Facial Tightening Research Articles

Facial tightening using a novel vacuum-assisted microneedle fractional radiofrequency system: A prospective, randomized, split-face study.

The microneedle fractional radiofrequency system (MFRS) is able to rejuvenate facial appearance by heating and coagulating certain depth of skin tissue. To evaluate the safety and efficacy of a novel vacuum-assisted MFRS for facial contour tightening. This prospective, randomized, split-face study included 21 patients who underwent three treatments with a vacuum-assisted MFRS at 1-month intervals. Half of the face was treated with the MFRS; the other half was untreated (control). Facial volume changes and wrinkles were objectively measured using a three-dimensional imaging system and VISIA-CR. Volume changes of the treated midface were -0.24 ± 0.75, -0.59 ± 0.92, and -0.55 ± 0.65 mL at 1, 3, 6 months follow-up; however, measurements of the control side were 0.08 ± 0.70, -0.08 ± 0.53, and - 0.10 ± 0.86 mL, indicating significant reductions (p < 0.05). The number of facial wrinkles on the treated side was significantly reduced to 12.44 ± 4.85 at 3 months and sustained at 6 months (11.11 ± 4.100) compared to the control side (14.89 ± 5.26 and 13.22 ± 4.44, respectively; p < 0.05). No long-term side effects occurred. The vacuum-assisted MFRS is safe and effective and is recommended for improving facial tightening and reducing wrinkles. This technology is sufficient to ensure the insertion depth, thus helping to improve the treatment accuracy and safety. The MFRS provides sustained effects for at least 6 months.

Evaluation of a Novel Microfocused Ultrasound with Three-Dimensional Digital Imaging for Facial Tightening: A Prospective, Randomized, Controlled Trial.

The excellent efficacy is mitigated by the limited safety profile of microfocused ultrasound procedures. We sought to assess the safety and tightening efficacy of a novel microfocused ultrasound. The randomized middle and lower face and submental region of the participants were treated with the novel device using the following transducers: M4.5, D4.5, M3.0, and D3.0. Improvement in paired comparison of pretreatment and posttreatment photographs, three-dimensional (3D) volumetric assessments, skin thickness measured by B-ultrasonography, and skin photoaging parameters were evaluated. Adverse events and patient satisfaction were also recorded. A total of 20 participants (20 female) were enrolled. Fourteen of 20 participants (70%) were judged to show clinically significant facial tightening during 3-month follow-up (P < 0.05). The mean volumetric change in the lower face, as quantitatively assessed after 3months was -0.29mL compared with +0.42mL on the control side (P < 0.05). The VAS pain score was 3.00 ± 1.19 without any oral or intramuscular anesthesia. A small sample size, lack of clinical scales, and impersonalized treatment parameters. The novel microfocused ultrasound appears to be a safe and effective modality for lower-face tightening. ChiCTR 2200064666.

The Safety and Efficacy of Macrofocused Ultrasound without Visualization on Enlarged Facial Pores among Thai Patients: A Pilot Study

Introduction. Visibly enlarged facial pores are familiar dermatologic concerns. Macrofocused ultrasound energy without visualization (MaFU‐WV) showed efficacy in facial tightening and an improvement in skin textural irregularities which opened the potential of the positive effects in reducing the appearance of facial pores. This study aims to assess the safety and efficacy of MaFU‐WV in tightening facial pores. Methods. This was a prospective, single‐blinded pilot study. Thirty‐four Thai subjects with enlarged pores received a single treatment of MaFU‐WV using a 2.0 mm transducer on bilateral malar areas of the face. Primary outcome measures included the pore count, pore volume, and pore index measurements using an instrument with a camera for image acquisition and software for analysis of skin. Secondary outcome measures incorporated two blinded dermatologists’ evaluation of clinical photographs and the subjects’ perception of improvement in their facial pores using a 6‐point scale. Measurements were taken at baseline, 1 week, 1 month, 3 month, and 6 month after treatment. Results. The pore count significantly decreased from baseline to 6 month after treatment (p &lt; 0.001). Pore volume was significantly lowered from baseline to 1 week and 1, 3, and 6 months after treatment (p &lt; 0.05). The pore index was likewise significantly reduced from baseline in every visit (p &lt; 0.05). The majority of photographic evaluations by blinded dermatologists were scored as a 1–25% pore minimizing effect across nearly all follow‐up visits. On the other hand, patient satisfaction kept improving until the end of the study at 6 months. No adverse events occurred throughout the conduct of the study. Conclusion. Macrofocused ultrasound energy using a 2 mm transducer is a safe and effective treatment for facial pore tightening. The trial is registered with registration number: TCTR20220719001.

15401 Histometric evaluation of a monopolar radiofrequency for the treatment of facial laxity

Background: A monopolar radiofrequency (RF) device can be applied for use on facial tightening. The device targets the dermis and fibrous septae, the treatment results in immediate collagen contraction as well as the induction of collagen remodeling. We aimed to evaluate histometric change of subjects treated by a monopolar RF device using novel tip.

Facial Tightening Effects, Following Focused and Radial Acoustic Wave Therapy Assessment, Using a Three‐Dimensional Digital Imaging

Background and ObjectivesAcoustic wave therapy is a novel facial tightening technique that involves nonthermal penetration of the skin and subcutaneous tissue, affecting cells and their metabolism, and resulting in an increased release of unwanted fat and activation of blood and lymphatic flow in tissues. The objective of this study was to investigate the effectiveness of acoustic wave therapy.Study Design/Materials and MethodsA total of 333 patients underwent multiple facial tightening treatment sessions using focused and radial acoustic waves. Each patient received 2,000–3,000 pulses of focused acoustic waves at a power of 0.45–0.88 mJ/mm2 with a pulse frequency of 3–5 Hz and 4,000 pulses of radial acoustic waves at 4‐bar power at a frequency of 21 Hz. These sessions were performed more than three times, and treatments were repeated at 1‐month intervals. Digital photographs superimposed three‐dimensional volumetric assessments, and three‐dimensional skin surface displacement calculations using vectors were used to evaluate the results 12 months after the last treatment. Patients also evaluated the results using a 5‐point Likert scale.ResultsImprovements in skin texture, clarity, and laxity were observed in digital photographs. Superimposed three‐dimensional color images showed marked volumetric reduction and/or formative modification for even contour toward the lower mid‐face. Most vectors showed three‐dimensional skin surface displacement at the lateral sides of the temples, cheeks, and chin, in an upward direction. These results were obtained and sustained for up to 12 months without edematous reactions. Almost all patients reported improvement, with 79% reporting “good” or “excellent” improvement. Complications were minor and transitory. Persistent side effects were not observed.ConclusionAcoustic wave therapy could be used as a standard facial tightening treatment, with skin rejuvenation effects shown on digital photographs and three‐dimensional quantification assessments. This noninvasive acoustic wave approach was found to be a safe, long‐lasting, and effective method for facial tightening. Lasers Surg. Med. 00:00–00, 2020. © 2020 Wiley Periodicals LLC

Monopolar radiofrequency treatment for facial laxity: Histometric analysis.

A monopolar radiofrequency device can be used in facial tightening. The device targets the dermis and fibrous septae, and the treatment results in immediate collagen contraction and the induction of subsequent collagen remodeling. We aimed to evaluate the histometric change of the subjects treated with a monopolar radiofrequency device using a novel tip. Eleven subjects with skin types III and IV participated in the study. They received a single session of a monopolar radiofrequency on the face, and biopsies were performed before treatment, and 2 and 6months after the treatment. Hematoxylin and eosin, Masson trichome, and Victoria blue stains were used. An image analysis was performed using the Image J software. The dermal density of collagen and elastic fiber, and the coherency of collagen fibers were assessed in the papillary, upper reticular, and lower reticular dermises, respectively. The monopolar radiofrequency treatments led to improvements in collagen fiber density and coherency. In the Masson trichome staining, the collagen fiber densities were 0.736±0.06 and 0.652±0.063 before treatment and increased to 0.773±0.044 (P=.018) and 0.686±0.05 (P=.045) in the papillary and lower reticular dermises, respectively. The density of the elastic fibers in all parts of the dermis showed a tendency to increase after treatment, though not statistically significantly. The mean coherency was higher after than before treatment. In this in vivo study, we found that the collagen and elastic fiber densities and architectural structures were improved after treatment.

Nonsurgical facial tightening after a fractional noninsulated microneedling radiofrequency treatment in Asians

AbstractBackgroundAs our previous three‐dimensional (3D) volumetric investigations have shown, noninsulated microneedle radiofrequency (NIMNRF) with 2.5‐mm penetration depth needles can induce long‐lasting tightening effects. However, further tightening effects for deeper tissues were sometimes required. The objective of this study was to investigate the efficacy of a novel fractional NIMNRF treatment strategy with 5.0‐mm penetration depth needles.Materials and MethodsTwenty Asian patients underwent full facial skin tightening using a sharply tapered NIMNRF applicator with a novel fractionated pulse mode. Patients received from 500 to 1000 pulses of 80 to 110 ms duration at a power of 10 to 14 W and a 1.5‐ to 5.0‐mm penetration depth. A topical anesthetic cream was applied before treatment. 3D volumetric assessments were performed at 6 months after the treatment. Patients rated their satisfaction using a 5‐point scale at each follow‐up.ResultsObjective assessments with superimposed 3D color images showed a significant volumetric reduction in lower two‐thirds of the face for all patients. About 85% of the patients were either “satisfied” or “very satisfied” with the treatment results. Side effects were mild and included a slight burning sensation and mild erythema that were minor and transitory. Posttreatment hyperpigmentation was not present, neither were other complications.ConclusionsThe advantages of the novel fractional NIMNRF treatment are the high potency of facial tightening effects, and reduction of discomfort and side effects. Taken together, these characteristics facilitate the ability to give repeated treatments and provide an alternative or adjunct treatment for patients with improved results.

微聚焦超声用于面部紧致治疗的罕见不良反应

Microfocused ultrasound (MFU) , as a new approach for facial skin tightening and lifting, has been widely applied in recent years. Its action mechanism is that heat can be transmitted to the deep dermis and superficial musculoaponeurotic system through precise and depth-consistent microcoagulation zones, leading to the contraction and remodeling of skin collagen without damage to the epidermis. MFU has high safety with few serious adverse reactions. However, there are still doubts whether it can lead to subcutaneous scar formation, the risk of lipolysis, or nerve, vessel and eye injuries, etc. Appropriate use and selection of patients can minimize the occurrence of these rare adverse reactions as much as possible. Key words: Ultrasonic therapy; Subcutaneous tissue; Facial tightening; Adverse reaction

Uso inmediato del plasma rico en plaquetas post laser CO2 fraccionado en fototipo de piel alto

Introduction: The treatment with carbon dioxide (CO2) laser fractionated in high skin phototypes, can result in pigmentation disorders, persistent erythema, edema, appearance of acne outbreak, among others. Due to this, it is necessary to apply complementary techniques that minimize these adverse effects. Objective: To identify the safety, efficacy and satisfactory synergistic effects after the application of platelet-rich plasma (PRP) after application of fractionated CO2 laser in the face with high phototypes, in order to diminish the adverse effects. Method: Clinical experimental study - open clinical trial - randomized with a universe of 32 hemies with phototypes IV and V of Fitzpatrick. A fractionated CO2 (CO2RE-Syneron Candela) laser was used and immediately autologous PRP was applied in the case hemifields. In controls, betamethasone and petrolatum. The photographic results were compared by showing them to 3 expert doctors without previous information so that they could determine the short, medium and long term findings in a simple scale. This was done at the skin clinic between July 2017 and September 2018 in Lima - Peru. Result: In the short term, satisfactory results were observed in the hemies treated with PRP. There was a decrease in the presence of post-inflammatory hyperpigmentation, erythema, edema and the appearance of acne, as well as an increase in the effect of facial tightening, attenuation of naso-genital grooves and expression lines in the hemias treated with PRP. However, in the long term, these last improvements are not significant in relation to the other control midfaces. Discussion: The fractionated CO2 laser generates histopathological changes similar to the wounds, so that the PRP absorbed at transepidermic level accelerates healing and reduces the possibility of side effects. Important results are seen in the prevention of dyschromias in these phototypes. Laser therapy combined with PRP is associated with greater satisfaction with laser monotherapy. The expected results are in early stages of recovery, while in the long term, there are no significant differences between the two midfaces. Conclusion: These results, in our population of high phototype, suggest that the immediate use of PRP post laser fractionated Co2, is an effective method to improve rehabilitation and healing, reducing the patient's downtime and decreasing the risks of adverse effects - secondary, It should be considered as an effective therapeutic alternative as post laser treatment. The small series of cases presented, leaves open the door to work with greater population and it would be very useful to be able to contrast the results obtained with those of future authors.

Facial Tightening Following a Single Acoustic Wave Treatment Using Focused and Radial Acoustic Waves

Background: Acoustic wave has been used for many medical purposes, and although it is widely applied in cosmetic procedures, it has not been conducted for facial rejuvenation and tightening. Acoustic wave has been proven to penetrate deeper than subcutaneous tissue, independent of skin color, and to be beneficial for skin tightening and body contouring. Objective: To evaluate the effectiveness of a single acoustic wave treatment session using unique focused and radial acoustic waves for facial tightening. Participants: Sixty Asian patients were treated between the years 2016 and 2018. The single acoustic wave treatment session consists of focused long planar acoustic pulses thought to have an effect on cells and their metabolism resulting in an increased release of fat, and radial short acoustic pulses thought to have an effect on tissues activating blood and lymphatic flow. Patients did not undergo any form of medical aesthetic treatment during the study. Measurements: Digital photographs and three-dimensional imaging were used to evaluate the results. Results: Objective assessments with digital photographs and superimposed three-dimensional color images showed preferable facial tightening effects and marked volumetric reduction on the lower one-third of the face. These results were obtained without the edematous reactions observed in laser and radiofrequency therapies, and were sustained up to 12 months. All of the patients reported satisfaction with the results and convenience of the procedure. Complications were minor and transitory, consisting of a slight tingly sensation to the teeth during the treatment, and mild erythema resolving within 5 hours. Side effects were not observed. Conclusions: The advantages of the single acoustic wave treatment are the high potency of facial tightening effects, reduction of discomfort and side effects. Taken together, these characteristics facilitate the ability to give repeated treatments and provide an alternative or adjunct treatment for patients with improved results.

A survey on monopolar radiofrequency treatment.

This questionnaire-based study was aimed to measure the level of appreciation, awareness of the special tips, and practice patterns of monopolar radiofrequency among Korean dermatologists practicing a specific monopolar radiofrequency device (Thermage® Inc., Hayward, CA). A total of 82 surveys were analyzed to show that the majority of participants (78.8%) were highly satisfied with the outcomes of monopolar radiofrequency treatment. All respondents were aware of the Eye Tip 0.25 cm2 , and the majority knew the difference between the Face tip (blue) and the Total tip (orange). Most (86.3%) agreed to the statement that 900 shots were appropriate for facial tightening in those between the ages of 35 and 65 years. 66.2% of participants reported to have perform monopolar radiofrequency to extra-facial sites within the past year. As for the tips, the Total tip was most popular for all body sties and the Big tip was favored for the abdomen, thighs and buttock. We hope our data allow dermatologists to better utilize monopolar radiofrequency.

The efficacy and safety of fractional unipolar radiofrequency on facial tightening

The efficacy and safety of fractional unipolar radiofrequency on facial tightening

Clinical efficacy and safety evaluation of a novel fractional unipolar radiofrequency device on facial tightening: A preliminary report.

Previous studies have shown that radiofrequency (RF) energy is safe and effective for improving skin laxity. Unlike monopolar and bipolar devices, little has been studied with the unipolar hand piece. We sought to evaluate the safety and efficacy of a novel fractional unipolar RF device on facial tightening. This was a retrospective, single-center study of 14 subjects with age-related facial laxity who underwent five sessions of fractional unipolar RF at an interval of 2 weeks, and then followed-up for 3 months. Standardized photos were taken at baseline and at 3-months follow-up, and were assessed by two independent dermatologists using a 4-point scale (0=no improvement, 1=mild improvement, 2=moderate improvement, 3=significant improvement). Punch biopsies (2 mm) were performed and a questionnaire was used to evaluate the patient's satisfaction and the incidence of adverse reactions. Fourteen subjects with mild to moderate age-related facial laxity were included in the study. The mean age of the subjects was 49.7 years (range 32-80). 35.7% of the subjects showed significant improvement, 50% moderate improvement, and 14.3% slight improvement of facial laxity in their follow-up photos. About 85.7% of the patients replied that they were either greatly satisfied or satisfied with the results at 3-months follow-up. Skin biopsies revealed an increase in collagen in the dermis. None of the subjects experienced any serious adverse events during or after the procedure. Our findings suggest that fractional Unipolar RF can be safely performed on the face and is effective in skin tightening. It has a great advantage over other forms of RF by being entirely painless.

Nonsurgical Facial Rejuvenation Procedures in Patients Under 50 Prior to Undergoing Facelift: Habits, Costs, and Results.

Facial rejuvenation in patients younger than 50 years of age has experienced an unprecedented growth with multimodality nonsurgical and less invasive rhytidectomy techniques. To analyze the nonsurgical treatment habits of patients prior to undergoing rhytidectomy at <50 years of age. Retrospective study to enlist patients who underwent primary rhytidectomy at age <50 years between January 1, 2003 and December 31, 2013 by the senior author (AAJ) to complete a survey. One hundred and fifty-seven patients were surveyed. Patients had nonsurgical rejuvenation starting at an average age of 37 years and rhytidectomy at an average age of 44 years. Thirty-two percent of responders had injectable treatments prior to their facelift, reporting a mean of 7 rounds of injectable treatments prior to pursuing rhytidectomy. Sixteen percent of responders had laser skin resurfacing undergoing 4 separate treatments prior to rhytidectomy, and 10% had energy-based facial tightening treatments one time prior to their rhytidectomy. Average expenditure on nonsurgical treatments prior to rhytidectomy was $7000 cumulatively. Fifty-nine percent of patients who went on to rhytidectomy did not report regret over this cost expenditure. Patients reported that they appeared 4 years younger after nonsurgical intervention, and 8 years younger after their facelift, a statistically significant difference (P = .048). Patients undergoing rhytidectomy <50 years old begin less invasive facial rejuvenation treatments at an even earlier age. The majority of these patients did not regret the costs associated with noninvasive treatments, even though they saw that rhytidectomy provided a greater rejuvenation effect. Rhytidectomy surgeons should incorporate nonsurgical techniques into their practice to best serve the needs of the modern aging face patient.

The efficacy and safety of multisession high intensity focused ultrasound (HIFU) with short treatment intervals on facial tightening: A preliminary report

The efficacy and safety of multisession high intensity focused ultrasound (HIFU) with short treatment intervals on facial tightening: A preliminary report

A intense-focused ultrasound tightening for the treatment of infraorbital laxity

Background: Infraorbital laxity is a common problem that increases with age. Blepharoplasty with lipectomy is a very commonly performed surgical procedure to treat this problem; however, it is invasive and is associated with the potential for re-emergence. Therefore, young patients may prefer a non-surgical procedure rather than to a surgical procedure. Intense-focused ultrasound (IFUS) has emerged as an effective, non-surgical, tissue-tightening procedure. Objective: This study assessed the safety and efficacy of IFUS (UltheraTM system, Ulthera Inc, Mesa, AZ, USA) for facial tightening in Asian patients with infraorbital laxity. Methods: We studied 15 patients who were treated with an IFUS device applied to both lower eyelids. The primary outcome measure was an objective improvement in a paired comparison of pre-treatment and post treatment (6 months) photographs. A secondary outcome measure was patient satisfaction as measured by a questionnaire. Results: The mean patient age was 50 years (range, 27–69). All patients received one to two treatments with intense-focused ultrasound. All patients in the study experienced both subjective and objective improvement. Conclusion: IFUS can be used as a non-invasive, skin-tightening procedure for infraorbital laxity. No serious, permanent, or delayed side effects were noted up to 6 months post treatment. Thus, this procedure can be effective and safe in the treatment of decreased laxity of the lower eyelids.

Barbed sutures in facial rejuvenation

Self-retaining barbed sutures, innovations for nonsurgical facial and neck rejuvenation, are currently available as short APTOS threads or long WOFFLES threads. The author uses APTOS threads for malar rounding, facial tightening and firming, and uses WOFFLES threads as a sling, suspending ptotic facial tissues to the firm, dense tissues of the temporal scalp.

Therma-lifting of the face, neck and brows

Our patients are increasingly focused on improving their appearance without any time necessary for healing. They are often even willing to achieve a less dramatic result and to return for multiple treatment sessions in exchange for a no downtime procedure. Thus, new and effective non-invasive techniques have become eminently important. The course of twenty consecutive patients were reviewed retrospectively. Prelimary results following radiofrequency enhanced Therma-lifting (Thermage, Hayward, Ca) indicate that facial tightening, eyebrow lifting and neck lifting can be achieved without visible skin inflammation or bruising.