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Next-gen RF combo treatment

Facial treatment that begins with combined bipolar radiofrequency (RF) and infrared light (IR) and ends with fractionated bipolar RF is a safe, well tolerated option for noticeably improving skin tone and texture, as well as reducing wrinkles, according to a new study.

U.S. researchers report on their multicenter study of 56 patients, including four men, on the efficacy of the combination. The subjects, with Fitzpatrick skin types I through VI and scores of two to seven in the Fitzpatrick Classification and Wrinkling and Degree of Elastosis scale, received three facial treatments, performed at four- to six-week intervals, to the forehead, nose, cheeks, periorbital and perioral areas.

The three authors, who have ties to Syneron Medical, which funded the study, used Syneron’s eTwo system and two of its applicators for noninvasive treatment of facial wrinkles. One of the applicators used IR light combined with bipolar RF, and one used fractional bipolar RF, alone. The fractionated bipolar RF, which immediately followed the IR light combined with bipolar RF treatment, was delivered by a matrix of multi-electrode pins fitted as disposable tips at the applicator’s distal end.

They applied topical anesthetic cream just before treatment, and air cooling during 84% of the treatments.

In their clinical assessments at 12 and 24 weeks after the last treatment session, they found the Mean Fitzpatrick Wrinkling ad Elastosis Score fell from 3.45 at baseline to 3.12 at three months and 2.96 at six months post final treatment. The physician researchers reported 88% of patients at 12 weeks and 82% of patients at 24 weeks had overall improvement in facial appearance. Patient evaluations were much the same, and 85% of subjects reported they were satisfied with their final results at six months, according to the study.

Nearly all the patients reported transient post-treatment erythema and edema. Transient crusting and blistering was seen in two patients — both with skin type I.

The authors note that their potential bias is a limitation of the study, as is the lack of patient masking for objective measurements.

Study author Alan H. Gold, M.D., who is a plastic surgeon in private practice in Great Neck, NY and Boca Raton, Fla., tells Cosmetic Surgery Times that the recommended facial rejuvenation treatment for patients would depend on the degree of wrinkling and skin textural changes, as well as the realistic goals and degree of improvement desired by the patient.

“Essentially, any patient with mild-to-moderate facial wrinkles who wishes gradual treatment and improvement with no significant ‘downtime,’ would be a candidate for this combination of treatments,” Dr. Gold says. “They are able to maintain their work, social and physical activity schedules essentially without interruption. For those who wish a single treatment and are willing to accept a possibly significant period of erythema, swelling, perhaps peeling, and the associated restriction in their activities and socialization, more aggressive chemical peeling, fractional or fully ablative laser resurfacing could be offered as an alternative.”

Still, for patients with deeper and more extensive wrinkling and laxity, more aggressive treatment and possibly surgery might be the preferred and more beneficial approach, he says.

“Laser treatment, whether fractional or, of course, fully ablative, is clearly a time-proven and effective treatment option, but one which is associated with greater ‘downtime,” Dr. Gold says. “The combination of the two treatment modalities (initial treatment with IR light in combination with bipolar RF followed immediately with fractional bipolar RF) results in significant improvement with an extremely high degree of patient satisfaction. It is our impression from the study that the degree of improvement and patient satisfaction is greater than we have seen from protocols of just RF, alone — although, many patients have been pleased with just that single treatment modality, as well.”

Disclosure: Dr. Gold chairs the Synderon-Candela medical advisory board, performs research and evaluates devices by the company, and may receive the company’s devices at a discount. 

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