Prospective Multicenter Clinical Trial of a Minimally Invasive Temperature-Controlled Bipolar Fractional Radiofrequency System for Rhytid and Laxity Treatment

Alexiades-Armenakas, Macrene; Newman, James; Willey, Andrea; Kilmer, Suzanne L.; Goldberg, David J.; Garden, Jerome M.; Berman, David M.; Stridde, Braden C.; Renton, Bradley; Berubé, Dany; Hantash, Basil M.

doi:10.1111/dsu.12065

Cited by 55 publications

(39 citation statements)

References 19 publications

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“…Six months after a single microneedle fractionated bipolar RF treatment, patients were noted to have a 25.6% mean improvement in facial rhytides and a 24.1% improvement in facial and neck laxity. 109 Other studies have substantiated significant improvements in skin laxity and rhytides at 6 months following a single treatment with such a device. 99,110 The noninsulated microneedle devices have advantages over the earlier, fully insulated microneedles.…”

Section: Fractional Radiofrequencymentioning

confidence: 97%

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

2017

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I n recent decades, there has been a revolution in energy-based treatment options for skin scarring, rejuvenation, and tightening. One of the most promising developments has been the introduction of fractional photothermolysis, developed by Anderson and Manstein in 2004. Fractionated systems deliver laser energy in a grid-like pattern, creating microscopic columns of ablative and/or coagulative damage termed microthermal zones (MTZs), which stimulate collagen remodeling.1 The incorporation of fractional photothermolysis into energy-based devices has allowed less destruction to surrounding tissue, leading to desired results with the minimization of unwanted side effects, leading to both ablative and nonablative laser devices becoming desirable treatment options for cutaneous scarring and rejuvenation. Given their impressive results, newer fractional laser treatment options, including picosecond lasers, quality-switched (QS) lasers, and combined ablative and nonablative lasers, are being investigated for the treatment of these common skin conditions.The following review addresses the current and emerging topics on fractional laser treatment of skin scarring and rejuvenation based on the device type, including ablative, nonablative, QS, picosecond, and hybrid fractional lasers (HFLs). Additionally, newer energy-based fractional devices, such as radiofrequency (RF) with and without microneedling and the use of fractionated technology for drug delivery, are discussed in the context of these common skin conditions. Fractionated lasersTreatment options for cutaneous scars and skin rejuvenation have evolved significantly since the rise in popularity of ablative lasers in the 1990s. Newer treatment options, including ablative fractional lasers (AFL) and nonablative fractional lasers (NAFL), have garnered favor, given the milder side effect profile in comparison with traditional fully ablative lasers. Ablative fractional lasersAcne scarring AFLs were developed in an attempt to achieve the efficacy of traditional ablative lasers with the milder side effect profile of fractional technology. Although a single treatment produces less dramatic, albeit noticeable, results than traditional fully ablative lasers can, multiple treatments result in greater clinical improvement.2 Currently, there are 3 types of AFLs available for scar treatment: the 10600-nm carbon dioxide (CO2), the 2940-nm erbium:yttrium aluminum garnet (Er:YAG), and the 2740-nm yttrium scandium gallium garnet (YSGG) lasers. AFL is associated with the increased risk of both protracted erythema and postinflammatory hyperpigmentation (PIH) in darker skin types, which has led many clinicians to prefer a longer series of NAFL treatments over AFL treatments to achieve similar results with a lower risk of side effects.Multiple studies support the efficacy of the fractional CO2 laser in acne scars. The overwhelming majority of these studies investigate the utility of these lasers in atrophic facial scars. While NAFLs typically require multiple sessions to achieve modest ...

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Section: Fractional Radiofrequencymentioning

confidence: 97%

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

2017

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“…The treatment area extended from the nasolabial and melolabial folds medially, preauricular region laterally, and inferior margins of the submental and submandibular regions inferiorly, as previously described. 1 All subjects received a single pass treatment. After each pulse, the FRF applicator was withdrawn, repositioned, and activated on the next treatment area until the target zone was fully treated.…”

Section: Fractional Radiofrequency Treatmentmentioning

confidence: 99%

“…1 Before and after photographs of subjects treated with 1 FRF session were sent to blinded board-certified physicians for grading using the Fitzpatrick scale for rhytides 2 and Alexiades scale for laxity. 3 The study showed that the subcohort with >20% improvement from baseline scores were treated using temperature and pulse duration settings that were lower than the subcohort with <20% improvement (66.7°C, 4.2 seconds vs 69.5°C, 4.9 seconds, respectively).…”

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confidence: 99%

“…3 The study showed that the subcohort with >20% improvement from baseline scores were treated using temperature and pulse duration settings that were lower than the subcohort with <20% improvement (66.7°C, 4.2 seconds vs 69.5°C, 4.9 seconds, respectively). 1 The author (M.A.) hypothesized that (1) smaller thermal injury volumes were more effective at inducing wound healing because of better oxygenation throughout the thermal injuries and (2) the percentage of partially denatured collagen, shown to be more effective at triggering neocollagenesis, was greater at lower settings.…”

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confidence: 99%

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Randomized, Blinded, 3-Arm Clinical Trial Assessing Optimal Temperature and Duration for Treatment With Minimally Invasive Fractional Radiofrequency

Alexiades

Berubé²

2015

Dermatologic Surgery

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“…Recently, it has been shown with real-time temperature feedback experiments that denaturation temperature of collagen ranges between 65 and 70 °C but is also dependent on the time of laser light exposure; in general, for every 5 °C decrease in temperature, a tenfold increase in time is needed to achieve the same degree of denaturation (Alexiades-Armenakas et al 2013 ). However, once collagen fi bers have been denatured by laser-generated heat, collagen rapidly contracts as fi bers shrink to one-third of their length resulting in immediate skin tightening.…”

Section: Mechanism Of Light: Tissue Effectmentioning

confidence: 99%

Skin Resurfacing with Carbon Dioxide Laser

Luebberding

Alexiades-Armenakas

2015

European Handbook of Dermatological Treatments

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A beautiful face is considered to possess smooth and fl awless skin, an even complexion, and fi rm facial features. Beauty is strongly associated with healthy and youthful skin. Nevertheless, over the course of a lifetime, the body's outer shell changes signifi cantly; genetics, aging, sun exposure, and lifestyle factors including nutrition, alcohol consumption, and smoking habits, as well as skin diseases and lesions, may contribute to visible skin changes. Consequently, wrinkles, brown spots, blotchy skin coloring, skin laxity, and scars become visible. However, since the desire for eternal youth and beauty is high and still increasing worldwide, the market for cosmetic and aesthetic treatment modalities is booming also.In the past three decades, numerous techniques have been developed including chemodenervation with botulinum toxins or skin augmentation using injectable soft tissue fi llers. Whereas these methods treat certain areas of the skin specifi cally, including wrinkles or volume • Skin aging manifested by rhytides, laxity, and photoaging has been treated by laser skin resurfacing using a large variety of modalities, with carbon dioxide (CO 2 ) laser proving to be the gold standard for the past few decades.• Standard ablative CO 2 laser resurfacing, while still the most highly effective, is associated with a greater side effect profi le and risk of complications. For these reasons, fractional ablative CO 2 laser resurfacing has emerged as a highly effective, yet far safer, top tier treatment for rhytides and photoaging of the aging skin.• In this chapter, we will address background information on standard and fractional CO 2 laser resurfacing; proper patient selection; pre-, peri-, and postoperative instructions; treatment, prevention, and management of complications; and clinical effi cacy.

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Prospective Multicenter Clinical Trial of a Minimally Invasive Temperature-Controlled Bipolar Fractional Radiofrequency System for Rhytid and Laxity Treatment

Abstract: Real-time temperature-controlled FRF is a highly reproducible, safe, effective nonsurgical treatment of face and neck rhytides and laxity and provides important insights into neocollagenesis, neoelastogenesis, and clinical outcomes.

Cited by 55 publications

References 19 publications

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

Randomized, Blinded, 3-Arm Clinical Trial Assessing Optimal Temperature and Duration for Treatment With Minimally Invasive Fractional Radiofrequency

Skin Resurfacing with Carbon Dioxide Laser

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