Bipolar Radiofrequency Treatment Research Articles

Bipolar Radiofrequency Treatment of the Vaginal Canal in Conjunction with Patient Education and Pelvic Floor Rehabilitation for the Treatment of Women with Mixed Urinary Incontinence

Bipolar Radiofrequency Treatment of the Vaginal Canal in Conjunction with Patient Education and Pelvic Floor Rehabilitation for the Treatment of Women with Mixed Urinary Incontinence

Treatment of Greater Trochanteric Pain Syndrome With Ultrasound-Guided Bipolar Pulsed Radiofrequency of the Trochanteric Branches of the Femoral Nerve: A Case Series of Nine Patients.

Greater trochanteric pain syndrome (GTPS) is a prevalent cause of lateral hip pain that often leads to significant functional limitations. Conservative treatment options include physical therapy, pharmacological treatment, and more invasive techniques such as corticosteroid injections. However, despite the high success rates reported with corticosteroid injections, a significant number of patients have their symptoms persist or recur. In this case series, we present the outcomes of nine patients with GTPS who underwent ultrasound-guided bipolar pulsed radiofrequency targeting the trochanteric branches of the femoral nerve. We aim to discuss the effectiveness and safety of this approach. Eligible patients referred to our centre underwent ultrasound-guided bipolar pulsed radiofrequency aimed at the trochanteric branches of the femoral nerve. The procedure consisted of one cycle at 42°C for six minutes, followed by the injection of ropivacaine (0.2%, 3 mL) and dexamethasone (12 mg). The Brief Pain Inventory - Short Form (BPI-sf)and Lequesne Algofunctional Index (LAI) were used before the procedure and at the third and sixth months post-procedure. We monitored immediate and late complications, as well as adverse effects. Our results indicate a favourable outcome for most patients, with an average pain reduction of 76.51% according to their report of the BPI-sf. Additionally, eight out of nine patients experienced at least 50% relief. These findings align with a previous case series, which reported a similar average pain reduction. Before the procedure, most patients were classified as "extremely severe" in the LAI, with an average score of 18.17. Although there was only a slight reduction of 16.84% at the six-month follow-up, this suggests a potential improvement in their functional status. We did not observe any immediate complications or adverse effects after the procedure, nor were any reported at the subsequent follow-ups, which is consistent with existing literature. Our study suggests that ultrasound-guided bipolar pulsed radiofrequency treatment is a promising minimally invasive technique for GPTS, especially for patients who do not respond to conservative treatments. Although our case series provides some evidence of effectiveness and safety, further controlled studies on a larger scale are necessary, particularly to compare this intervention with the use of corticosteroid injections alone.

Evaluation of short-term face rejuvenation effects of non-ablative bipolar radiofrequency treatment performed by Med-RF© device.

Skin laxity and wrinkling are common signs of the aging process. This physiological condition of the skin is often accompanied by psychological and social concerns, especially for females, entailing considerable expenses for cosmetics and pharmaceuticals to cease or slow down its advancement. The objective of this study was to evaluate the short-term impact of a new non-ablative radiofrequency device available in the skin face cosmetic field. A randomized study was run on 62 healthy subjects with normal-age related-grade skin laxity, subdivided into two groups. Group 1 received one treatment with Modula RF device (Wavemed, San Cesareo RM, Italy) over the whole face surface. Group 2 received three monthly treatments. Clinical improvements of the exposed areas were detected by measuring skin parameters, such as total water content, elasticity, and sebum levels at baseline and 1 h after the treatment. Data showed significant effects of Med-RF treatment on skin hydration (p < 0.001), skin elasticity (p < 0.0001), and sebum (p = 0.0009). Moreover, a negative linear correlation was obtained between women's age and hydration. In conclusion, the results of this study suggest that radiofrequency significantly improves the subjective and objective judgment of patients and doctors, supported by the positive results obtained on the skin quality parameters evaluated. These results confirm that Med-RF technology represents an important tool to achieve face rejuvenation in the field of non-invasive procedures.

Efficacy Assessment of a Pulsed-Type Bipolar Radiofrequency Microneedling Device for Treating Facial Acne Vulgaris Using a Skin-Color Imaging System: A Pilot Study

Facial acne vulgaris with post-inflammatory erythema is one of the most common problems encountered in dermatologic clinics. It can leave hypertrophic scars and cause psychological problems. Thus, effective therapeutic interventions are needed. The aim of this study was to evaluate the efficacy and safety of a pulsed-type bipolar radiofrequency (RF) device for treating acne and post-inflammatory erythema. Eighteen patients who had been diagnosed with acne underwent three sessions of bipolar RF treatment at 4 week intervals. Efficacy was assessed based on the number of acne lesions and the total area of lesions. Acne lesion count and area were determined by color correction using the Viola–Jones algorithm after converting the photos into a CIELAB image and extracting the area higher than the erythema threshold from the A* channel. Most patients showed significant clinical improvement after the treatments. Acne lesion counts of the forehead, left malar, right malar, and total areas of the left malar and right malar were decreased significantly after sessions (all p &lt; 0.05). Adverse effects such as pinpoint bleeding and pain were noted. However, they were transient and not severe enough to stop treatment. Thus, such pulsed-type bipolar radiofrequency microneedling is a safe and effective treatment for acne and post-inflammatory erythema.

Comparison between ultrasound-guided monopolar and bipolar pulsed radiofrequency treatment for refractory chronic cervical radicular pain: A randomized trial.

Many patients complain of chronic cervical radicular pain, and pulsed radiofrequency (PRF) is known to have a positive effect for alleviating neuropathic pain. In the present study, we used ultrasound (US) guidance and compared the effects of monopolar PRF with those of bipolar PRF in patients with chronic cervical radicular pain refractory to repeated transforaminal epidural steroid injections. Sixty-six patients with chronic cervical radicular pain were included in this study. Patients were randomly assigned to one of the two groups: monopolar or bipolar PRF group (n= 33 per group). Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, and at 1 and 3months after the treatment. Target stimulation site was the extraforaminal nerve root. Compared to the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at 1 and 3months after the treatment. Reductions in the NRS scores over time were significantly larger in the bipolar PRF group. Three months after the treatment, 18 patients (54.5%) in the monopolar PRF group and 27 (81.8%) in the bipolar PRF group reported successful pain relief (pain relief of ⩾50%). US-guided PRF can be an effective interventional technique for the management of chronic refractory cervical radiculopathy. Moreover, bipolar PRF has better treatment outcome than monopolar PRF.

Vaginal Bipolar Radiofrequency Treatment of Mild SUI: A Pilot Retrospective Study.

Background and Objectives: This retrospective study investigates the action of a bipolar, temperature controlled, endovaginal RF handpiece for the treatment of mild, moderate, and severe stress urinary incontinence with a minimally invasive approach. Stress urinary incontinence (SUI) is a common condition resulting in involuntary urine leakage, with an associated social and psychological impact. SUI is the most common type of urinary incontinence in women. Materials and Methods: We retrospectively studied 54 patients for this study. The bipolar radiofrequency energy used in all patients was 50 W, with temperatures maintained between 41 °C and 44 °C. Two sessions were performed four weeks apart. In order to monitor all patients before the first treatment and 4 months after the second treatment, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was used. Paired Student’s t test was used to elaborate the statistical data. Results: The average frequency of urine leak improved from “2–3 times a week” (2.1 ± 1.3 points before the treatment) to “once a week” (0.8 ± 1.3 points 4 MFU post-treatment). The average volume improved from “small/moderate quantity” (3.2 ± 1.6 points before the treatment) to “none” (0.9 ± 1.4 points 4 MFU post-treatment). No adverse events or side effects were found. Conclusion: Our preliminary results represent a good starting point to check the effectiveness and validity of the bipolar radiofrequency temperature-controlled method in the treatment of SUI.

The MICRO-Lift: A Ligaments-Based Anatomic Technique for Lower Face and Neck Rejuvenation Using Bipolar Radiofrequency.

The aim of this paper is to present the results of a new technique for lower face and neck rejuvenation named the MICRO-lift (Minimally Invasive, Combined Radiofrequency, Outpatient lift). This technique is based on a bipolar radiofrequency treatment applied to specific ligamentous areas. Inclusion criteria were patients with skin laxity of the neck and jowls, with or without fat accumulation. Patients who presented platysma sag and alteration of subplatysmal structures were excluded from the study. The distribution of the energy was adapted to the ligament anatomy, differentiating three areas based on the energy concentration. In all patients, sex, age at surgery, type of anesthesia, radiofrequency parameters and complications were registered. In all cases, standard photographs and satisfaction interviews were conducted preoperatively and postoperatively. Satisfaction evaluation was also assessed. Sixty-five patients underwent MICRO-lift technique for the lower face and neck. All patients in our series were female. There were no major complications. Minor complications included transient paralysis of the marginal mandibular (4,6%), infection of the submental incision that required incisional drainage (3,1%), and deep skin burn in the neck (1,5%). Fifty-nine patients were satisfied a year after the treatment (90,8%). The MICRO-lift can produce outstanding and satisfying improvements in cervicofacial appearance. This new approach offers a predictable strategy to achieve the desired aesthetic results, making this procedure more reliable and reproducible for both novel and experienced surgeons with bipolar radiofrequency. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Transvaginal radiofrequency energy for the treatment of urinary stress incontinence: A comparison of monopolar and bipolar technologies in both pre‐ and post‐menopausal patients

A study to compare the effect of two different radio frequency energy models (mono polar and bipolar) for the treatment of urinary stress incontinence. Retrospective chart review, which was conducted at 2 sites, 69 patients received treatment with a bipolar radiofrequency device. Out of those 69 patients, 13 patients received bipolar in conjugation with CO2 laser treatment, while 32 patients received monopolar frequency. The study protocol normally consists of three sessions of treatment. Each session was four weeks apart with a whole 6-month duration follow-up. Results were evaluated by urogenital distress inventory (UDI)-6 questionnaire before and after treatment. The bipolar group improved UDI-6 scores across time more so than did the monopolar group with some evidence suggesting that the bipolar radiofrequency treatment was more effective compared to the monopolar radiofrequency. Three months after treatment, the bipolar group UDI-6 values were lower than those of the monopolar group. Six months after treatment, the UDI-6 scores increased in both groups, suggesting decrease efficacy with time however, the bipolar group's UDI-6 scores were consistently lower than the monopolar group's scores. This study shows benefit of both monopolar and bipolar radiofrequency device in patients with stress urinary incontinence and mixed UI, with bipolar RF more efficacious than monopolar RF. More randomized prospective studies are needed to confirm these findings.

Commentary on: Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy

Commentary on: Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy

Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy.

Noninvasive treatments for skin tightening are gaining popularity. However, no studies have assessed bipolar fractional radiofrequency treatment on suprapatellar skin. The purpose of this study was to evaluate the efficacy of bipolar fractional radiofrequency treatment on suprapatellar skin. Twenty patients received 1 bilateral suprapatellar bipolar fractional radiofrequency treatment. They returned 7 days, 3 weeks, 3 months, and 6 months posttreatment. Noninvasive measurements were obtained at each visit, including high-resolution ultrasonography, optical coherence tomography, transepidermal water loss and skin elasticity. Microbiopsies were collected in the treatment area for histologic and gene expression analyses. Three clinicians completed photographic evaluations comparing texture and laxity at baseline vs 6 months posttreatment. Fifteen subjects completed all 6 visits. Both transepidermal water loss and dermal-epidermal junction roughness were increased at 3 weeks and 3 months posttreatment. Both attenuation coefficient and stiffness were increased significantly at 3 and 6 months posttreatment. Blood flow 0.5 mm below the surface and expression of epidermal hyaluronic acid and inflammatory genes IL-1b and IL-6 were significantly higher at 7 days posttreatment compared with pretreatment and 3 months posttreatment. There were no statistically significant changes in collagen- or elastin-related genes and proteins at 7 days or 3 months posttreatment. An improvement in texture and laxity was observed at 6 months posttreatment in 17.7% and 24.4% of photographs, respectively. Radiofrequency treatment by microneedling of suprapatellar skin shows limited effects in decreasing skin laxity and improving skin appearance. At a molecular level, the treatment resulted in lower elastin and hyaluronic acid levels and increased dermal-epidermal junction roughness based on histology and optical coherence tomography imaging.

120 Bipolar Radiofrequency Treatment of Labia Majora and Menora: A Minimally Invasive Solution to a Growing Surgical Problem

120 Bipolar Radiofrequency Treatment of Labia Majora and Menora: A Minimally Invasive Solution to a Growing Surgical Problem

090 Effects of Bipolar Radiofrequency Treatment on Subjective and Objective Endpoints in Post-Partum Pelvic Floor Disorders

Post-partum pelvic floor disorders (PFDs) are estimated to impact 24% of women in the United States. The term ‘pelvic floor disorders’ refers to stress urinary incontinence, overactive bladder, pelvic organ prolapse, sexual dysfunction and fecal incontinence. Current treatment options for PFDs include biofeedback, laser, electrical muscle stimulation (EMS), and/or operative intervention. At 40-45 degrees Celsius, radiofrequency heat applied to vaginal and vulvar tissue induces an inflammatory cascade that Results in fibroblast proliferation, production of collagen and elastin and the formation of healthy new tissue as opposed to scar tissue. To evaluate effects of radiofrequency (VotivaTM ,InMode Aesthetics) on pelvic floor tone and subjective symptoms in post- partum women. This is a single center retrospective study of post-partum women with symptoms of PFDs treated with a bipolar vaginal radiofrequency device ( VotivaTM, InMode) Resting pelvic floor muscle tone and maximal pelvic floor contraction were measured a total of 3 times via UROstym.TM Changes in mean resting (UROstym min) and maximal muscle contraction (UROstym max) were determined by ANOVA . Subjects were divided into two groups according to number of treatments completed. Evaluation of patient perception of improvement was determined using a patient symptom improvement index (PSI) with a 5-level measure (0-4).

In-office treatment of nasal valve obstruction using a novel, bipolar radiofrequency device.

ObjectivesTo assess the safety and effectiveness of in‐office bipolar radiofrequency treatment of nasal valve obstructionStudy DesignProspective, nonrandomized, multicenter case seriesMethodsAdult patients with a Nasal Obstruction Symptom Evaluation scale (NOSE) score ≥60 were selected. Patients were clinically diagnosed with dynamic or static internal nasal valve obstruction as primary or significant contributor to obstruction and were required to have a positive response to nasal mechanical dilators or lateralization maneuvers. Bilateral radio‐frequency treatment was applied intranasally using a novel device, under local anesthesia in a single session. Safety and tolerance were assessed by event reporting, inspection, and Visual Analogue Scale (VAS) for pain. Efficacy was determined using the NOSE score and patient‐reported satisfaction survey at 26 weeks.ResultsFifty patients were treated. No device or procedure‐related serious adverse events occurred. Soreness, edema, and crusting resolved by 1 month. The mean baseline NOSE score was 79.9 (SD 10.8, range 60–100), and all had severe or extreme obstruction. At 26 weeks, mean NOSE score was 69% lower at 24.7 (P < .0001) with 95% two‐sided confidence intervals 48.5 to 61.1 for decrease. The decrease in NOSE score did not differ significantly between patients who did or did not have prior nasal surgery. Patient satisfaction mean by survey was 8.2 of 10.ConclusionIn office treatment of internal nasal valve obstruction using a bipolar radiofrequency device is safe and well‐tolerated. Nasal obstruction, as assessed using the NOSE questionnaire at 26 weeks, was markedly improved with high patient satisfaction.Level of Evidence2b, prospective cohort

Evaluation of therapeutic efficacy of radiotherapy for the treatments of herpes zoster neuralgia with infrared thermography and depression scale

Objective To evaluate the therapeutic effect of high-voltage long-duration bipolar pulsed radiofrequency (PRF) radiotherapy on postherpetic neuralgia (PHN) by measuring temperature shift on abnormal skin with infrared thermography and examining mood improvement with depression scale. Methods Thirty patients suffered from herpes zoster on the torso for 2-4 months were enrolled in this study. Demographic data of these patients were collected. Preoperative pain symptoms and mood status were respectively assessed with VAS and Hamilton Depression Scale-17 (HAMD-17). Infrared thermograph of the lesioned skins were taken and the temperature differences between the lesioned and the normal skins were analyzed. The standard 600 s high-voltage (50-70 V) long-duration (30 ms) bipolar pulsed radiofrequency (3 Hz) radiotherapy was performed under the guidance of CT. The VAS scores, thermographs and HAMD-17 scores were recorded after radiotherapy. Results In a total of 30 patients, the VAS were significantly reduced 1 and 3 days after radiotherapy (P 0.05). The infrared thermography showed that the temperature was (0.53±0.28) °C higher in lesioned area than in healthy area, but the difference was significantly reduced 1 and 3 days after radiotherapy[1 day: (0.27±0.22) °C, 3 days: (0.28±0.24) °C]. Preoperative HAMD-17 scores in 24 out of 30 patients were greater than 17 and did not change after operation. Interestingly, there was a significant correlation between VAS and HAMD-17 scores before (P=0.006, r=0.492) and after operation (P=0.023, r=0.872). Conclusions After 1 and 3 days treatment, high-voltage long-duration bipolar pulsed radiofrequency radiography relieved pain symptoms, reduced temperature in abnormal skin, but did not improve moods, in patients suffered from postherpetic neuralgia. Key words: Thermal imaging; Bipolar pulsed radiofrequency treatment; Neuralgia, postherpetic; Depression

Enhanced high-energy protocol using a fractional bipolar radiofrequency device combined with bipolar radiofrequency and infrared light for improving facial skin appearance and wrinkles.

Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have been shown in previous trials to safely and effectively improve the appearance of facial wrinkles. To evaluate a high-energy protocol with combined bipolar radiofrequency and infrared light energies for improvement in photoaged facial skin. Seventy-two patients presenting with mild to moderate facial wrinkles underwent a single full-face treatment (n=54) or two treatments (n=18) at 6-week intervals. Independent blinded assessment and investigator assessment were performed, using the Fitzpatrick Wrinkle and Elastosis Scale (0-9) and the Global Aesthetic Improvement scale. Patients also completed a self-assessment questionnaire concerning satisfaction with the treatment. All patients achieved some degree of improvement in their wrinkles and skin appearance, following a single treatment or two treatments with the enhanced-energy protocol. Blinded evaluation demonstrated 71% and 70% of the patients showing improvement of one unit or greater on the Fitzpatrick Scale, at the 12-week and 24-week follow-ups post-treatment, respectively. Similar results were reported by investigators. Under the Global Aesthetic Improvement Scale, investigators observed 87%, 91% and 81% of patients showing improvement at the 6-, 12-, and 24-week post-treatment end, respectively. Patients tolerated the treatments well and were satisfied with the clinical results. The enhanced-energy treatment protocol, with fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light applications, yields significant improvement of skin texture, wrinkling, and overall appearance following a single treatment. The results appear gradually over time and are maintained for at least 6months' post-treatment.

A Fractional Bipolar Radiofrequency Device Combined with a Bipolar Radiofrequency and Infrared Light Treatment for Improvement in Facial Wrinkles and Overall Skin Tone and Texture.

A variety of techniques and energy-based technologies are currently utilized for the treatment of facial wrinkles. Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have both been reported to be safe and effective for the non-invasive treatment of wrinkles and overall facial rejuvenation. A multicenter, prospective clinical trial evaluated a protocol of treatment with a device incorporating bipolar radiofrequency and infrared light followed by treatment with a fractional bipolar radiofrequency device for facial wrinkle reduction and improvement in the overall appearance of aged facial skin. Fifty-six patients with mild to moderate facial wrinkles received three full-face treatments (forehead, nose, cheeks, periorbital, and perioral areas) at 4 to 6 week intervals and were evaluated at 12 and 24 weeks after the last treatment. Clinical photographs at baseline and follow-ups were assessed by both the investigators and patients using the Global Aesthetic Improvement scale. Treatment safety was evaluated. Study participants also completed a satisfaction and improvement questionnaire. Fitzpatrick Wrinkling and Elastosis Score was decreased significantly at three months (P < .01; paired t test) and at six months (P < .001; paired t test) after the final treatment. Investigators' assessments of overall improvement in facial appearance, demonstrated 88% improvement at 12 weeks and 82% at 24 weeks after the final treatment. Subject evaluations were similar, consistently reporting improvement in wrinkles and overall facial skin appearance throughout the study, and high a degree of satisfaction with their final results. Subjects tolerated the procedures well, with only transient mild to moderate erythema and edema occurring in most patients, and without complications. A combined protocol of bipolar radiofrequency and infrared light treatment followed by fractionated bipolar radiofrequency treatment results in safe, well tolerated, and effective improvement in overall skin tone and texture and reduction of facial wrinkles. 4 Therapeutic.

Comparative assessment of monopolar and bipolar radiofrequency surgery of inferior turbinate

The aim of this study was to compare early outcomes of monopolar (MP) and bipolar (BP) radiofrequency (RF) treatment of inferior turbinate hypertrophy from the perspective of both the patient and the surgeon. Prospective, randomized, single-blind study. Seventy-one patients with inferior turbinate hypertrophy resistant to medical treatment. BP RF was used in 36 patients and MP RF in 35 patients, respectively. Patients received no other treatment during a 6-month follow-up. They were evaluated for symptoms such as nasal obstruction severity, nasal obstruction frequency, postnasal drip, nasal crusting, hyposmia, patient satisfaction, and preoperative pain with the use of a visual analogue scale (VAS) before surgery and then 1 and 7 days as well as 1, 3, and 6 months after surgery. No significant difference was observed regarding symptoms of patients after BP and MP inferior turbinate RF surgery in a long-term follow-up. Patients treated with MP RF showed early symptom improvement on days 1 and 7 days after surgery compared to the BP group. Procedure duration of MP RF was longer than that of BP RF. Pain during surgery was reported more frequently in the BP group. MP and BP RF treatment showed no difference in long-term efficacy. However, MP RF therapy was associated with early symptom improvement and less pain reported by patients in comparison to the BP RF group.

The Efficacy and Safety of Bipolar Radiofrequency Treatment with Non-Insulated Penetrating Microneedles for Acne Vulgaris and Acne Scars

Other SectionsAbstractINTRODUCTIONMATERIALS AND METHODSRESULTSDISCUSSIONACKNOWLEDGMENTSFigureTableReferences

The clinical experience and efficacy of bipolar radiofrequency with fractional photothermolysis for aged Asian skin.

Bipolar radiofrequency (RF) technology is developed based on fractional thermolysis, and the literature concerning the efficacy of the rejuvenation and treatment of acne scars has been reported in Europe and the United States of America. Therefore, we examined bipolar RF treatment using fractional thermolysis to evaluate the efficacy and safety of the treatment of Asian photo-aging skin, particularly 'wrinkles' and 'sagging.' Ten Japanese women (mean age: 58.6, skin type III-IV) received three fractional bipolar RF treatments every 4-6weeks. For the objective evaluation, we evaluated the improvement of the wrinkles on the forehead, lateral canthus (crow's feet) and lower eyelid, and the sagging of the nasolabial fold using digital photographs captured using Visia(™) . For the subjective evaluation, the participants were asked to describe the improvements observed in the wrinkles on the forehead, lateral canthus (crow's feet) and lower eyelid, and sagging nasolabial fold and to evaluate the level pain experienced using a 10-point VAS score. The objective evaluation in each category showed significant improvements in the wrinkles on the lateral canthus (crow's feet) and lower eyelid. As for the nasolabial fold, 60% of the subjects showed improvements, scoring from good to excellent (51-100% improvement), although there was a little improvement of the wrinkle on the forehead. Similar improvements were observed in the subjective evaluation. During each treatment, oedema and erythema were observed in all participants, but the oedema disappeared the following day in all cases. However, mild erythema persisted for an average of 3.1days. Micro debris disappeared after an average of 5.2days. The participants were satisfied, as we allowed them to apply make-up the next day. There were no other severe adverse reactions observed during the treatment. The 10-point VAS score was 3.8, and no participants dropped out due to discomfort. Little improvement was observed in the forehead wrinkles in either the objective or the subjective evaluation. The results obtained in this study indicate that fractional bipolar RF is an effective and safe treatment for the 'wrinkling' and 'sagging' of Asian photo-aging skin.

Phosphatidylcholine and bipolar radiofrequency for treatment of localized fat deposits

Bipolar radiofrequency (RF) is capable of delivering higher energy fluencies direct to the dermis through a needle electrode. This produces heat when the tissue electrical resistance converts the electric current to thermal energy in the tissue. A 38-year-old man visited our clinic for reduction of submental fat deposit, but otherwise in overall good health. After deciding to perform phosphatidylcholine (PPC) injections subcutaneously, we concerned about edema and swelling of injection site lasted several weeks. We wanted to shorten the period of edema and swelling, and we decided to add bipolar RF treatment. After 1 week of PPC injection combined with RF treatment, overall volume of jowl was decreased and edema and swelling on the PPC injected site markedly subsided. This reduction of fat deposit lasts longer than 1 year. Follow-up for 1 year demonstrated that the cosmetic results were well maintained.