Comparative histometric analysis of the effects of high-intensity focused ultrasound and radiofrequency on skin

Introduction: High-intensity focused ultrasound (HIFU) and radiofrequency (RF) are used for non-invasive skin tightening. Neocollagenesis and neoelastogenesis have been reported to have a mechanism of controlled thermal injury. Objective: To compare neocollagenesis and neoelastogenesis in each layer of the dermis after each session of HIFU and monopolar RF. Methods: We analyzed the area fraction of collagen and elastic fibers using the Masson's Trichrome and Victoria blue special stains, respectively, before and after 2 months of treatments. Histometric analyses were performed in each layer of the dermis, including the papillary dermis, and upper, mid, and deep reticular dermis. Results: Monopolar RF led to neocollagenesis in the papillary dermis, and upper, mid, and deep reticular dermis, and neoelastogenesis in the papillary dermis, and upper and mid reticular dermis. HIFU led to neocollagenesis in the mid and deep reticular dermis and neoelastogenesis in the deep reticular dermis. Among these treatment methods, HIFU showed the highest level of neocollagenesis and neoelastogenesis in the deep reticular dermis. Conclusions: HIFU affects deep tissues and impacts focal regions. Monopolar RF also affects deep tissues, but impacts diffuse regions. We believe these data provide further insight into effective skin tightening.     

A novel non-invasive radiofrequency dermal heating device for skin tightening of the face and neck

Background: Loose, lax skin is a common cosmetic complaint. Previous non-invasive skin tightening devices had modest efficacy and were associated with pain or downtime. New technologies may allow for effective skin tightening with a series of radiofrequency (RF) treatments with no downtime. Objective: To evaluate the efficacy and safety of a novel bipolar RF device for skin tightening. Methods: Fifteen consecutive female patients were enrolled in the case series; 14 completed the study and were included in the analysis. The device under investigation is a novel, bipolar RF device allowing for achievement and maintenance of optimal dermal temperatures to stimulate collagen remodeling and skin tightening. Patients underwent a series of 4–6 weekly treatments. Three blinded, experienced cosmetic physicians evaluated paired pre-treatment and post-treatment photographs and determined the associated improvement, if any. Results: All patients (14/14) were determined to have a clinical improvement, as the pre-treatment and post-treatment photographs were correctly identified by the evaluators. It was observed that 21% (3/14) of patients had significant improvement, 50% (7/14) had moderate improvement, and 29% (4/14) had mild improvement. No pain, side effects, or adverse events were observed. Conclusions: This novel bipolar RF device represents a safe, effective treatment option for non-invasive skin tightening.     

A intense-focused ultrasound tightening for the treatment of infraorbital laxity

Abstract

Background: Infraorbital laxity is a common problem that increases with age. Blepharoplasty with lipectomy is a very commonly performed surgical procedure to treat this problem; however, it is invasive and is associated with the potential for re-emergence. Therefore, young patients may prefer a non-surgical procedure rather than to a surgical procedure. Intense-focused ultrasound (IFUS) has emerged as an effective, non-surgical, tissue-tightening procedure. Objective: This study assessed the safety and efficacy of IFUS (Ulthera^TM system, Ulthera Inc, Mesa, AZ, USA) for facial tightening in Asian patients with infraorbital laxity. Methods: We studied 15 patients who were treated with an IFUS device applied to both lower eyelids. The primary outcome measure was an objective improvement in a paired comparison of pre-treatment and post treatment (6 months) photographs. A secondary outcome measure was patient satisfaction as measured by a questionnaire. Results: The mean patient age was 50 years (range, 27–69). All patients received one to two treatments with intense-focused ultrasound. All patients in the study experienced both subjective and objective improvement. Conclusion: IFUS can be used as a non-invasive, skin-tightening procedure for infraorbital laxity. No serious, permanent, or delayed side effects were noted up to 6 months post treatment. Thus, this procedure can be effective and safe in the treatment of decreased laxity of the lower eyelids.     

Clinical and histological evaluation of microneedle fractional radiofrequency treatment on facial fine lines and skin laxity in Koreans

Background

Facial wrinkles and sagging are the most visible signs of aging and can cause profound distress. Microneedle fractional radiofrequency (MFR) is a minimally invasive procedure, which utilizes both microneedling and radiofrequency energy to rejuvenate the skin.

Objective

To describe the safety and efficacy of a temperature-controlled MFR device on facial fine lines and laxity.

Patients and Methods

A retrospective chart & histology review was performed on individuals who received bipolar MFR for facial rejuvenation. A total of 15 Koreans with a median age of 46 years were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the participants' satisfaction scores. Histologic changes before, immediately after MFR and at 4 months follow-up was examined. Complications were also recorded.

Results

Partially denatured collagen fibers and dermal shrinkage was observed immediately after MFR whereas an increase in elastin and collagen was noted at 4 months follow-up. 86.7% of recipients considered the results satisfactory. Consensus ratings by two independent dermatologists on the objective outcomes at 4-month follow-up were very much improved (53.3%), much improved (26.7%) and improved (20%). Treatment was well tolerated and did not cause any significant long-lasting discomfort.

Conclusion

Temperature-controlled bipolar MFR is a minimally invasive treatment option to consider for facial fine lines and laxity via neo-collagenesis and neo-elastogenesis. The procedure was safe and clinically effective.     

Use of a novel combined radiofrequency and ultrasound device for lipolysis,skin tightening and cellulite treatment

Introduction: Skin laxity and excessive subcutaneous fat are growing cosmetic concerns. The objective of this study is to evaluate the efficacy and safety of a novel radiofrequency and ultrasound workstation for lipolysis, circumference reduction, treatment of skin laxity and cellulite. Materials and methods: Two hundred seventy-five (235 women and 40 men) patients were enrolled into the study. Each patient received 3 treatment sessions, each session comprising Ultrasound and Radiofrequency treatments, at two-week intervals. Some received treatment for the abdomen, some for the thighs and some for both. Efficacy was assessed accordingly by measuring changes in abdominal circumference, thigh circumference and appearance of cellulite. Any adverse effect was noted. Result: Paired t-test between measurements at baseline and 4 weeks after 3rd session was significant amongst all the groups, showing that most patients showed improvement in abdominal and/or thigh circumferences. No significant adverse effects were noted during or after the treatment. Conclusion: A combination of alternating hot and cold module Ultrasound and Radiofrequency technologies is a safe and effective modality for lipolysis and to treat skin laxity and cellulite.     

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.     

Comparison of effect between high intense focused ultrasound devices for facial tightening: Evaluator-blinded,split-face study

Background: Various high intense focused ultrasound (HIFU) devices have been introduced in recent years for improving skin laxity, with satisfactory results. However, there is no comparative study on the efficacy and safety of available HIFU devices. Objective: To compare the efficacy and safety of two HIFU devices for facial skin tightening and subsequently, to validate the quantitative assessment. Methods and materials: We performed a split-face comparative study in 20 Korean patients. Two different HIFU devices were used on each side of the face. Patients received one treatment session on the same number of coagulative zones. Patient assessments were recorded. Three blinded clinicians evaluated paired pretreatment and post-treatment photographs. Quantitative assessment using a fixed point as well as a variable point was additionally performed for objective evaluation. Results: Qualitative assessments of both HIFU devices conducted by both clinicians and patients generally showed mild to moderate improvement, similar to previous studies. The two devices had similar efficacy in blinded clinician and quantitative assessment, although there were some differences in patient satisfaction and degree of pain. There was a correlation between clinician qualitative scores and quantitative values, which suggests successful skin tightening. Conclusion: To the author's knowledge, both HIFU devices tested can be used safely and effectively for facial tightening.     

探讨高强度聚焦超声技术在治疗子宫肌瘤中的应用

目的:研究高强度聚焦超声技术对于治疗子宫肌瘤的临床治疗效果。方法:对我院收集到的20例子宫肌瘤患者实施HIFU技术治疗措施,在研究开始前、治疗后30d和60d分别使用MRI检查测定其肌瘤大小,并观察其临床症状改变和产生的不良症状情况。结果:在治疗后30d和60d,患者的肌瘤大小和研究开始前相比都没有显著差异(P>0.05);患者在经过HIFU技术治疗后与研究开始前出现的临床症状人数相比有明显的降低(P<0.05);治疗后30d有6例患者出现了不良症状,60d时出现了1例,且其均在短时间内自行康复。结论:HIFU技术能够显著减轻子宫肌瘤患者的临床症状,具有较好的效果。