title: Nonablative 4-MHz dual radiofrequency wand rejuvenation treatment for periorbital rhytides and midface laxity.
abstract: OBJECTIVE
  To evaluate the wrinkle-reducing effects of 4-MHz radiofrequency (RF) energy applied to human periorbital, frontal, and midface facial skin using clinical wrinkle grading, patient self-satisfaction survey, and limited histologic studies.
  
  
  METHODS
  Thirty-two patients, ranging from 29 to 71 years of age with skin types varying from class I to class III using the Fitzpatrick Wrinkle Classification system, underwent 8 weekly treatment sessions of nonablative RF therapy on the periorbital, frontal, and midface regions and were subjected to follow up for 6 months after treatment. Pretreatment and post-treatment evaluations were compared. Two female subjects gave informed consent for RF treatment for the right upper eyelid and no treatment for left upper eyelid. Specimens from both upper eyelids then underwent histologic examination using light and transmission electron microscopy.
  
  
  RESULTS
  Pre- and post-RF treatment evaluation by 3 independent observers using the Fitzpatrick wrinkle classification system showed progressive improvements in wrinkle score at 1-, 3-, and 6-month intervals (p < 0.01). Self-evaluation of 32 patients using a 9-point rating scale after application of RF treatment also showed improving satisfaction (p < 0.01). The most commonly noted adverse reaction was transient erythema (62.5%) lasting from a few hours to a day. Transmission electron microscopy (25,000×) showed scattered diffuse changes in collagen fibril architecture with a shift from smaller-diameter collagen fibers in the untreated samples to larger-diameter fibers in the treated samples and a loss of distinct fibril borders.
  
  
  CONCLUSIONS
  Four-megahertz dual RF wand delivery rejuvenation treatment produces a reduction in periorbital and midface rhytides.
authors.affiliation: Department of Ophthalmology, University of Santo Tomas Hospital, University of Santo Tomas, España, Manila, Philippines. rmjavate_md@yahoo.com
authors.forename: Reynaldo M
authors.initials: RM
authors.lastname: Javate
authors.forename: Raul T
authors.initials: RT
authors.lastname: Cruz
authors.forename: Jemshed
authors.initials: J
authors.lastname: Khan
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Trakos
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003094:Collagen / Q000528:radiation effects / Q000648:ultrastructure; D005145:Face / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000473:pathology / Q000528:radiation effects; D017060:Patient Satisfaction; D011846:Radio Waves / Q000009:adverse effects; D000078702:Radiofrequency Therapy; D011859:Radiography; D015361:Rhytidoplasty; D015595:Skin Aging / Q000473:pathology / Q000528:radiation effects*; D016896:Treatment Outcome
chemical_list: D003094:Collagen