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Facial Plast Surg 2014; 30(01): 062-067
DOI: 10.1055/s-0033-1363756
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Skin Tightening Technologies

Ryan M. Greene
1   Greene MD Plastic Surgery and Laser Center, Weston, Florida
2   Voluntary Assistant Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida
,
Jeremy B. Green
3   Dr. Brandt Dermatology Associates, Coral Gables, Florida
4   Voluntary Assistant Professor, Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida
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Publikationsdatum:
31. Januar 2014 (online)

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Abstract

Radiofrequency (RF) and intense focused ultrasound (IFUS) are increasingly used to address skin laxity of the face and neck. Both nonablative RF and ultrasound create a heat-induced tissue response that leads to collagen remodeling and other ultrastructural changes. Although these treatments are not meant to replace surgical procedures, patient satisfaction in the majority of studies has been consistently high. This article discusses the various RF and IFUS technologies currently in use and reviews pertinent clinical studies evaluating their efficacy and safety.

Keywords

radiofrequency - ultrasound - skin tightening - laxity
 

  • References

  • 1 Farage MA, Miller KW, Maibach HI. Degenerative changes in aging skin. In: Farage MA, Miller KW, Maibach HI, , eds. Textbook of Aging Skin. Berlin, Germany: Springer-Verlag; 2010: 25-35
    CrossrefGoogle Scholar
  • 2 Fisher GJ, Varani J, Voorhees JJ. Looking older: fibroblast collapse and therapeutic implications. Arch Dermatol 2008; 144 (5) 666-672
    CrossrefPubMedGoogle Scholar
  • 3 Fligiel SE, Varani J, Datta SC, Kang S, Fisher GJ, Voorhees JJ. Collagen degradation in aged/photodamaged skin in vivo and after exposure to matrix metalloproteinase-1 in vitro. J Invest Dermatol 2003; 120 (5) 842-848
    CrossrefPubMedGoogle Scholar
  • 4 Oikarinen A. The aging of skin: chronoaging versus photoaging. Photodermatol Photoimmunol Photomed 1990; 7 (1) 3-4
    PubMedGoogle Scholar
  • 5 Arnoczky SP, Aksan A. Thermal modification of connective tissues: basic science considerations and clinical implications. J Am Acad Orthop Surg 2000; 8 (5) 305-313
    CrossrefPubMedGoogle Scholar
  • 6 Kist D, Burns AJ, Sanner R, Counters J, Zelickson B. Ultrastructural evaluation of multiple pass low energy versus single pass high energy radio-frequency treatment. Lasers Surg Med 2006; 38 (2) 150-154
    CrossrefPubMedGoogle Scholar
  • 7 Ruiz-Esparza J. Near [corrected] painless, nonablative, immediate skin contraction induced by low-fluence irradiation with new infrared device: a report of 25 patients. Dermatol Surg 2006; 32 (5) 601-610
    CrossrefPubMedGoogle Scholar
  • 8 Fisher GH, Jacobson LG, Bernstein LJ, Kim KH, Geronemus RG. Nonablative radiofrequency treatment of facial laxity. Dermatol Surg 2005; 31 (9 Pt 2) 1237-1241 , discussion 1241
    PubMedGoogle Scholar
  • 9 Alexiades-Armenakas M, Dover JS, Arndt KA. Unipolar versus bipolar radiofrequency treatment of rhytides and laxity using a mobile painless delivery method. Lasers Surg Med 2008; 40 (7) 446-453
    CrossrefPubMedGoogle Scholar
  • 10 Ruiz-Esparza J. Nonablative radiofrequency for facial and neck rejuvenation. A faster, safer, and less painful procedure based on concentrating the heat in key areas: the ThermaLift concept. J Cosmet Dermatol 2006; 5 (1) 68-75
    CrossrefPubMedGoogle Scholar
  • 11 Burns JA. Thermage: monopolar radiofrequency. Aesthet Surg J 2005; 25 (6) 638-642
    CrossrefPubMedGoogle Scholar
  • 12 Alster TS, Lupton JR. Nonablative cutaneous remodeling using radiofrequency devices. Clin Dermatol 2007; 25 (5) 487-491
    CrossrefPubMedGoogle Scholar
  • 13 Ee HL, Barlow RJ. Lasers, lights and related technologies: a review of recent journal highlights. Clin Exp Dermatol 2007; 32 (1) 135-137
    PubMedGoogle Scholar
  • 14 Sukal SA, Geronemus RG. Thermage: the nonablative radiofrequency for rejuvenation. Clin Dermatol 2008; 26 (6) 602-607
    CrossrefPubMedGoogle Scholar
  • 15 Elsaie ML. Cutaneous remodeling and photorejuvenation using radiofrequency devices. Indian J Dermatol 2009; 54 (3) 201-205
    CrossrefPubMedGoogle Scholar
  • 16 Gold MH, Goldman MP, Rao JR, Carcamo AS, Ehrlich M. Treatment of wrinkles and elastosis using vacuum-assisted bipolar radiofrequency heating of the dermis. Dermatol Surg 2007; 33 (3) 300-309
    CrossrefPubMedGoogle Scholar
  • 17 Abraham MT, Vic Ross E. Current concepts in nonablative radiofrequency rejuvenation of the lower face and neck. Facial Plast Surg 2005; 21 (1) 65-73
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 18 Friedman DJ, Gilead LT. The use of hybrid radiofrequency device for the treatment of rhytides and lax skin. Dermatol Surg 2007; 33 (5) 543-551
    CrossrefPubMedGoogle Scholar
  • 19 Mayoral FA. Skin tightening with a combined unipolar and bipolar radiofrequency device. J Drugs Dermatol 2007; 6 (2) 212-215
    PubMedGoogle Scholar
  • 20 Zelickson BD, Kist D, Bernstein E , et al. Histological and ultrastructural evaluation of the effects of a radiofrequency-based nonablative dermal remodeling device: a pilot study. Arch Dermatol 2004; 140 (2) 204-209
    CrossrefPubMedGoogle Scholar
  • 21 Pope K, Levinson M, Ross EV. Selective Fibrous Tissue Heating: An Additional Mechanism for Capacitively Coupled Monopolar Radiofrequency. Haywood, CA: Thermage, Inc; 2005
    Google Scholar
  • 22 Narins DJ, Narins RS. Non-surgical radiofrequency facelift. J Drugs Dermatol 2003; 2 (5) 495-500
    PubMedGoogle Scholar
  • 23 Fitzpatrick R, Geronemus R, Goldberg D, Kaminer M, Kilmer S, Ruiz-Esparza J. Multicenter study of noninvasive radiofrequency for periorbital tissue tightening. Lasers Surg Med 2003; 33 (4) 232-242
    CrossrefPubMedGoogle Scholar
  • 24 Bassichis BA, Dayan S, Thomas JR. Use of a nonablative radiofrequency device to rejuvenate the upper one-third of the face. Otolaryngol Head Neck Surg 2004; 130 (4) 397-406
    CrossrefPubMedGoogle Scholar
  • 25 Nahm WK, Su TT, Rotunda AM, Moy RL. Objective changes in brow position, superior palpebral crease, peak angle of the eyebrow, and jowl surface area after volumetric radiofrequency treatments to half of the face. Dermatol Surg 2004; 30 (6) 922-928 , discussion 928
    CrossrefPubMedGoogle Scholar
  • 26 el-Domyati M, el-Ammawi TS, Medhat W , et al. Radiofrequency facial rejuvenation: evidence-based effect. J Am Acad Dermatol 2011; 64 (3) 524-535
    CrossrefPubMedGoogle Scholar
  • 27 Javate RM, Cruz Jr RT, Khan J, Trakos N, Gordon RE. Nonablative 4-MHz dual radiofrequency wand rejuvenation treatment for periorbital rhytides and midface laxity. Ophthal Plast Reconstr Surg 2011; 27 (3) 180-185
    PubMedGoogle Scholar
  • 28 Taub AF, Tucker RD, Palange A. Facial tightening with an advanced 4-MHz monopolar radiofrequency device. J Drugs Dermatol 2012; 11 (11) 1288-1294
    PubMedGoogle Scholar
  • 29 Jacobson LG, Alexiades-Armenakas M, Bernstein L, Geronemus RG. Treatment of nasolabial folds and jowls with a noninvasive radiofrequency device. Arch Dermatol 2003; 139 (10) 1371-1372
    CrossrefPubMedGoogle Scholar
  • 30 Alster TS, Tanzi E. Improvement of neck and cheek laxity with a nonablative radiofrequency device: a lifting experience. Dermatol Surg 2004; 30 (4 Pt 1) 503-507 , discussion 507
    CrossrefPubMedGoogle Scholar
  • 31 Weiss RA, Weiss MA, Munavalli G, Beasley KL. Monopolar radiofrequency facial tightening: a retrospective analysis of efficacy and safety in over 600 treatments. J Drugs Dermatol 2006; 5 (8) 707-712
    PubMedGoogle Scholar
  • 32 Emilia del Pino M, Rosado RH, Azuela A , et al. Effect of controlled volumetric tissue heating with radiofrequency on cellulite and the subcutaneous tissue of the buttocks and thighs. J Drugs Dermatol 2006; 5 (8) 714-722
    PubMedGoogle Scholar
  • 33 Friedman DJ, Gilead LT. The use of hybrid radiofrequency device for the treatment of rhytides and lax skin. Dermatol Surg 2007; 33 (5) 543-551
    CrossrefPubMedGoogle Scholar
  • 34 Hsu TS, Kaminer MS. The use of nonablative radiofrequency technology to tighten the lower face and neck. Semin Cutan Med Surg 2003; 22 (2) 115-123
    CrossrefPubMedGoogle Scholar
  • 35 Bogle MA. Radiofrequency energy and hybrid devices. In: Alam M, Dover JS, , eds. Procedures in Cosmetic Dermatology Series: Non-Surgical Skin Tightening and Lifting. Philadelphia: WB Saunders; 2008: 21-32
    Google Scholar
  • 36 Eastwood M, McGrouther DA, Brown RA. Fibroblast responses to mechanical forces. Proc Inst Mech Eng H 1998; 212 (2) 85-92
    PubMedGoogle Scholar
  • 37 Montesi G, Calvieri S, Balzani A, Gold MH. Bipolar radiofrequency in the treatment of dermatologic imperfections: clinicopathological and immunohistochemical aspects. J Drugs Dermatol 2007; 6 (9) 890-896
    PubMedGoogle Scholar
  • 38 Atiyeh BS, Dibo SA. Nonsurgical nonablative treatment of aging skin: radiofrequency technologies between aggressive marketing and evidence-based efficacy. Aesthetic Plast Surg 2009; 33 (3) 283-294
    CrossrefPubMedGoogle Scholar
  • 39 El-Domyati M, El-Ammawi TS, Medhat W, Moawad O, Mahoney MG, Uitto J. Electro-optical synergy technique: a new and effective nonablative approach to skin aging. J Clin Aesthet Dermatol 2010; 3 (12) 22-30
    PubMedGoogle Scholar
  • 40 Sadick NS, Alexiades-Armenakas M, Bitter Jr P, Hruza G, Mulholland RS. Enhanced full-face skin rejuvenation using synchronous intense pulsed optical and conducted bipolar radiofrequency energy (ELOS): introducing selective radiophotothermolysis. J Drugs Dermatol 2005; 4 (2) 181-186
    PubMedGoogle Scholar
  • 41 Doshi SN, Alster TS. Combination radiofrequency and diode laser for treatment of facial rhytides and skin laxity. J Cosmet Laser Ther 2005; 7 (1) 11-15
    CrossrefPubMedGoogle Scholar
  • 42 Alexiades-Armenakas M, Rosenberg D, Renton B, Dover J, Arndt K. Blinded, randomized, quantitative grading comparison of minimally invasive, fractional radiofrequency and surgical face-lift to treat skin laxity. Arch Dermatol 2010; 146 (4) 396-405
    CrossrefPubMedGoogle Scholar
  • 43 Hruza G, Taub AF, Collier SL, Mulholland SR. Skin rejuvenation and wrinkle reduction using a fractional radiofrequency system. J Drugs Dermatol 2009; 8 (3) 259-265
    PubMedGoogle Scholar
  • 44 Lee HS, Lee DH, Won CH , et al. Fractional rejuvenation using a novel bipolar radiofrequency system in Asian skin. Dermatol Surg 2011; 37 (11) 1611-1619
    CrossrefPubMedGoogle Scholar
  • 45 Laubach HJ, Makin IR, Barthe PG, Slayton MH, Manstein D. Intense focused ultrasound: evaluation of a new treatment modality for precise microcoagulation within the skin. Dermatol Surg 2008; 34 (5) 727-734
    CrossrefPubMedGoogle Scholar
  • 46 Van Leenders GJ, Beerlage HP, Ruijter ET, de la Rosette JJ, van de Kaa CA. Histopathological changes associated with high intensity focused ultrasound (HIFU) treatment for localised adenocarcinoma of the prostate. J Clin Pathol 2000; 53 (5) 391-394
    CrossrefPubMedGoogle Scholar
  • 47 Alam M, White LE, Martin N, Witherspoon J, Yoo S, West DP. Ultrasound tightening of facial and neck skin: a rater-blinded prospective cohort study. J Am Acad Dermatol 2010; 62 (2) 262-269
    Google Scholar
  • 48 Suh DH, Shin MK, Lee SJ , et al. Intense focused ultrasound tightening in Asian skin: clinical and pathologic results. Dermatol Surg 2011; 37 (11) 1595-1602
    CrossrefPubMedGoogle Scholar
  • 49 Lee HS, Jang WS, Cha YJ , et al. Multiple pass ultrasound tightening of skin laxity of the lower face and neck. Dermatol Surg 2012; 38 (1) 20-27
    CrossrefPubMedGoogle Scholar
  • 50 Chan NP, Shek SY, Yu CS, Ho SG, Yeung CK, Chan HH. Safety study of transcutaneous focused ultrasound for non-invasive skin tightening in Asians. Lasers Surg Med 2011; 43 (5) 366-375
    CrossrefPubMedGoogle Scholar