Results
All patients completed a series of six treatments according to the manufacturer’s protocol. Six 30-second passes were performed in each area after reaching a temperature of 40–42°C. Two patients had eight passes in each area because the appearance of their wrinkles was of greater significance. All treatments were carried out using a power of 5 Watts. Patients’ baseline degree of elastosis varied from 1–9 (average 5.1±2.4) on the Fitzpatrick Elastosis and Wrinkle Scale. All patients, except for one, had a decrease in Fitzpatrick wrinkle score. These results show a very low rate of non-responding patients; approximately 5% compared to the 15–20% non-responding rate usually seen in these types of procedures. Before and after pictures can be seen in Figures 5–7.
Figure 6 Periorbital iFine treatment in a 60-year-old male patient. (A) Baseline and (B) after six treatment sessions. There is a significant reduction of the tear trough
Patients’ feedback was carried out using questionnaires. Following treatment, a mild erythema appeared on the treatment area, which dissipated after 20–90 minutes. Seventy-nine percent of patients reported that the treatment was very comfortable, and 21% reported minimal discomfort. No patient had experienced moderate or higher discomfort during treatment. No adverse events occurred during the treatments (Figure 8). In addition, patient satisfactionwith the treatment results was evaluated. A moderate improvement (51–75%) was achieved for 12 patients, and a significant improvement (>76%) was achieved in three patients (Figure 9).
Meeting expectations
All patients reported the same or better treatment results with the EndyMed Pro system, compared with other skin tightening devices. When asked whether the treatment met expectations, 68% reported ‘yes’ and 32% reported ‘yes to some extent’ (Figure 10). When asked at the end of the last session whether the treatments had met their expectations, all patients answered ‘yes’. All patients also reported that they would recommend the treatment to their friends.
The use of the EndyMed Pro system was pleasing, both for the physician and her patients. The author found the ease of use and the short treatment time needed to complete a full treatment around the eyes to be convenient and cost-effective for the clinic. The overall impression of the author is shown in Figure 11.
The effect of Filipino culture on aesthetic treatments
Figure 7 Periorbital iFine treatment in a 60-year-old female patient. (A) Baseline and (B) after six treatment sessions. There is a significant reduction of wrinkles and lifting of upper eyelid
Cultural bias for youthful looks permeates Filipino society. Mass media plays an important role in perpetuating the pristine, taut and sprightly female in all forms, whether it is the mother cradling her child, the executive closing a business deal, or the teacher giving instructions to her wards in the classroom. In cinema and television, it is not uncommon for the general audience to notice lines around the eyes, on the forehead and around the mouth, and make derogatory remarks. They want their idols — despite their advanced age— to continue to look and act young.
The introduction of iFine in the Philippine market offers an option to the different demographics. The interest was palpable not only among female groups, but also from the male sector, largely owing to aversion to derogatory remarks. Nobody wants to hear that he or she looks 10 or 15 years older than their actual age.
As iFine presents a non-invasive procedure, this further galvanised the initial interest. Many felt comfortable that no needles or other invasive procedures would be used. Skeptics, however, remained, but they were manageable in number. From the initial batch of patients who received iFine treatments, almost all have expressed their pleasure at the ease of application and at the immediacy of results.
Discussion and conclusions
Multi-source RF has been shown as an effective, non-invasive treatment for face and body skin tightening and fractional RF skin resurfacing12. One of the main challenges is to have an effective treatment while remaining completely safe for the patients. Mayoral et al4 reported that some of the risks of treatment may be caused when being too aggressive with other technologies. The 3DEEP technology was reported to maintain a high level of safety combined with an excellent level of efficacy for wrinkles and lax skin9, and also when using the iFine Handpiece12.
Figure 8 Distribution of patients’ discomfort during treatment. Most of the patients found the treatment to be comfortable
Figure 9 Distribution of patients’ opinions on the level of cosmetic change following six treatment sessions
The results obtained in this study demonstrate significant reduction of periorbital wrinkles and skin laxity using a painless, non-invasive treatment technology. The multi-source RF technology (EndyMed Pro) was found to be safe, effective and comfortable both for the therapist and patient.
Some patients who took part in the study were younger than 30 years of age, and therefore their FWS was low. In these cases, physical appearance may be part of their occupation; therefore, their appearance is very important, particularly with regard to improvement in wrinkles around the eyes.
Figure 10 Distribution of patients’ satisfaction with the treatment
Figure 11 Physician evaluation of overall improvement
Eye rejuvenation can also be considered as an anti-ageing process, as the use of RF encourages an increase in the quantity and quality of the collagen component of the skin.
All patients but one who participated in this study had a decrease in their FWS, which proves the effectiveness of the 3DEEP technology. The patients seemed to maintain the same results, or even to have an improvement in their wrinkle appearance, at 3-month follow-up.
EndyMed 3DEEP is a safe and effective non-invasive technology leading to skin tightening, and the iFine handpiece is a remarkable breakthrough for periorbital skin rejuvenation. The author believes that the non-invasive facial treatments are gaining popularity and their demand will increase in the future owing to the growing requirement for rapid treatments with no downtime.
