Clementoni Matteo Tretti, Munavalli Girish S
Skin House, Milan, Italy.
Dermatology, Laser, and Vein Specialists of the Carolinas, Charlotte, North Carolina.
Lasers Surg Med. 2016 Jul;48(5):461-70. doi: 10.1002/lsm.22499. Epub 2016 Mar 4.
The aging process is commonly associated with skin laxity in the lower face and neck. Conventional surgery can correct this at least to some extent, but is invasive. Fractional high-intensity focused radiofrequency delivered to the dermis with insulated microneedles has recently attracted attention in facial rejuvenation. The present pilot study was designed to assess the efficacy of HiFR for skin laxity of the lower face and neck.
Thirty-three patients (7 males, 26 females, age range 37-74 years) with mild to moderate skin laxity of the lower face/neck participated in the study. Three treatments were given at monthly intervals with protocols developed by the authors, three passes per session, at decreasing dermal depths for each pass. Histologic assessment of skin immediately after treatment was performed to identify the site and area of damage in the dermis. Clinical digital photography was taken at baseline and at 6 months after the final treatment session, based on which standardized computer measurement of improvement in the gnathion and cervicomental angles was the primary objective evaluation. A global assessment of improvement was graded by blinded assessors based on the photography. A telephone survey of patient satisfaction was performed at 12 months post-treatment.
A significant post-treatment decrease in the cervicomental and gnathion angles was seen of 28.5° and 16.6°, respectively (P < 0.0001 for both). Histology immediately post-treatment showed a clear demarcated and roughly oval area of coagulation associated with the tip of the needle, confined to the dermis and not involving the epidermis. In the global assessment 81.8% of the patients achieved moderate or higher results, and 87% of patients were very satisfied or better. Downtime was minimal, lasting 3-4 days, and no persistent adverse events were recorded.
Fractional HiFR proved safe and effective in the treatment of neck laxity in a large age range of patients, including the elderly. Lasers Surg. Med. 48:461-470, 2016. © 2016 Wiley Periodicals, Inc.
衰老过程通常与面部下半部和颈部的皮肤松弛有关。传统手术至少在一定程度上可以纠正这一问题,但具有侵入性。最近,通过绝缘微针将分次高强度聚焦射频传递至真皮层在面部年轻化方面引起了关注。本初步研究旨在评估分次高强度聚焦射频(HiFR)治疗面部下半部和颈部皮肤松弛的疗效。
33例(7例男性,26例女性,年龄范围37 - 74岁)面部下半部/颈部轻度至中度皮肤松弛的患者参与了本研究。按照作者制定的方案,每月进行一次治疗,每次治疗进行三遍,每遍的真皮深度递减。治疗后立即对皮肤进行组织学评估,以确定真皮层损伤的部位和面积。在基线时以及最后一次治疗后6个月进行临床数码摄影,在此基础上,对颏下点和颈颌角改善情况进行标准化计算机测量是主要的客观评估指标。由盲法评估者根据照片对改善情况进行整体评估分级。在治疗后12个月进行患者满意度电话调查。
治疗后颈颌角和颏下点角度分别显著下降了28.5°和16.6°(两者P均<0.0001)。治疗后立即进行的组织学检查显示,与针尖相关的凝固区域界限清晰且大致呈椭圆形,局限于真皮层,未累及表皮。在整体评估中,81.8%的患者取得了中度或更高的效果,8