Abstract

Objectives: Pairing fractional resurfacing and fractional microneedling radiofrequency (RF) technologies can be an ideal modality for addressing age-related skin imperfections such as fine lines and wrinkles and where alteration of the skin texture and quality are simultaneously presented.The goal is to create electrothermal injury with large cylindrical fractional micro- coagulative zones spanning the dermis at a pre-set depth (1.5-2.5 mm) and microablative epidermal perforation (at 300-350µm depth). Introduction: Microneedling RF is an array of 5x5 non-insulated needles, 300 µm in diameter tapered to 127µm at most distal point of entry . Fractional RF is composed of an array of 14 x 8 tiny electrodes arranged to deliver pulsed RF energy. . It generates superficial fractional micro-ablation wounds on the epidermis with subsequent (coagulative and bulk) thermal wound below the epidermis-dermis interface, in order to initiate a wound healing process cascade to improve skin texture,smoothness and tightens (skin rejuvenation) Materials / method: Two different applicators and their fractional tips Microneedling RF followed by microablative RF were used on 30 patients (15 males and 15 females) age 40 to 70 y/o, enrolled and treated for a total of 3 sessions, once a month . 100 pulses were used for each side for each of applicator tips. Follow-up period was 3 months after the last treatment. The fractional microneedling RF parameters were 1,5mm depth-11W power- 80msec pulse width for microneedle RF and 2W power -20m/sec pulse width for microablative RF. Results: After 3 months patients showed significant clinical improvement in skin quality (reduction of wrinkles and lines of the cheeks, texture improvement, reduction of pigmentation). Significant clinical improvement was detected in fine-line and wrinkles and skin texture (following GAIS scale). Downtime was not prolonged. No significant adverse events have been reported. Conclusion: Coablative RF technique yields better results than alternate single modality fractional RF -in reducing the number of sessions (3 instead 4) but performing 6 treatments instead 4 without an increasing of downtime or side effects