Commentary on: Percutaneous Selective Radiofrequency Nerve Ablation for Glabellar Frown Lines

Abstract

Ablation of nerve tissue with radiofrequency-generated (RF-generated) heat is an established technique for treating patients with cardiac arrhythmias.1,2 The application of this concept to the ablation of motor nerve function in the face was introduced by Gregorio Hernandez-Zendejas and Jose Guerrerosantos3 in 1994, when they were attempting to find a less invasive treatment to provide forehead symmetry in patients with unilateral frontalis muscle paralysis from Bells palsy or iatrogenic causes by ablating the function of the temporal branch of the facial nerve on the opposite side. During their study, they found that they could soften glabellar “frown” lines by ablating motor nerves to the muscles that act on the glabellar skin to produce creasing in that area. Subsequently, other authors—as referenced by Dr. Kim and his coauthors in “Percutaneous Selective Radiofrequency Nerve Ablation for Glabellar Frown Lines”—reported with varying success their attempts to similarly apply RF technology to soften glabellar skin lines. My experience with motor nerve ablation through RF-generated heat began in 2006. The technique my colleagues and I applied has been published by Newman.4 Except for some minor differences, our technique was remarkably similar to that described by Kim et al. Dr. Kim and his coauthors obtained a significant improvement in glabellar skin lines for at least 12 months postoperatively in 21 of 27 patients (87%). This is interesting, considering that the same technique was applied in all 27 patients. One might expect that the six patients who did not maintain their good clinical result for at least 12 months were treated at the beginning of the study, but those six …