Abstract

Objectives: (1) Identify factors contributing to obtuse submental angles. (2) Explain how digastric muscle laxity affects submental fullness. (3) Evaluate electrical muscle stimulation with synchronized radiofrequency for submental volume reduction. (4) Develop non-invasive treatment plans for submental improvement. (5) Assess clinical outcomes with MRI and patient feedback. Introduction: Cervicofacial rejuvenation raises concerns due to obtuse submental angles, involving skin, subcutaneous fat, platysma muscle, subplatysmal fat, and anterior digastric muscle bellies. Historically, non-invasive treatments focused on fat and skin, neglecting the anterior bellies' impact. Muscle protrusion significantly affects submental appearance and should be considered in rejuvenation strategies. Muscle deterioration causes the hyoid bone to descend, worsening submental fullness. Electrical muscle stimulation with synchronized radiofrequency can enhance muscle tone, reducing submental volume. Materials / method: This retrospective study involved twenty-nine (n=29, 28 females and 1 male, 22-59 years, skin type II-V) participants undergoing four (4) treatment sessions targeting the submentum, with intervals of 5-10 days between treatments. The treatment used non-invasive, self-adhesive applicators combining electrical facial muscle stimulation and Sync RF+ energy. MRI was used to assess lifting of the anterior bellies of the digastric muscle, defined as shortening of the lax muscle due to fiber densification. Follow-ups were conducted one month and three months post-treatment. Results: The analysis of MRI scans revealed a statistically significant (p<0.001) lifting of the anterior bellies of the digastric muscle. Specifically, the anterior bellies of the digastric muscle displayed an average 7.88% elevation at the 1-month follow-up and further improved to 14.36% elevation at the 3-month follow-up visit. Notably, both the left and right bellies of the muscle maintained their original volume throughout the study (p>0.05) at both follow-ups. Conclusion: This retrospective study supports the conclusions of the original research, which had initially documented a reduction in submental fat and an overall decrease in submental volume. This study specifically examined the impact of employed electrical facial muscle stimulation and Sync RF+ technologies on muscle tissue and observed a lifting effect on the anterior bellies of the digastric muscle.