Abstract

Objectives: Radiofrequency microneedling (RFMN) treatment is the latest generation of fractional skin rejuvenation methods.However, the efficacy and safety of RFMN, and how it combines with other collagen stimulation methods remains unclear.Hyperdiluted PLLA was shown to be effective in tightening skin in the under chin/neck/décolleté areas. The benefits of combining treatments was long-lasting biostimulatory properties. But it is important to note, that the skin of this areas is thin, and sometimes following the rules can not help you to avoid complications like hyperstimulation and tissue fibrosis Introduction: Radiofrequency (RF) works to uniformly heat the skin for immediate heat-related skin shrinkage.1. Poly -L-Lactic Acid (PLLA) is a soft-tissue injectable bio-stimulatory agent approved for the treatment of wrinkles that acts by stimulating the skin to produce collagen. PLLA is a biocompatible, biodegradable and bioresorbable polymer. It is an alpha hydroxy acid polymer of the lactic acid L-enantiomeric structure that has been safely used in many applications and in medicine for more than 30 years.The purpose of our report is to evaluate the efficacy of combination RFMN treatment +PLLA lifting Materials / method: 15w subjects with mild to moderate skin laxity received RFMN and bio stimulation with PLLA at the same time. Subjects were followed for 6 months.One vial of PLLA was prepared by adding 6 cc of Bacteriostatic 0.9% Sodium Chloride 72 hours prior to planned injections. On the day of planned injections, an additional 2 cc of 2% Lidocaine HLC was added to the vial. The total mixture was a dilution of 16 cc/vial. Microcannula (25 g) injections along the inner area of each patient were performed till 1 vial was completely infiltrated. Massage for 5 minutes was performed Results: All 15 patients have easy rehabilitaion after combined treatment (mild redness, xerosis and small bruisers during 3-5 days) 85% were extremly satisfied with results (skin tightening, amazing collagen production, reducing wrinkles and fat in the submental areas. The best result we can realise after 8 weeks. But 26% (4 patients) notice the non-inflamated nodules after 4 months (the areas of hypercollagen stimulation or hypercorrection ). All these patients with delay complications were treated with intralesion dexametazone and Natrium Chloride injections and 2 sessions of mild RFMN Conclusion: Combination therapy with PLLA and Microneedling RF device give excellent improvement in the appearance of wrinkles , but can cause the hyper stimulation of collagen production and hypercorrection. The combination synergistically promotes collagen synthesis and subsequently improves wrinkling, but better do not combine this methods in one session in the areas with thin subcutaneous fat layer. The best results (reducing fat compartments, skin tightening, amazing collagen production) we receive after combined treatment with 3-4 months interval between sessions.