Patient Satisfaction and Efficacy of Accent Radiofrequency for Facial Wrinkle Reduction

Document Type : Original Article (s)

Authors

1 Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 General Practitioner, Rsearcher, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Radiofrequency (RF) is a new technique to treat facial wrinkles. This study was designed to assess the efficacy of Accent RF in wrinkle reduction of different areas of the face..Methods: Patients with mild to severe facial wrinkles were treated with Accent using RF energies of 35 to 145 watts. The average energy used in this study was 83.11 watts. Patients received 4 subsequent weekly RF sessions. Wrinkle improvement was rated by two double- blinded physicians comparing 6-month post-treatment and pre-treatment photographs. Moreover, patient satisfaction was assessed at 1 and 6 months after the last session of the treatment.Findings: Overall, 45 women participated in this study. One month after the last treatment, 8.9% of the patients declared their dissatisfaction, 53.3% were relatively satisfied, 33.3% were satisfied, and 4.4% were very satisfied. At the 6th month, 4.4% of the patients were dissatisfied, 31.1% were relatively satisfied, 46.7% were satisfied, and 17.8% were very satisfied. Patient satisfaction 6 months after the last treatment was significantly higher than 1 month post-treatment. After 6 months, patient satisfaction was not more than 75% in any treatment areas of the face.Conclusion: Comparing the findings of this study with previous studies suggests using higher energy levels and more treatment sessions to result in better clinical improvement of facial wrinkles.

Keywords


  1. Gold MH, Goldman MP, Rao J, Carcamo AS, Ehrlich M. Treatment of wrinkles and elastosis using vacuum-assisted bipolar radiofrequency heating of the dermis. Dermatol Surg 2007; 33(3): 300-9.
  2. Alam M, Dover JS, Arndt KA. Energy delivery devices for cutaneous remodeling: lasers, lights, and radio waves. Arch Dermatol 2003; 139(10): 1351-60.
  3. Goldberg DJ, Cutler KB. Nonablative treatment of rhytids with intense pulsed light. Lasers Surg Med 2000; 26(2): 196-200.
  4. Narurkar VA. Lasers, light sources, and radiofrequency devices for skin rejuvenation. Semin Cutan Med Surg 2006; 25(3): 145-50.
  5. Burns JA. Thermage: monopolar radiofrequency. Aesthet Surg J 2005; 25(6): 638-42.
  6. Friedman DJ, Gilead LT. The use of hybrid radiofrequency device for the treatment of rhytides and lax skin. Dermatol Surg 2007; 33(5): 543-51.
  7. Hardaway CA, Ross EV. Nonablative laser skin remodeling. Dermatol Clin 2002; 20(1): 97-111.
  8. Sadick NS, Makino Y. Selective electro-thermolysis in aesthetic medicine: a review. Lasers Surg Med 2004; 34(2): 91-7.
  9. Kim KH, Geronemus RG. Nonablative laser and light therapies for skin rejuvenation. Arch Facial Plast Surg 2004; 6(6): 398-409.
  10. 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): 232-42.
  11. Bogle MA, Ubelhoer N, Weiss RA, Mayoral F, Kaminer MS. Evaluation of the multiple pass, low fluence algorithm for radiofrequency tightening of the lower face. Lasers Surg Med 2007; 39(3): 210-7.
  12. Abraham MT, Mashkevich G. Monopolar radiofrequency skin tightening. Facial Plast Surg Clin North Am 2007; 15(2): 169-77.
  13. De F, I, Del Cueto SR, Perez E, Redondo P. Adverse reactions after nonablative radiofrequency: follow-up of 290 patients. J Cosmet Dermatol 2007; 6(3): 163-6.
  14. Emilia del PM, Rosado RH, Azuela A, Graciela GM, Arguelles D, Rodriguez C, 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): 714-22.
  15. 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): 446-53.
  16. Rinaldi F. Studio critico retrospettivo sull'efficacia della radiofrequenza non ablativa nel ringiovanimento cutaneo.. 2006;2:17-23. J Plast Dermatol 2006; 2: 17-23.
  17. Rinaldi F, Sorbellini E, Bezzola P. The treatment of abdomen skin laxity with non ablative radiofrequency using FACES technique. J Plast Dermatol 2006; 2(3):17-22.
  18. Zdinak LA, Summerfield ME. Nonablative skin therapies. Ophthalmol Clin North Am 2005; 18(2): 237-48.
  19. DeHoratius DM, Dover JS. Nonablative tissue remodeling and photorejuvenation. Clin Dermatol 2007; 25(5): 474-9.
  20. Ruiz-Esparza J, Gomez JB. The medical face lift: a noninvasive, nonsurgical approach to tissue tightening in facial skin using nonablative radiofrequency. Dermatol Surg 2003; 29(4): 325-32.
  21. 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): 1371-2.
  22. 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): 503-7.
  23. Iyer S, Suthamjariya K, Fitzpatrick RE. Using a radiofrequency energy device to treat the lower face: a treatment paradigm for a nonsurgical facelift. Cosmetic Dermatology 2003; 18: 37-40.
  24. 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
  25. ; 30(6): 922-8.
  26. Ruiz-Esparza J. Noninvasive lower eyelid blepharoplasty: a new technique using nonablative radiofrequency on periorbital skin. Dermatol Surg 2004; 30(2 Pt 1): 125-9.
  27. Mitz V, Leblanc P, Maladry D, Aboudaram T. [Results of biplane face lifts with maximal skin underlining and vertical SMAS flap]. Ann Chir Plast Esthet 1996; 41(6): 603-12.
  28. Alexiades-Armenakas MR, Dover JS, Arndt KA. The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. J Am Acad Dermatol 2008; 58(5): 719-37.
  29. Carruthers J, Carruthers A. Shrinking upper and lower eyelid skin with a novel radiofrequency tip. Dermatol Surg 2007; 33(7): 802-9.
  30. Hsu TS, Kaminer MS. The use of nonablative radiofrequency technology to tighten the lower face and neck. Semin Cutan Med Surg 2003; 22(2): 115-23.
  31. Fisher GH, Jacobson LG, Bernstein LJ, Kim KH, Geronemus RG. Nonablative radiofrequency treatment of facial laxity. Dermatol Surg 2005; 31(9 Pt 2): 1237-41.
  32. 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.
  33. McBride G. Facial Plastic and Reconstructive Surgery: New Patients, New Reasons, New Techniques. ENT Today 2006.
  34. Finzi E, Spangler A. Multipass vector (mpave) technique with nonablative radiofrequency to treat facial and neck laxity. Dermatol Surg 2005; 31(8 Pt 1): 916-22.
  35. Yu CS, Yeung CK, Shek SY, Tse RK, Kono T, Chan HH. Combined infrared light and bipolar radiofrequency for skin tightening in Asians. Lasers Surg Med 2007; 39(6): 471-5.
  36. 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): 283-94.
  37. Hruza G, Taub AF, Collier SL, Mulholland SR. Skin rejuvenation and wrinkle reduction using a fractional radiofrequency system. J Drugs Dermatol 2009; 8(3): 259-65.
  38. Zelickson BD, Kist D, Bernstein E, Brown DB, Ksenzenko S, Burns J, 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): 204-9.
  39. Fritz M, Counters JT, Zelickson BD. Radiofrequency treatment for middle and lower face laxity. Arch Facial Plast Surg 2004; 6(6): 370-3.
  40. Alexiades-Armenakas M. Rhytides, laxity, and photoaging treated with a combination of radiofrequency, diode laser, and pulsed light and assessed with a comprehensive grading scale. J Drugs Dermatol 2006; 5(8): 731-8.
  41. Dover JS, Zelickson B. Results of a survey of 5,700 patient monopolar radiofrequency facial skin tightening treatments: assessment of a low-energy multiple-pass technique leading to a clinical end point algorithm. Dermatol Surg 2007; 33(8): 900-7.
  42. Biesnman BS. Radiofrequency Devices: Monopolar vs bipolar vs radiofrequency plus laser; indications; treatment approaches; novel applications; results. In: Arndt KA, Dover JS, Anderson RR, editors. Controversies and Conversations in Laser and Cosmetic Surgery. Symposium Proceeding. Denver, CO.; 2005.
  43. Elsaie ML, Choudhary S, Leiva A, Nouri K. Nonablative radiofrequency for skin rejuvenation. Dermatol Surg 2010; 36(5): 577-89.
  44. Wirtzer A. Nonablative radiofrequency for skin rejuvenation. Dermatol Surg 2010; 36(12): 2083-4.
  45. Ee HL, Barlow RJ. Lasers, lights and related technologies: a review of recent journal highlights. Clin Exp Dermatol 2007; 32(1): 135-7.
  46. 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.
  47. DeHoratius DM, Dover JS. Nonablative tissue remodeling and photorejuvenation. Clin Dermatol 2007; 25(5): 474-9.
  48. Weiss RA, Weiss MA, Beasley KL, Munavalli G. Our approach to non-ablative treatment of photoaging. Lasers Surg Med 2005; 37(1): 2-8.
  49. Elsaie ML. Cutaneous remodeling and photorejuvenation using radiofrequency devices. Indian J Dermatol 2009; 54(3): 201-5.
  50. Abraham MT, Vic RE. Current concepts in nonablative radiofrequency rejuvenation of the lower face and neck. Facial Plast Surg 2005; 21(1): 65-73.