facial rejuvenation. DESIGN: Prospective study with longitudinal follow-up of a validation cohort set in an urban, private practice of an ambulatory facial plastic surgery center in southern California. METHODS: A consecutive sample was enrolled of 35 healthy adults with moderate facial aging, manifested by skin laxity, rhytids, and ptosis (brow, midface, jowls). Following intravenous sedation anesthesia, the study area was treated with 115-144 J/cm2 using the non-ablative RF device (ThermaCool TC). The main outcome measures were the objective measurement of brow height, investigator evaluation of skin parameters, a patient satisfaction questionnaire, and standardized photography, at fixed time intervals. RESULTS: At 12 weeks, a statistically significant increase in mean vertical brow height of 1.6-2.4 mm was observed in patients treated exclusively with the RF device (p<0.0001). All skin parameters (laxity, wrinkles, clarity, pore size) were improved. Complications and side effects were minimal. Patients were uniformly satisfied. CONCLUSIONS: The ThermaCool TC RF system represents a promising non-invasive method of obtaining moderate facial rejuvenation in the appropriately selected patient. Long-term results are pending.     

Effect of a new infrared light device (1100-1800 nm) on facial lifting.

Laser skin resurfacing procedures can be classed into two categories - invasive and non-invasive. The last several decades have witnessed a host of advancements in ablative laser therapy and other ablative modalities for the rejuvenation of skin, including the CO(2) laser, the erbium : yttrium aluminum garnet laser, chemical peels, and dermabrasion. Despite the excellent results that can result from the practice of these techniques by experienced surgeons, the invasive nature of these devices is associated with inherent risks and patient discomfort. Therefore, much of the focus has been on non-ablative lasers and intense-pulsed light devices. We evaluated the efficacy and safety of treatment with the new infrared light device (1100-1800 nm), Titan, and assessed the degree of improvement associated with two-time laser treatments, as compared to one-time laser treatment.     

Intense focused ultrasound (IFUS) with a modified parameter on facial tightening: A study on its safety and efficacy

Background: Intense focused ultrasound (IFUS) is a novel treatment modality for skin laxity. The delivery of thermal energy to the deeper tissue layers effectively tightens the skin but can also cause significant fat atrophy, limiting its use in patients with a lean face. Objectives: We sought to evaluate the safety and efficacy of modified IFUS on facial rejuvenation. Patients and methods: This was a retrospective, single-center study of 28 subjects with age-related facial laxity who underwent 3 sessions of IFUS (Ultraskin^TM, WONTECH Co., Daejeon, Korea) at an interval of four weeks, and then followed up for three months. IFUS was first applied using a 4-MHZ, 4.5-mm transducer followed by a 7-MHZ, 3-mm transducer. Approximately 200–300 treatment lines were applied to the face during each session. Standardized photographs were taken at baseline and follow-ups and were assessed by two independent dermatologists. A questionnaire was used to evaluate patient satisfaction and the incidence of adverse reactions. Results: Twenty-eight subjects with mild-to-moderate age-related facial laxity were included in the study. The mean age of the subjects was 48 (range 29–74) years. About 32.1% of the subjects showed significant improvement and 57.1% showed improvement of facial laxity in their follow-up photographs. All of them (100%) replied that they were either greatly satisfied or satisfied with the results at three-month follow-up. None of the subjects experienced any serious adverse events including fat atrophy after the procedure. Conclusion: Modified IFUS (three sessions, four weeks apart, 200–300 treatment lines per session) can be safely performed with good clinical results.     

Intense focused ultrasound for facial tightening: Histologic changes in 11 Patients

Introduction: Intense focused ultrasound (IFUS) is a novel modality for treating skin laxity that produces thermal effects at various depths while sparing the overlying tissue. This study assessed histologic changes and the safety and efficacy of intense focused ultrasound (Doublo^TM, HIRONIC Co., Sungnam, Korea) for tightening of facial skin in Asian patients. Methods: Eleven patients with facial laxity were treated with IFUS and evaluated before and after treatment. Mean age was 46 years (range, 35–64 years). Two available hand-pieces with different focal depths (3 mm and 4.5 mm) were used with three to five passes 1–2 mm apart. Outcome assessment included photographic evaluation by two blinded investigators, skin biopsies before and two months after treatment, and patient satisfaction. Results: Subjective and objective analyses showed 63.6% and 72.7% improvement at the two-month evaluation, respectively. Histologic evaluation by hematoxylin and eosin (H&E) and Masson's trichrome staining showed increased collagen fibers in the lower dermis and between fat layers. Discussion and conclusions: Intense focused ultrasound can be used as a non-invasive skin tightening technique in Asian patients. It induced collagen generation in the dermis and fat layers and was effective and safe in our study population.     

Reverse sural artery flap for distal lower extremity defects

Traumatic and various dermatological conditions resulting in skin and subcutaneous tissue loss on the lower limb cause a therapeutic challenge for the dermatological surgeon, because this anatomical location lacks adequate skin laxity and has limited local soft tissue, especially around the heel. In this report, we present our experience with the reverse sural artery flap on seven patients. The soft tissue defect was traumatic in two patients. We also treated three diabetic patients. There were no immediate or late surgical complications in four cases; flap and donor site healing was uneventful. The remaining three cases were diabetic, and all presented with the following complications: rejection of split skin graft at donor site, infection at the flap border and superficial flap necrosis. The flap necrosis was concluded to be at least in part due to the patient's noncompliance with postoperative measures. We conclude that the reverse sural artery flap is a satisfactory alternative in the reconstruction of lower limb defects, but we also feel that the importance of proper evaluation prior to surgery in terms of vascular impairment and patient compliance should be emphasized to ensure a successful surgical outcome.     

Nonablative cutaneous remodeling using radiofrequency devices

In recent years, several new radiofrequency devices have been introduced for treatment of a variety of skin conditions, particularly, skin wrinkling and laxity. These nonsurgical systems induce tissue tightening and contour changes through dermal collagen remodeling without disruption of the overlying epidermis, obviating a significant recovery period or risk of serious adverse sequelae. As such, radiofrequency-based systems have been used successfully for nonablative skin rejuvenation, atrophic scar revision, and treatment of unwanted hair, vascular lesions, and inflammatory acne.     

The use of lasers and light sources in skin rejuvenation

Smooth, wrinkle-free skin is associated with supposed attractiveness, youthfulness, and health, while rhytids have a negative impact on one’s perceived appearance, image, and self-esteem. Noninvasive esthetic procedures such as laser or light therapy have been used to achieve and attain a more youthful appearance. Currently, there is a wide range of lasers and devices available for the regeneration and healing of skin. Lasers and light sources for skin rejuvenation involve the removal of aged skin tissue via thermal heat from high-powered lasers, stimulating the surrounding tissues to recover through natural wound-healing processes. In contrast, photobiomodulation, which makes use of low energy lasers or light emitting diodes, uses no heat and has shown positive effects in the reduction of wrinkles and improving skin laxity.     

Efficacy of a new fractional CO2 laser in the treatment of photodamage and acne scarring

This study evaluates the efficacy and safety of a novel fractional CO₂ laser device for improving facial rhytids, hyperpigmentation, enlarged pores, skin laxity, and acne scarring. Subjects (n= 15) were treated three to five times at 3‐week intervals. Biopsy specimens were used to evaluate healing response and neocollagenesis. Clinical improvement was rated on a quartile rating scale from digital photographs. Subject discomfort during treatment was evaluated on a scale of 0 to 5. Fourteen subjects who completed the study achieved good to excellent improvement in overall appearance, with 60% rated excellent. Improvement in photodamage was good to excellent in 92% of subjects, and reduction in rhytids was good to excellent in 85%. A total of 79% of subjects achieved good to excellent improvement in pore sizes and skin laxity. Subject discomfort during treatment was 3.0 ± 0.7. Erythema persisted for 2–3 days, and subjects resumed normal activities 1–2 days after the procedure. Histological slides after a single treatment showed new collagen formation. The SmartSkin fractional CO₂ system (Cynosure, Inc., Westford, MA, USA) provides significant improvement for the treatment of facial wrinkles, hyperpigmentation, pore size, and skin laxity associated with photodamage.     

Cellulite treatment using a novel combination radiofrequency,infrared light,and mechanical tissue manipulation device

Background. Most post‐pubertal women exhibit cellulite, particularly in the thigh and buttock regions. The prevalence of cellulite has led to many attempts at treatment, including a variety of topical solutions, massage‐based therapies, and surgical techniques—most with suboptimal clinical effects. The purpose of this controlled study was to evaluate a novel combination device involving radiofrequency, infrared light, and mechanical tissue manipulation for the treatment of cellulite.

Methods. Twenty adult women (ages 25–57 years) of various skin phototypes (I–V), and with moderate bilateral thigh and buttock cellulite, received eight biweekly treatments to a randomly selected side (the contralateral side serving as a non‐treated control). A combined bipolar radiofrequency, infrared light, and mechanical suction‐based massage device was applied at 20 watts RF, 20 watts IR (700–1500?nm) light, and 200 millibar vacuum (750?mmHg negative pressure). Patients were evaluated using standardized digital photography and circumferential leg measurements at baseline, prior to each treatment session, and at one, three, and six months after the final treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = <25%, 1 = 25%–50%, 2 = 51%–75%, 3 = >75% improvement) were made independently by two masked medical assessors after the series of treatments. Final post‐treatment body weight and patients' subjective evaluations were recorded.

Results. Ninety per cent (18/20) of patients noticed overall clinical improvement, and 17 of these 18 patients reported that they would pursue treatment of the contralateral thigh. Side effects were limited to transient erythema in most patients, and bruising was observed in 2/20 patients after the first couple of treatment sessions, but not as the treatment series progressed. Clinical improvement scores averaged 1.82 (corresponding to ～50% improvement) after the series of treatments. Circumferential thigh measurements were reduced by 0.8?cm on the treatment side.

Conclusions. Cellulite can be significantly and safely reduced with the use of a noninvasive device that combines bipolar RF, infrared light, and mechanical massage. The effects of treatment appear to be prolonged, but maintenance treatments may be necessary to further enhance the clinical results achieved.     

Clinical evaluation of non-ablative radiofrequency facial rejuvenation

OBJECTIVE: To evaluate the clinical efficacy of non-ablative cutaneous radiofrequency (RF) facial rejuvenation. DESIGN: Prospective study with longitudinal follow-up of a validation cohort set in an urban, private practice of an ambulatory facial plastic surgery center in southern California. METHODS: A consecutive sample was enrolled of 35 healthy adults with moderate facial aging, manifested by skin laxity, rhytids, and ptosis (brow, midface, jowls). Following intravenous sedation anesthesia, the study area was treated with 115-144 J/cm² using the non-ablative RF device (ThermaCool TC^TM). The main outcome measures were the objective measurement of brow height, investigator evaluation of skin parameters, a patient satisfaction questionnaire, and standardized photography, at fixed time intervals. RESULTS: At 12 weeks, a statistically significant increase in mean vertical brow height of 1.6-2.4 mm was observed in patients treated exclusively with the RF device (p&lt;0.0001). All skin parameters (laxity, wrinkles, clarity, pore size) were improved. Complications and side effects were minimal. Patients were uniformly satisfied. CONCLUSIONS: The ThermaCool TC RF system represents a promising non-invasive method of obtaining moderate facial rejuvenation in the appropriately selected patient. Long-term results are pending.