Predetermined Energy Delivery as an Endpoint for Radiofrequency Skin Tightening

Abstract

Introduction:

Clinicians have been advised to perform radiofrequency (RF) skin tightening by observing subjective parameters such as the number of passes or superficial edema or tissue elevation to determine endpoints in treatment. Common to these techniques is the difficulty in reproducing the endpoint and the lack of consistency both during treatment and with subsequent treatments. This study was initiated to investigate whether total delivered energy to a given cosmetic unit is a reliable parameter for reproducing treatments in the same individual and whether it could be used as a parameter to predict results.

Materials and Methods:

Five patients who desired skin tightening of cosmetic units involving the face and body were treated with a novel RF delivery device in which the endpoint of treatment was predetermined at a given energy level measured in kilojoules. At the end of 5 treatments, a comparison of treatment endpoints and patient self-evaluation, as well as evaluation of photographic results by a nontreating physician were correlated.

Results:

Using a preselected delivery of total energy per cosmetic unit, 5 patients received a total of 5 treatment sessions each. When clinical results did not meet expectations, the total energy levels were increased at the next treatment session. All patients reported relative comfort during the treatments. No topical or regional anesthesia was used. Patient satisfaction was reported at 80%. Patients evaluated their own outcomes at slightly less than 50% improvement, and a nontreating physician evaluated outcome based on clinical photography at 50%.

Conclusions:

A system of quantitation for the delivery of RF to promote skin tightening is presented. Predetermined energy delivery is a reproducible variable with which to compare subsequent treatments as well as a method for adjusting RF delivery in subsequent treatment sessions in an attempt to produce optimal results. Patient impressions as well as evaluation by a nontreating physician were recorded and found to be in agreement concerning the efficacy of treatment.