title: Near [corrected] painless, nonablative, immediate skin contraction induced by low-fluence irradiation with new infrared device: a report of 25 patients.
abstract: BACKGROUND
  Nonablative radiofrequency (NARF) has been the only method for producing noninvasive skin tightening. Nevertheless, significant pain during the procedure is an important downside of this technology. A new nonablative medical device, Titan (Cutera, Inc., Brisbane, CA, USA), capable of fluences much lower than those possible with NARF, was tested as a less painful alternative.
  
  
  OBJECTIVE
  To produce skin contraction leading to lifting of eyebrows and/or improvement of lower face and neck skin laxity using fluences below pain levels.
  
  
  METHODS
  Twenty-five patients were treated. Standardized photographs were obtained preoperatively, after a few days, a few weeks, and up to 12 months after the procedure.
  
  
  RESULTS
  Immediate changes were obtained in 22 of 25 patients. Examination of photographs revealed that the initial improvement was maintained throughout the follow-up period.
  
  
  CONCLUSIONS
  Immediate true skin contraction persisting through the immediate, intermediate, and long-term follow-up was found in the vast majority of patients in this group. Edema as an artifact simulating immediate improvement was excluded by serial photographs taken during the follow-up period. Skin contraction occurred at low fluences, below the threshold of pain. This, to the best of our knowledge, has not been previously described in the medical literature.
authors.affiliation: University of California, San Diego, California, USA. jarues@earthlink.net
authors.forename: Javier
authors.initials: J
authors.lastname: Ruiz-Esparza
mesh_terms: D000328:Adult; D000368:Aged; D004548:Elasticity; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007259:Infrared Rays / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012060:Rejuvenation; D019233:Retreatment; D012867:Skin / Q000528:radiation effects*