Over the past decade, aesthetic professionals have witnessed an increasing demand for non-ablative facial treatments with minimal to no downtime. One of the non-ablative treatments available today uses radiofrequency (RF), which has the advantage of volumetric heating with no epidermal damage. In this study, the author focused on eye rejuvenation treatment using a novel non-invasive multi‑source, phase-controlled RF device. Nineteen patients participated in the study, which encompassed six treatment sessions over 2 months. An average Fitzpatrick wrinkle score of 5.1 decreased to 2.8 after the six sessions. All patients reported a visible improvement after the treatment course, with 79% reporting a cosmetic change greater than 50%, and 16% reporting a cosmetic change of 26–50%. No unexpected adverse effects were detected or reported. All patients reported the treatment to be comfortable.
Facial treatments for skin rejuvenation and wrinkle reduction have been used in the aesthetic industry for a number of years. Over the past decade, there has been a growing demand for non-invasive treatments with minimal to no downtime or discomfort. The need for effective and safe rejuvenation treatments is especially important when considering treatment to the periorbital area.
From the age of 30 years, human body collagen production is reduced by 1–2%. The decrease in quantity and function of collagen in the dermal and sub-dermal layers causes skin laxity and the appearance of wrinkles1, 2. One of the most common and effective methods for collagen remodelling and wrinkle reduction is through the use of radiofrequency (RF). Skin resurfacing and RF energy has been used for medical and aesthetic purposes for more than 100 years. Non-ablative RF devices generate heat as a result of tissue resistance to the movement of electrons within the RF field.
Heat is generated through resistance of the tissue to the RF current, causing a biochemical cascade that influences collagen remodelling and triggers production of new collagen. RF waves penetrate the skin much more efficiently than light energy and are independent of skin colour, offering a clinical benefit in deep dermal heating in darker or Asian skin types.
Heating mechanisms
Current RF devices use two basic mechanisms of heating. The first generation, also called monopolar (or unipolar), uses a single generator, which delivers energy to a single electrode that emits energy onto the skin. RF current is dispersed in the tissue, flowing towards a grounding pad, or grounded through the body. In order to achieve enough heat at the desired targeted depth, high energy and intense cooling are needed, frequently associated with significant patient discomfort3–5.
Figure 2 The iFine handpiece
With the second generation, bipolar, the RF current flows between two electrodes, which are placed on the skin’s surface. Most of the thermal energy is concentrated very superficially along the shortest path between the electrodes, making the treatment less effective for the deep dermis and hypodermis. This technology usually uses an active cooling system for the electrodes in order to prevent adverse events, such as burns6, 7.
Another type of bipolar system is called multipolar RF, which use more than two electrodes (most commonly, between three and eight electrodes). However, since these systems use only one RF generator, only two electrodes can be controlled at one time, making the flow of energy the same as standard bipolar8. A further disadvantage of most existing RF devices is the size of the handpiece. Most handpieces today are relatively bulky and big, and therefore make it difficult to treat hard-to-reach small wrinkles around the eyes.
