Midface treatment is a vastly under-appreciated component of facial rejuvenation. The midfacial region encompasses the cheeks, nasolabial folds, and tear troughs. Traditional surgical lower face-lifts do not effectively target midfacial structures; therefore, midface rejuvenation is often addressed with fat grafting or other injectable fillers alone or in combination with a surgical midface lift. Long pulse (pulse greater than one second) fractionated radiofrequency (FRF) has shown impressive results for treatment of lower face laxity with a single treatment. 1 However, FRF has not been previously reported for midface improvement. Thus, we present a novel modified treatment protocol for FRF, and the first reported retrospective review demonstrating FRF technology for improvement of midfacial aging.
| ME THODSAn institutional review board-approved retrospective review was performed and included patients who received midfacial treatment with a bipolar FRF device (Profound, Candela Corp) with at least 3-month follow-up pictures. Prior to the procedure, 5% topical lidocaine was applied to the treatment area. Facial nerve blocks were performed in combination with dermal infiltration of 0.25% lidocaine with epinephrine. The treatment was performed with 3-4 mm spacing using the dermal handpiece. The treatment area extended from just inferior to the infraorbital rim, laterally along the zygomatic arch to the tragus, and the minimum inferior limit of the treatment included the upper neck and submentum. 2 Photographs were taken at baseline and at least 3 months