Multi-source radio frequencies against wrinkles and sagging skin. Part 1

One of the main causes of skin laxity is a decrease in the amount and functionality of dermal and subcutaneous collagen. Physiological aging leads to sagging skin and the appearance of wrinkles.

RF energy affects the skin by emitting high frequency radio waves that interact with the skin and cause thermal (temperature) changes. It has been established that heating the dermis to 55-65^oC for a certain period of time triggers the process of collagen restructuring, which results in the destruction of ineffective, damaged collagen and the production of new collagen.

Types of radio frequencies and their uses

RF systems have gradually become more and more popular over the past decades. This is partly due to the ability of RF energy to penetrate deep into the skin, regardless of skin color, which is characteristic of optical energies. In the skin, RF energy triggers a significant thermal effect at a certain depth, which depends on various parameters such as the technology used and the electrode configuration. The use of monopolar RF (first generation) systems that use an RF electrode requires more user expertise due to the higher energy density of the electrode. The use of this type of system is often painful and requires intensive active cooling in order to protect the epidermis. Furthermore,

The use of bipolar (second generation radio frequencies) or multipolar (third generation radio frequencies) radio frequencies is limited due to the shallow nature of the energy flow between two or more bipolar electrodes connected to a single RF generator. Despite expectations, the improvements offered by first, second and third generation systems are limited due to the low amount of skin heat generated.

The new generation of RF technology (fourth generation) uses multiple RF generators for optimal control of the thermal effect. The Multi-Source RF Therapy System (EndyMed Pro, EndyMed Medical, Caesarea, Israel) enables volumetric, homogeneous, directed and controlled heating for use during non-ablative RF treatments. The FDA has approved the EndyMed Pro, which is powered by 3DEEP technology and equipped with 6 RF generators that make it possible to control the phase of the flow between each pair of electrodes. The generated electric fields repel/attract, providing the perfect combination of energy directed to a deep ball of skin with minimal heating surface. Repulsive forces between adjacent electromagnetic fields direct energy vertically into the target tissue, reducing the amount of energy passing through the skin surface. In addition, multiple generators provide better energy distribution across the electrodes, reducing the energy density at each electrode, which in turn makes the procedure more comfortable and safe for the patient.

In the current study, the author tested a new treatment protocol for non-ablative skin firming of the entire face. The treatment was carried out using the EndyMed Pro multi-source RF system. The system causes energy to penetrate deep into the skin, causing a non-ablative deep skin heating effect that results in painless skin tightening.

Materials and methods

A total of 30 patients (all females aged 38-76) were treated using the EndyMed Pro 3DEEP System.

Multi-source RF therapy

During each session, the patient underwent a non-ablative facelift procedure; the company's recommended application included dividing the cheeks and neck into two separate treatment zones. The first two therapy sessions were performed 2 weeks apart, an additional two sessions were performed 4 weeks apart (i.e., the patient underwent a total of 6 treatment sessions). Patients returned after 1 and 3 months to check the results.

The procedure was performed using the EndyMed Pro, a phase-controlled, multi-source RF system that emits RF energy at 1 MHz up to 65 watts. All patients were treated with a small facial handle.

The non-ablative deep skin heating mode is painless and therefore requires neither anesthesia nor postoperative care. Before starting the non-ablative procedure, the skin was washed with soap and water to remove makeup and other cosmetics. The treated area (face and neck) was divided into two parts (two halves, approximately 25 x 10 cm). Since the treated area was more than twice the size recommended by the manufacturer, the maximum energy (65 W) was used for the treatment. The use of maximum energy allowed the operator to maintain the desired skin surface temperature in order to reach the end point and trigger collagen restructuring. Each treated area was heated for 10-15 minutes, during which the skin surface temperature was maintained at 40-42

о^С.

The treated areas were visually assessed for skin reaction including swelling, bruising and textural changes during the procedure. To interview both doctors and patients, special questionnaires were used, the task of which was to evaluate various parameters, such as the effectiveness, safety and convenience of the procedure, along with the subjective opinion of patients. The patient filled out a questionnaire after 6 sessions, checks after 1 and 3 months, and the doctor filled out a questionnaire for each patient.

Clinical improvement in skin firmness and texture was assessed by the clinician using an improvement scale.

Results of using multi-source radio frequencies

All patients completed 6 complete sessions except for one patient who completed only 5 sessions and one who completed 8 sessions. A patient who had completed 5 sessions was unable to attend the sixth due to personal reasons. In a patient who had 8 sessions, 2 out of 6 were shorter than required, so the doctor decided to give this patient two more sessions. Three months after treatment on the Fitzpatrick Wrinkle and Elastosis Scale, the condition of the patients improved by at least one level.

According to Prime magazine.