Efficacy and Histological Evaluation of Combined Muscle Stimulation Technology, Targeted Ultrasound, and Radiofrequency for Complete Facial Rejuvenation
Main Article Content
Abstract
Background: Aging is a multifactorial biological process that affects various tissues and structures at the cellular level. Advanced medical technologies that simultaneously target different skin layers may provide synergistic outcomes that surpass those of individual treatments.
Aims: To evaluate the safety and efficacy of a single-session multimodal treatment combining HIFES with Radiofrequency (RF), targeted ultrasound (TUS) with RF, and RF microneedling technologies for facial rejuvenation.
Methods: This prospective study enrolled 52 subjects who received the consecutive application of HIFES+RF, TUS+RF, and RF microneedling in one treatment session. Follow-up visits were conducted at 1 and 3 months post-treatment. Outcome measures included histological analysis of collagen, elastin, and hyaluronic acid (HA) density, 2D photographic evaluation using the Global Aesthetic Improvement Scale (GAIS), and 3D skin analysis with QuantifiCare software focusing on evenness, wrinkle depth, and pore size.
Results: At 3 months, collagen and elastin density increased by 39.53% and 130.04%, respectively, while HA density increased by 230.02%. GAIS scores indicated 100% of subjects showed overall facial improvement. Quantitative skin analysis revealed a 31.20% improvement in skin evenness, a 47.31% reduction in pores, and a 43.36% reduction in wrinkles. Additionally, 84.00% of subjects rated the treatment as comfortable, and 76.90% reported satisfaction with the results.
Conclusion: A single-session multimodal treatment combining HIFES+RF, TUS+RF, and RF microneedling is safe, well-tolerated, and effective in improving key markers of facial aging. The synergistic effects of this approach enhance dermal remodeling through multiple cellular pathways, supporting its clinical relevance in comprehensive facial rejuvenation.
Article Details
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References
2. Iqbal SP. The Relationship between Aesthetics and Self-Esteem. J Bahria Univ Med Dent Coll. Published online 2024.
3. Woodward JA, Fabi SG, Alster T, Colón-Acevedo B. Safety and efficacy of combining microfocused ultrasound with fractional CO2 laser resurfacing for lifting and tightening the face and neck. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2014;40 Suppl 12:S190-193. doi:10.1097/ DSS.0000000000000228
4. Beer KR. Combined treatment for skin rejuvenation and soft-tissue augmentation of the aging face. J Drugs Dermatol JDD. 2011;10(2):125-132.
5. Alster TS, Doshi SN, Hopping SB. Combination surgical lifting with ablative laser skin resurfacing of facial skin: a retrospective analysis. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2004;30(9):119 1-1195. doi:10.1111/j.1524-4725.2004.30370.x
6. Carruthers JDA, Glogau RG, Blitzer A, Facial Aesthetics Consensus Group Faculty. Advances in facial rejuvenation: botulinum toxin type a, hyaluronic acid dermal fillers, and combination therapies--consensus recommendations. Plast Reconstr Surg. 2008;121(5 Suppl):5S-30S. doi:10.1 097/PRS.0b013e31816de8d0
7. Butterwick K, Sadick N. Hand Rejuvenation Using a Combination Approach. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2016;42 Suppl 2:S108-118. doi:10.1097/DSS.0000000000000687
8. Friedmann DP, Fabi SG, Goldman MP. Combination of intense pulsed light, Sculptra, and Ultherapy for treatment of the aging face. J Cosmet Dermatol. 2014;13(2):109-118. doi:10.1111/jocd.12093
9. Hooper D. Commentary on Maximizing Panfacial Aesthetic Outcomes. Dermatol Surg. 2020;46(6): 818. doi:10.1097/DSS.0000000000002287
10. Sadick NS. Combination Aesthetic Therapies for Whole-Body Rejuvenation. Clin Surg. 2017;2(14 44). https://www.clinicsinsurgery.com/full-text/cis-v2-id1444.php
11. Kim SB, Kim S, Heo Y ran, Kim HJ. Evaluation of a novel device combining RF and HIFES technologies for the non-invasive correction of asymmetric smiles and facial rejuvenation: A case report. Skin Res Technol. 2024;30(8):e13885. doi:10.1111/srt.13885
12. Cotofana S, Halaas Y, Kinney B, Goldberg D, Cohen J. Simultaneous Emission of Synchronized Radiofrequency and HIFES for Non-invasive Facial Rejuvenation: The Mechanism of Action.
13. Porsch H, Mehić M, Olofsson B, Heldin P, Heldin CH. Platelet-derived growth factor β-receptor, transforming growth factor β type I receptor, and CD44 protein modulate each other’s signaling and stability. J Biol Chem. 2014;289(28): 19747-19757. doi:10.1074/jbc.M114.547273
14. Duncan D, Bernardy J, Hodkovicova N, Masek J, Prochazkova M, Jarosova R. The Superior Effect of Radiofrequency With Targeted Ultrasound for Facial Rejuvenation by Inducing Hyaluronic Acid Synthesis: A Pilot Preclinical Study. Aesthetic Surg J Open Forum. 2024;6:ojae005. doi:10.1093/ asjof/ojae005
15. Meyer PF, de Oliveira P, Silva FKBA, et al. Radiofrequency treatment induces fibroblast growth factor 2 expression and subsequently promotes neocollagenesis and neoangiogenesis in the skin tissue. Lasers Med Sci. 2017;32(8):1727-1736. doi:10.1007/s10103-017-2238-2
16. El-Domyati M, Barakat M, Awad S, Medhat W, El-Fakahany H, Farag H. Multiple microneedling sessions for minimally invasive facial rejuvenation: an objective assessment. Int J Dermatol. 2015; 54(12):1361-1369. doi:10.1111/ijd.12761
17. Nguyen L, Blessmann M, Schneider SW, Herberger K. Radiofrequency Microneedling for Skin Tightening of the Lower Face, Jawline, and Neck Region. Dermatol Surg. 2022;48(12):1299. doi:10.1097/DSS.0000000000003607
18. Clark-Loeser LR, Halaas Y. Revolutionary Fractional RF Microneedling Enables Deep Tissue Penetration Without Full Needle Insertion for Skin Rejuvenation and Fat Reduction.
19. Duncan D. Novel Approach to Fractional Radiofrequency Microneedling: Optimizing Patient Experience. Am J Biomed Sci Res. 2024;24(4). doi:10.34297/AJBSR.2024.24.003227
20. Kinney BM, Bernardy J, Jarošová R. Novel Technology for Facial Muscle Stimulation Combined With Synchronized Radiofrequency Induces Structural Changes in Muscle Tissue: Porcine Histology Study. Aesthet Surg J. 2023;43 (8):920-927. doi:10.1093/asj/sjad053
21. Kent DE, Fritz K, Salavastru C, Jarosova R, Bernardy J. First Evidence of Cutaneous Remodelling Induced by Synchronized Radiofrequency Aided by High-Intensity Facial Muscle Stimulation: Porcine Animal Model. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2024;50(2):178-181. doi:10.1097/DSS.0000000000004028
22. Duncan D, Bernardy J, Hodkovicova N, Masek J, Prochazkova M, Jarosova R. The Superior Effect of Radiofrequency With Targeted Ultrasound for Facial Rejuvenation by Inducing Hyaluronic Acid Synthesis: A Pilot Preclinical Study. Aesthetic Surg J Open Forum. 2024;6:ojae005. doi:10.1093/ asjof/ojae005
23. Boyd CM, Chilukuri S. Radiofrequency vs. Synchronized Radiofrequency and Targeted Ultrasound Technology for Enhanced Skin Hydration.
24. Bernardy J. Investigation of Histological Changes Induces by a Novel Fractional Radiofrequency Device for Skin Rejuvenation in Porcine Skin Tissue. In: ; 2023.
25. Gupta J, Park SS, Bondy B, Felner EI, Prausnitz MR. Infusion pressure and pain during microneedle injection into skin of human subjects. Biomaterials. 2011;32(28):6823-6831. doi:10.1016/j.biomaterials.2011.05.061
26. Purves D, Augustine GJ, Fitzpatrick D, et al. Mechanoreceptors Specialized to Receive Tactile Information. In: Neuroscience. 2nd Edition. Sinauer Associates; 2001. Accessed January 13, 2025. https://www.ncbi.nlm.nih.gov/books/NBK10895/
27. Gowda A, Healey B, Ezaldein H, Merati M. A Systematic Review Examining the Potential Adverse Effects of Microneedling. J Clin Aesthetic Dermatol. 2021;14(1):45-54.