Abstract

Objectives: To assess the clinical outcomes, safety profile, and comparative outcomes of RFMN alone and the combination treatment with RFMN and Tm laser. Introduction: Radiofrequency microneedling (RFMN) is a widely used treatment for skin laxity and wrinkles. Recently, combining RFMN with a 1927nm thulium (Tm) laser and Vitamin A serum has gained growing use in clinical practice. However, comparative data on the efficacy of RFMN alone versus RFMN/Tm laser for skin rejuvenation remain limited. Materials / method: Patients were assigned to either the RFMN or RFMN/Tm laser group. The RFMN treatment arm received one to three sessions at six-week intervals, while the RFMN + Tm group underwent one to three RFMN/Tm laser sessions, followed by two additional Tm laser sessions. Follow-up visits were scheduled three and six months post-treatment. Submental volume and pores were assessed with 3D imaging, and skin tone evening was evaluated using the CIEL*a*b* color space. Two blinded investigators rated outcomes using Likert scales. Results: The study included 30 patients in the RFMN group and 27 in the RFMN/Tm group. Both treatments led to significant improvements in skin laxity (−4.72 cm³ for RFMN, −6.06 cm³ for RFMN/Tm), with no significant difference between groups. However, the RFMN/Tm group showed greater improvements in pores and skin tone. Blinded assessments confirmed significant enhancements in both cohorts, with superior overall results in the combination group. Treatments were well tolerated, with lower pain scores in the RFMN/Tm group (3.8 vs. 5.6; p < 0.05). Downtime lasted a few days in both groups. Conclusion: Both RFMN and RFMN + Tm laser treatments are effective and safe for addressing skin laxity, wrinkles, and lower face lifting. The addition of Tm laser improves pore appearance and skin tone. Minimal downtime and high patient satisfaction was reported.