Dayan Steve
Department of Otolaryngology, University of Illinois, Chicago, Illinois.
J Cosmet Dermatol. 2019 Oct;18(5):1182-1185. doi: 10.1111/jocd.13057. Epub 2019 Jun 26.
Facial and neck skin tightening, and rejuvenation began decades ago with maximally invasive incisional face-lift surgery. Aesthetic trends, patient demands, and innovative technology brought about minimally invasive and noninvasive interventions-such as radiofrequency, ultrasound, laser and intense pulsed light as well as dermal fillers and other injectables-to address facial and neck skin laxity. These procedures reduce facial and neck skin laxity with less risk and less downtime than maximally invasive face-lift or face-lift plus liposuction; however, these interventions are often deemed to offer reduced results.
To evaluate the safety and efficacy-as well as patient satisfaction-of Rotational Fractional Resection (RFR) in subjects with mild-to-moderate submental fat and mild-to-moderate submental skin laxity.
Rotational fractional resection with the Nuvellus (Recros, Inc) platform, which uses 1.5 mm in diameter rotating scalpels-termed scalpets-to resect lax skin followed by a rotating cannulas to perform focal lipectomy through resected access ports.
Thirtyone patients were evaluated 30 days after RFR, in an ongoing prospective, multi-center, nonrandomized study.
The majority of subjects had a ≥1-grade improvement in investigator-evaluated skin laxity and lipodystrophy; 84% of subjects were satisfied with their neck and jawline appearance and 97% of subjects they would likely recommend the procedure. Minimal procedural and post-procedural pain, minimal scarring in 94% of subjects, and no severe skin-related adverse effects.
Rotational fractional resection is essentially a new concept that has a risk and side effect profile that is comparable or better than-surgical skin tightening, with measurable permanent results approaching that of surgical skin tightening. This investigational procedure advances the evolution of facial and neck aesthetic procedures with results approaching those of surgery in a single treatment.
Early RFR results are promising but, yet to be conclusive. However current outcome reports identify a procedure that meet patient demands for a minimally invasive office- based procedure to look better with limited downtime.
面部和颈部皮肤紧致及年轻化始于数十年前的最大侵入性切开式面部提升手术。美学潮流、患者需求以及创新技术催生了微创和无创干预手段，如射频、超声、激光和强脉冲光，以及真皮填充剂和其他注射剂，以解决面部和颈部皮肤松弛问题。这些手术相较于最大侵入性面部提升术或面部提升加吸脂术，能降低面部和颈部皮肤松弛风险且恢复时间更短；然而，这些干预措施通常被认为效果有限。
评估旋转式分次切除术（RFR）在轻度至中度颏下脂肪和轻度至中度颏下皮肤松弛患者中的安全性、有效性以及患者满意度。
使用Nuvellus（Recros公司）平台进行旋转式分次切除术，该平台使用直径1.5毫米的旋转手术刀（称为解剖刀）切除松弛皮肤，随后使用旋转套管通过切除的切口进行局部脂肪抽吸。
在一项正在进行的前瞻性、多中心、非随机研究中，对31例患者在RFR术后30天进行评估。
大多数受试者在研究者评估的皮肤松弛和脂肪营养不良方面有≥1级改善；84%的受试者对其颈部和下颌轮廓外观满意，97%的受试者表示可能会推荐该手术。手术中和术后疼痛轻微，94%的受试者瘢痕极小，且无严重的皮肤相关不良反应。
旋转式分次切除术本质上是一个新概念，其风险和副作用与手术皮肤紧致相当或更好，可测量的永久性效果接近手术皮肤紧致。这种研究性手术推动了面部和颈部美学手术的发展，单次治疗效果接近手术效果。
早期RFR结果很有前景，但尚未得出定论。然而，目前的结果报告确定了一种满足患者需求的手术，即一种微创的门诊手术，能在有限的恢复时间内让患者看起来更好。
