Sponsored by Aesthetics Biomedical
Vivace, the radiofrequency (RF) microneedling treatment device from Aesthetics Biomedical (Phoenix, Ariz.), is setting records with consumers and providers. The Vivace Experience provides a personalized approach to treatment coupled with products that ensure comfort, outcomes and minimize downtime.
Consumers, young and older, have embraced Vivace RF microneedling. At the start of 2021, Vivace is the most requested microneedling treatment on RealSelf, a trusted online platform for individuals considering elective cosmetic treatments. Consumer searches and demand made Vivace the top trending microneedling treatment in 2020 as well. Vivace also ranks #1 among all the microneedling device options on RealSelf, for driving leads to physicians. And most importantly, Vivace has three times more reviews on RealSelf than the next leading microneedling competitor.
W. Grant Stevens, MD, FACS
Emil A. Tanghetti, MD
Ashley Magovern, MD
Shelby Miller, DNP, FNP-C
Michael DeWolfe, MD Plastic and Reconstructive Surgeon Elevare MD Chicago, IL
Kelly DeWolfe Advanced Practice Nurse Elevare MD Chicago, IL
Tara Brown, MD Ophthalmologist San Diego, CA
Physicians have also given their thumbs up to Vivace. According to Tara Brown, MD, a San Diego, Calif.-based ophthalmologist who specializes in cosmetic procedures and surgery, Vivace is her top-selling service at the start of 2021. “Especially in the last six months, demand for Vivace has really exploded,” she reported.
While many consider FDA-cleared Vivace treatment an ideal skin tightening and rejuvenation option for middle-aged patients, Dr. Brown says she has young influencers who have heard about Vivace and want the treatment. For the younger set, Vivace tightens pores, decreases blemishes and more, with little downtime. “The young people love it,” she emphasized.
Vivace is also ideal for patients who want a comprehensive skin treatment for the face, neck and décolleté, according to plastic and reconstructive surgeon Michael DeWolfe, MD, of Elevare MD in Chicago, Ill. “The treatment creates a uniform glow to the skin, while tightening, improving fine lines and reducing pore size,” he shared.
Kelly DeWolfe, an advanced practice nurse and acute care nurse practitioner at Elevare MD, finds that Vivace is a great treatment for clients in their 20s and 30s who have textural issues like acne scarring or are beginning to see signs of aging. Vivace gives them the smoothness and evenness they desire without makeup,” she stated. “I also love it for clients in their 40s and 50s who are noticing the aging process. Vivace stimulates collagen production and can provide the lifting and tightening that they desire.”
For Ashley Magovern, MD, owner and founder of Manhattan Dermatology, Manhattan Aesthetics and glowmd skin care (Manhattan Beach, Calif.), her Vivace patients often come back asking for more. “That is something we don’t always see [with other treatments]. I think patients really appreciate the difference that they are seeing in their skin. Their friends comment on their skin, and we are finding their friends are calling and asking for Vivace,” she said.
Many providers say it is hard to find a facial rejuvenation treatment that is as effective, comfortable and with as little downtime. “Many don’t realize that the combination of RF and microneedling has less downtime than microneedling alone,” Dr. Magovern pointed out.
“A lot of our patients want procedures where they can function and don’t have a significant amount of downtime. The Vivace procedure with its dermal wounding is very well suited to that,” said Sacramento, Calif.-based, dermatologist Emil A. Tanghetti, MD. “There is some slight swelling and erythema for a few days and that is about it. People can function normally. Typically, people are able to go back to their activities the next day without a problem.”
Shelby Miller, DNP, FNP-C, board certified nurse practitioner and owner of RUMA Aesthetics in Lehi, Utah, says the Vivace is the “Lamborghini of RF microneedling.”
“One of the most highly recommended and sought-after medical skincare treatments right now is fractional microneedling with radiofrequency,” Ms. Miller stated. “We are thrilled to offer the top-of-the- line Vivace treatment at RUMA Medical Aesthetics. The mixture of both multidepth microneedling and various levels of RF heat is changing the skincare game for uneven skin tone and texture. We have loved having this machine at our practice.”
Vivace RF microneedling has been fully verified and validated, according to plastic surgeon W. Grant Stevens, MD (Marina Del Ray, Calif.), chairman of Cle’ Global Aesthetics and clinical professor of surgery at the University of Southern California Keck School of Medicine, Division of Plastic Surgery.
“For verification, Vivace recently published anelectrocoagulationandthermaldiffusion study that looked at the thermal effects of RF microneedling with a porcine skin model. The Vivace showed best thermal coagulations using a 1 MHz insulated microneedle and showed that the radiofrequency diffuses uniformly within the dermis,” Dr. Stevens reported. “Vivace then took their porcine skin model study and performed it in abdominoplasty to verify the electrocoagulation within the human skin tissue to further the translation of study results to the clinical practice.”
Vivace was also validated through a clinical trial that allowed Aesthetics Biomedical to obtain FDA clearance for fine lines and wrinkles in Fitzpatrick Skin Types I-V, Dr. Stevens added.
“Vivace is one of the only devices in the RF microneedling marketplace that truly has comprehensive scientific understanding of radiofrequency and how it is applied combined with microneedling,” Dr. Stevens noted.
Dr. Stevens referred to a recent study published in August 2020 in the Journal of Cosmetic Dermatology,1 in which researchers examined the histologic effects of RF microneedling on porcine skin. Researchers compared dermal thermal effects of a RF microneedling device producing 1 and 2 MHz signal amplitudes, with respective voltage and current gradients, utilizing non-insulated and insulated needles, according to the study’s abstract.
Investigators conducted two separate animal studies to evaluate the electrocoagulation and thermal diffusion effects using the device. They assessed electrocoagulation effects histologically using hematoxylin and eosin staining and studied heating effects through thermal imaging.
The investigators found the 1 MHz insulated needle produced larger coagulations with an increase in power. The 1 MHz non-insulated array was comparable to the 2 MHz insulated array with similar histologic features. According to the authors, “Full thermal diffusion occurs seconds after the [radiofrequency] conduction time.”
The Aesthetics Biomedical-funded study shows that significant changes happen to RF microneedling treated tissue in real time.
“As much as we can see the effects of treatment when we are doing it on patients, we cannot tell what is actually going on under the skin,” Dr. Brown explained. “Radiofrequency microneedling with Vivace actually causes real coagulation and tightening, leading to a cascade of controlled inflammation which is then ultimately going to lead you to more collagen and elastin.”
Vivace Differentiators: Treatment is Comfortable
Dr. Brown, who’s first experience with microneedling was surprisingly painful, noted that one of the things that stands out about Vivace treatment is that it is the most comfortable microneedling option on the market.
“Before I bought the Vivace, I had a microneedling treatment done on myself by a dermatologist. I do not know what brand he used but I do know it felt like I was getting slapped in the face for 30 minutes straight. When he started, I jumped and he asked, ‘Are you ok?’ I said ‘Yes, but I was not expecting that.’ He explained that it always kind of catches people off guard because it is such an abrupt motion when the needles go in,” Dr. Brown recalled. “When my rep brought the Vivace by, I tried it, and it was so much better. It has a super smooth, gentle motion. Still the same needles, still the same radiofrequency, but a lot more pleasant.”
For an optimal patient experience, providers apply a topical numbing cream prior to the treatment to ensure comfort. “Everyone can tolerate the Vivace. The key is a really good numbing cream,” Dr. Brown emphasized.
Dr. Magovern finds that performing Vivace is so relaxing for her, as well as for her patients, that it offers an opportunity for doctor-patient bonding. “Vivace is an easy procedure to do in the scope of an aesthetic provider’s day, taking about 30 minutes to perform,” she shared. “It also is easy on patients, and they tend to be comfortable and relaxed. I feel like it is a great time to connect with your patients.”
Customizable Treatments & Consistent Results
Vivace is known for not only comfort and minimal downtime, but also consistent results, Dr. DeWolfe stated. “The robotic motor allows gentle delivery of pulses unlike those that utilize ‘snap’ motors,” he reported. “Vivace RF also senses if the needles are experiencing an increased impedance and keeps the needles from causing damage.”
Dr. DeWolfe explained that the Vivace utilizes 36 gold plated needles to penetrate the skin. The technology simultaneously delivers up to approximately 60 W of energy when using 1 MHz, via a chevron circuit, which allows even distribution and prevents hot spots.
“Depth of treatment can vary between 0.5 mm up to 3.5 mm at 0.1 mm increments,” Dr. DeWolfe said. “In addition, Vivace offers simultaneous delivery of red or blue light LED for anti-aging or antibacterial properties. You essentially are receiving three treatments in one: microneedling, radiofrequency and LED light therapy.”
Vivace’s needles are insulated except at the distal 0.4 mm, Dr. Brown said. The design allows for a controlled delivery of radiofrequency to the tissue, she pointed out.
Every individual is different, so the ability to personalize treatment is important.
“I will do passes at different layers and at different strengths. It is so endlessly customizable,” Dr. Brown expressed. “Even people of color, like myself, can feel comfortable [with this treatment], knowing that the RF is not going to cause inflammation, hypopigmentation or hyperpigmentation at the skin’s surface.”
According to Ms. DeWolfe, almost everyone is a good candidate for Vivace. “It is safe for most skin types and can be performed year-round, unlike lasers, which I am very conservative with during the summer months,” she stated.
There are times, however, when Vivace is not the best treatment option.
“I would avoid treating someone with moderate or severe active acne to avoid spreading bacteria and worsening breakouts,” Dr. DeWolfe explained. “In addition, patients with severe wrinkling and poor skin quality are not good Vivace candidates,” he advised. “Those patients likely require deeper resurfacing to get an improvement,” he said.
Providers say they use the Vivace technology as a stand-alone treatment or in combination with other devices and topicals.
In Ms. DeWolfe’s experience, she achieves best results when she uses varying depths for each of her three passes with the device. This allows her to treat both superficial and deep areas of the skin to create meaningful change. “We recommend a series of three treatments spaced six to twelve weeks apart for best results,” she said. “However, I’m confident that even with one treatment patients will see a change.”
“With treatment, patients can expect to see a reduction of fine lines, shrinking pore size, moderate skin tightening, improvement of acne scarring and improvement of skin tone and texture,” Dr. DeWolfe indicated.
Dr. Brown often combines Vivace treatment with platelet-rich plasma (PRP). “The PRP is going to get us the patient’s own growth factors, which are going to be superior to any sort of growth factor serum that you can find,” she said.
Dr. Brown injects the PRP straight into the face in problem areas and saves a couple of ccs to drip on the face post-treatment.
“Those microchannels stay open after treatment, so I take advantage of that by dripping the PRP right on as soon as I am done with the needles,” she said.
Dr. Magovern, who also offers patients treatment combining PRP and Vivace, says that in her experience the combination quickens healing and enhances outcomes.
Aesthetic clinicians also combine the Vivace device with other modalities to treat skin and aging concerns.
“We like to stack Vivace RF treatments with other devices such as a CO2 laser or facial,” Dr. DeWolfe confirmed.
To enhance results, Dr. Tanghetti combines Vivace with devices that target different parts of the skin. “The Vivace primarily wounds the dermis. We can combine it with something that is primarily directed at epidermal rejuvenation and wounding, such as a thulium procedure or a fractional picosecond procedure,” he stated.
“The goal is to use other devices that improve results without increasing downtime. That means treating patients over a period of time – in three or four treatments – rather than one treatment,” Dr. Tanghetti added.
Good Skincare Helps to Enhance Results
Ms. DeWolfe loves SoME Skincare, which utilizes a patient’s own PRP to provide a personalized skincare regimen. “I find that incorporating SoME Skincare enhances the textural improvements and radiance that Vivace excels at,” she said.
Dr. Brown, a big believer in augmenting treatment with good skincare, uses a variety of products, including the Vivace Experience Kit, which includes a booster serum and soothing mask for the ultimate patient experience.
“I will use the Boost Serum immediately after the procedure, and then the patient takes it home and uses it morning and night. It is just a very good all-around peptide serum,” she advised. “Then, there is a soothing sheet mask that everybody loves. It goes on when the whole face is done and takes away some of the redness.” This total experience minimizes downtime and accelerates outcomes.
Dr. Magovern also recommends patients use the Vivace Experience Kit post treatment. “In addition, we recommend incorporating a vitamin C serum into their regimen,” she added. “We do not like patients to put makeup on for several hours after treatment because the channels are open for a finite period of time, so we want to take advantage of that with the good stuff that we put in. We don’t want anything that can irritate the skin or cause an allergic or irritant reaction.”
Aesthetics Biomedical announced in October 2020 that it partnered with the popular professional skincare brand SkinCeuticals (New York, N.Y.) to offer Vivace Radiofrequency Microneedling with a SkinCeuticals C E Ferulic post-treatment protocol.
SkinCeuticals C E Ferulic daytime vitamin C serum is proven to deliver advanced environmental protection and visible anti-aging results.
According to the Aesthetics Biomedical press release about the collaboration, “C E Ferulic works to further enhance the Vivace Experience 24 hours post treatment and provides astonishing results after just one session. SkinCeuticals antioxidant formulations are the gold standard and results have shown a 44% improvement in skin radiance, 36% improvement in the appearance of wrinkles and 37% increase in skin firmness.”
The bottom line is that today’s aesthetic providers have plenty of devices from which to choose. “I think people have to pick devices that have a track record and that work. Certainly, the Vivace unit is one of those devices,” Dr. Tanghetti affirmed. “Based on the histology and our results, I am convinced that this is a very effective treatment that we extensively utilize in our practice.”
1. An evaluation of electrocoagulation and thermal diffusion following radiofrequency microneedling using an in vivo porcine skin model. Wootten. Journal of Cosmetic Dermatology - Wiley Online Library.