IMCAS

Improving Digastric Muscle Laxity via Radiofrequency and Electrical Facial Muscle Stimulation: A Submental Fullness Reduction

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.

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COABLATIVE FRACTIONAL RADIOFREQUENCY -A NON- INJECTIVE TECHNIQUE FOR THE TREATMENT OF AGEING SKIN

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

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Insulated versus non-insulated microneedling radiofrequency, a 36 months experience

Objectives: This study compares two types of needles used by microneedling radiofrequency (MRF) devices. We only included facial indications
Efficacy and safety in each indication as well as treatment and posttreatment protocols are also included in the current study

Introduction: Microneedling radiofrequency has been used for over a decade in skin tightening, acne scars treatment, hyperhidrosis, telangiectasia, assisted drug delivery and improving surgical scars. Several hypotheses were suggested to explain the mechanism of neo-callogenesis induced by MRF and some of them were supported by histological studies, however, due to the variable effects in variable indications, other mechanisms are still to be elucidated
There's no consensus on treatment protocols for each indication. Variable types of needles, power, spacing are used.

Materials / method: Retrospective analysis of 40 patients underwent solely MRF treatment for 3-5 monthly sessions. Patients with variable types of acne scars (rolling, boxcar scars, icepicks scars), telangiectasia, wide pores and accompanying active acne lesions were included.
We excluded patients with combined treatment modalities, those with only active acne without any other indication, patients with any dermatological condition other than acne
a blinded dermatologist assessed before and after photos and grade them into 5 grades (0=no improvement, 1= minimal, 2= fair, 3= moderated, 4= excellent improvement)

Results: Insulated needles were superior to non-insulated needles only in cases with rolling acne scars, no significant difference in other types of acne scars or in other indications. However, partial recurrence of rolling scars was noticed on long term (over 6 months) follow ups. which suggests that rolling scars might require combination treatment to prevent reformation of fibrous tissue. No recurrence was noticed in other indications

Conclusion: Both insulated and non-insulated needles MRF are effective and safe in ace scars treatment, skin tightening and telangiectasia. Except for rolling acne scars, using non-insulated needles can be more cost effective.
secondary outcomes suggest that sole treatment of rolling acne scars with insulated MRF can be liable for recurrence

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Maximizing Aesthetic Results with the Most Powerful Monopolar Radiofrequency: Clinical Techniques and Strategies

Objectives: To evaluate the effectiveness of delivering 300 shots in a single session on one side of the face versus 100 shots per session for three sessions with one-moth intervals on the contralateral side, assessing their respective contributions to skin lifting and tightening.

To compare the efficacy of two delivering methods – gliding and stamping, in achieving optimal results with monopolar RF treatment.

To investigate the synergistic effects and safety profile of combining Microfocused Ultrasound treatment with monopolar RF, both on the same day and in separate settings with a one-month interval.

Introduction: With the growing popularity of non-invasive skin rejuvenation procedures, monopolar radiofrequency (RF) treatment has emerged as a promising modality for skin lifting and tightening. This study aims to contribute to the existing knowledge by conducting a split-face investigation into the impact of varying treatment parameters on the efficacy and safety of monopolar RF.

Materials / method: A rigorous split-face study design was employed, with each participant undergoing different treatments on opposing sides of the face. Parameters such as the number of shots per session, delivery method (gliding vs. stamping), energy levels, and mode of operation (Standard vs. Comfort) were systematically varied and evaluated.

Results: The stamping method was found to yield superior results compared to gliding method at equivalent energy levels, albeit with higher reported pain scores. Interestingly, the gliding method allowed for an increased in energy levels, resulting in enhanced outcomes. While there was a slight inclination favoring the single-session approach, separated sessions also demonstrated efficacy.
The combination of MFU and RF on the same day showed better results compared to separate sessions, hinting at a potential synergistic effect between the two modalities.
No observable side effects were reported.

Conclusion: This comprehensive comparative analysis utilizes diverse evaluation methods, providing a thorough understanding of the nuanced factors influencing the effectiveness and safety of monopolar RF treatment. These findings offer valuable guidance for clinicians and practitioners in optimizing treatment protocol for non-invasive skin rejuvenation.

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Укажите, пожалуйста, лица (индивидуальное, предприятие, организация): Tentech, Elogio Asia

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A comparative study between fractional microneedling radiofrequency versus intralesional steroids in treatment of alopecia areata

Objectives: A randomized controlled trial to evaluate and compare the efficacy and safety of fractional microneedling radiofrequency and intralesional steroids in treatment of alopecia areata by trichoscopic assessment before and after each modality and compared to control areas in the same patient.

Introduction: Alopecia areata is a tissue specific autoimmune disorder targeting anagen hair follicles, resulting in non scarring hair loss. It is a relatively common disease with a average lifetime incidence of 1.7%, with a significant psychological burden on affected individuals. It's quite difficult to treat, with only few treatments evaluated in randomized controlled trials. Fractional microneedling radiofrequency delivers both mechanical and thermal injury inducing hair growth stimulation. Corticosteroids are the classic first line treatment in alopecia areata but with some side effects.

Materials / method: Patients with at least 3 patches of alopecia areata, clinically and trichoscopically confirmed. Age ranging from 13-65 years. After taking consent, in each patient one patch was treated with fractional microneedling radiofrequency, the second with intralesional triamcinolone injection (5 mg/ml) and the third patch was left untreated (control). Patients were treated with 6 sessions on 3 weekly basis. Photography and dermoscopic evaluation was done before and after the sessions. Severity of alopecia tool score(SALT) was done to assess the improvement, together with patient satisfaction scores.

Results: Significant improvement in trichoscopic scaled scores of dystrophic and terminal hairs, as well as patient satisfaction and percentage of clinical improvement, occurred in both fractional microneedling radiofrequency and intralesional corticosteroids injection, with no significant statistical difference.

Conclusion: This study is the first controlled study to be conducted in evaluating the efficacy, safety and tolerability of fractional microneedling radiofrequency in alopecia areata cases, which showed impressive response with significant trichoscopic and clinical imrovement with no statistical significant difference to intralesional steroids injection and with less side effects. Fractional Microneedling Radiofrequency can be considered as a good alternative to steroids injection in treatment of alopecia areata cases.

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Energy-based devices with high amplification power for the reduction of subcutaneous and visceral fat combined with submaximal exercise: 6-month follo

Objectives: The study aimed to evaluate effects of combined intervention on the volume of abdominal fat, analysing changes in lipid profile, metabolic factors, and inflammatory markers.

Introduction: Use of electromagnetic energy as an alternative to surgical procedures for subcutaneous fat reduction has gained popularity in recent years. This pilot study, the effects of using amplified radio-frequency energy in the medium wave delivery range, in conjunction with exercise intervention, were investigated for their potential reduction of abdominal subcutaneous and visceral fat.

Materials / method: 34 participants were selected and assigned to a 10-day intervention utilizing a Radiofrequency device. Every weekday of except Saturday and Sunday. Application of amplified energy through a belt covering abdominal area, area of 800 cm2 followed by 45-minute submaximal aerobic exercise. Measurements were conducted pre-treatment and after the intervention. Lipid profile, leptin, insulin, and protein C were measured. Body fat was measured by MRI of the entire abdomen. Follow-up measurements were also taken at the 6-month mark.

Results: Statistically significant decrease in both subcutaneous and visceral fat in the abdominal area, as well as a decrease in weight, waist-to-hip, and all biochemical values, without side effects, just a slight redness. These effects on abdominal fat were maintained at the 6-month follow-up with no reports of regaining fat.

Conclusion: Utilization of amplified radiofrequency with an abdominal belt with static electrodes with temperature sensors, together with exercise intervention has significant potential for reducing abdominal subcutaneous and visceral fat, while also improving associated factors safely and effectively even after a follow-up period.

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Full-thickness Skin Rejuvenation by a Novel Dual-Length Microblade Radiofrequency Technique: A Proof-of-Concept Study Using Human Skin

Objectives: This study evaluated the dual-depth targeting capability and the ability to induce rejuvenation in each layer of vertical skin anatomy, i.e., the epidermis, papillary dermis, and reticular dermis, using full-thickness human facial skin

Introduction: A novel dual-length microblade radiofrequency (DLMR) device has been developed to achieve full-thickness skin rejuvenation by stimulating the papillary and reticular dermis simultaneously. This modality’s dual-level targeting concept need to be validated on human skin, although its clinical efficacy has been demonstrated in a previous study.

Materials / method: Human facial skin samples were obtained from thirteen Asian patients who had facelift surgery for ex vivo and in vivo studies. DLMR-treated ex vivo skin samples were analyzed using a digital microscope, thermal imaging, and hematoxylin and eosin (H&E) staining immediately after application. For the in vivo analysis, both treated and untreated samples from symmetrical areas were stained with H&E, Masson's trichrome, and Verhoeff-Van Gieson method. Total collagen content and mRNA expression levels of collagen types I/III and vimentin were also analyzed.

Results: The novel DLMR technique successfully induced thermal stimulation in the papillary and reticular dermis. The thickness, stacks, and dermal–epidermal junction (DEJ) convolution of the epidermis treated with DLMR were significantly increased. Collagen bundles in the dermis treated with DLMR exhibited a notable increase in thickness, density, and horizontal alignment. Dermal collagen levels were significantly higher in the morphometric and TCA data, as well as in the qPCR data for dermal matrix proteins.

Conclusion: The novel DLMR technique offers precise and independent targeting of both the papillary and reticular dermis, demonstrating it as an effective modality for achieving full-thickness skin rejuvenation.

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Укажите лица (индивидуальное, предприятие, организация): AGNES Medical

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Fractional Er:YAG laser versus microneedling radiofrequency in treatment of atrophic acne scars

Objectives: To study efficacy and safety of ablative fractional Er:YAG laser 2940 nm and microneedling radiofrequency for facial atrophic acne scar.

Introduction: Efficacy and safety of ablative fractional laser used for treatment of acne scars have been described in several studies. Recently, microneedling radiofrequency treatment has been showing promising results with low risk of side effects and rapid healing time

Materials / method: 21 patients with atrophic postacne scars were randomized to MRF for one half of the face and laser for the other half. Four sessions were performed monthly. For evaluation, the validated scale “Quantitative Global Grading System for Postacne Scarring” and patient's satisfaction were used before and 3 months after treatment. Optical coherence tomography imaging of the skin was used as an objective tool for assessment.

Results: Both sides showed significant improvement on clinical evaluation with no significant difference. Optical coherence tomography assessment showed significant increase of both epidermal and dermal thickness compared to baseline

Conclusion: : Both MRF and ablative fractional Er. YAG laser 2940 nm are effective in the treatment of post acne scars. Microneedling radiofrequency is better tolerated, with lower downtime and fewer side effects.

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Efficacy of fractional CO2 laser therapy combined with PRP injection vs. fractional CO2 laser therapy combined with synthetic products in vaginal dryness treatment

Objectives: This clinical trial aimed to evaluate and compare the efficacy of fractional CO2 laser therapy combined with Platelet-Rich Plasma (PRP) injections versus fractional CO2 laser therapy combined with products containing hyaluronic acid and peptides in the treatment of vaginal dryness.

Introduction: Vaginal dryness affects approximately 17% of women aged 18 to 60, causing discomfort, dyspareunia, burning sensations, and decreased sexual desire, significantly impacting quality of life. Despite existing treatments, there is a growing need for more effective solutions.

Materials / method: A total of 280 women presenting with symptoms of vaginal dryness were enrolled in this randomized controlled trial. Participants were screened for underlying gynecological conditions and infections. They were then randomized into three groups: 100 women received fractional CO2 laser therapy with PRP injections, 100 women received fractional CO2 laser therapy with products containing hyaluronic acid and peptides, and 80 women received laser therapy with placebo injections. Treatments were administered in four sessions at three-week intervals, with follow-up assessments conducted six months post

Results: The group treated with products containing hyaluronic acid and peptides showed the most substantial improvements, with 89% reporting reduced pain and burning, 79% experiencing increased sexual desire, and 85% having fewer urinary infections. Furthermore, 90% reported reduced vulvar discomfort, 78% noted less vaginal discharge, and 88% experienced decreased post-coital bleeding. In comparison, the PRP group demonstrated improvements in 60% for pain and burning, 32% for sexual desire, and 48% for urinary infections, with notable improvements in vulvar discomfort (52%), vaginal discharge (42%), a

Conclusion: Fractional CO2 laser therapy combined with products containing hyaluronic acid and peptides proved significantly more effective in alleviating symptoms of vaginal dryness than therapy combined with PRP injections. These findings suggest products containing hyaluronic acid and peptides as a promising treatment option for women experiencing vaginal dryness.

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Cold plasma as an effective treatment for acne vulgaris: A case series

Objectives: Despite the various therapeutical modalities for acne, novel treatments with fewer adverse effects and recurrences should be examined. This study proposes plasma therapy as a beneficial treatment for acne vulgaris. Our findings suggest cold plasma is an effective adjunctive therapy for treating acne patients' inflammatory lesions. However, further investigations with a larger sample size must confirm this result.

Introduction: Acne vulgaris, a prevalent dermatologic disease, imposes a considerable psychosocial effect on the population. Several treatments are available for acne, with noticeable adverse effects. Plasma, a developing therapeutic modality, is employed in different inflammatory conditions with minimal side effects.

Materials / method: This case series study sought to evaluate the efficacy of plasma therapy in acne vulgaris. Patients meeting specific eligibility criteria were enrolled in this study at the Dermatology Clinic of Shohada-e-Tajrish Hospital from 2021 to 2022. Plasma was applied for patients once weekly for eight consecutive weeks. Evaluation tools included the Investigator Global Assessment of Acne (IGA), Global Acne Grading System (GAGS), and Cardiff Acne Disability Index (CADI).

Results: A total of 15 eligible patients, including 12 women and three men with a mean age of 26.60 ± 6.20, were included. All patients had mild-moderated acne with notable improvement after plasma therapy. The mean GAGS and IGA scores were 14.73 ± 6.19 and 2.67 ± 0.82 at baseline and 4.80 ± 3.97 and 0.87 ± 0.83 after cold plasma therapy, respectively. The decrease in GAGS (P<0.001) and IGA (P<0.001) was significant.
Also, the quality of life of acne patients assessed with the CADI improved significantly after a complete course of therapy (P<0.001).

Conclusion: Our findings support the application of cold plasma as an effective adjunctive therapy for inflammatory lesions in acne patients. However, further investigations with a larger sample size must confirm this result.

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First Clinical Trial of 1726nm Laser Targeting Sebaceous Glands in Moderate to Severe Acne : Extended follow up in Japan

Objectives: 1. To present the first clinical report with an extended follow-up of 1726 nm laser treatment for acne in Asian patients.
2. To evaluate the 1726 nm laser as a novel, safe, and effective treatment modality that selectively targets the sebaceous glands.
3. To analyze the variability of treatment outcomes among subjects, particularly during shorter follow-up periods, and to assess the potential for progressive improvement with longer observation.

Introduction: Acne is the leading cause of dermatological consultations among adolescents and young adults. Delayed or ineffective treatment increases the risk of permanent scarring. While isotretinoin and photodynamic therapy (PDT) have been mainstays for managing severe acne, concerns about adverse effects and treatment inconvenience remain. In 2022, the 1726 nm laser, targeting sebaceous glands selectively, received FDA approval. However, clinical insights on its use are still limited. This study presents our experience from the first clinical trial with long time follow-up conducted in Japan.

Materials / method: Thirteen subjects aged 16–38 years with moderate to severe acne underwent three sessions of 1726 nm laser treatment at monthly intervals. Follow-up evaluations, including photographic documentation and investigator assessments using the Investigator’s Global Assessment (IGA) score, were conducted at 4, 12, 26, and 52 weeks post-treatment. Additionally, a survey was administered to assess subjects' satisfaction with the treatment.

Results: At the 4-week follow-up, most patients demonstrated a noticeable reduction in sebum production. By the 12-week follow-up, improvements in acne were less remarkable and varied among the subjects. However, with extended follow-up periods, a consistent trend of progressive improvement was observed in the majority of patients. Adverse effects were primarily limited to pain and mild erythema during the procedure.

Conclusion: While this novel modality is safe and demonstrates effectiveness over an extended period, the results may vary among subjects. Further analysis with a larger sample size is necessary to fully establish its efficacy and optimize treatment outcomes.

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Эта работа представлена благодаря поддержке: usage of the laser

An Amazing Method for Increasing Facial Volume Using High-Intensity Focused Ultrasound (HIFU) Without Filler Injections

Objectives: Typically, methods such as filler injections or fat grafting are commonly chosen to increase facial volume. However, as more patients seek natural results recently, I would like to introduce a method that utilizes an Energy-Based Device (HIFU) to achieve a natural increase in facial volume. Decreased medial cheek fat volume during aging leads to loss of a youthful facial shape. Increasing facial volume by methods such as adipose-derived stem cell (ASC) injection can produce facial rejuvenation.

Introduction: High-intensity focused ultrasound (HIFU) can increase adipogenesis in subcutaneous fat by modulating cilia on ASCs, which is accompanied by increased HSP70 and decreased NF-κB expression. We evaluated the effect of HIFU on increasing facial adipogenesis in swine (n = 2) via modulation of ASC cilia. Expression of CD166, an ASC marker, differed by subcutaneous adipose tissue location. CD166 expression in the zygomatic arch (ZA) was significantly higher than that in the subcutaneous adipose tissue in the mandible or lateral temporal areas.

Materials / method: HIFU was applied only on the right side of the face, which was compared with the left side, where HIFU was not applied, as a control. HIFU produced a significant increase in HSP70 expression, decreased expression of NF-κB and a cilia disassembly factor (AURKA), and increased expression of a cilia increasing factor (ARL13B) and PPARG and CEBPA, which are the main regulators of adipogenesis. All of these changes were most prominent at the ZA. Facial adipose tissue thickness was also increased by HIFU.

Results: Adipose tissue volume, evaluated by magnetic resonance imaging, was increased by HIFU, most prominently in the ZA. In conclusion, HIFU increased ASC marker expression, accompanied by increased HSP70 and decreased NF-κB expression. Additionally, changes in cilia disassembly and length and expression of adipogenesis were observed. These results suggest that HIFU could be used to increase facial volume by modulating adipogenesis.

Conclusion: Clinically, we recommend the application of low-energy HIFU (0.1-0.2J, dot-type, approximately 400-800J, 10 sessions per week) to the buccal fat pad and areas with localized volume deficiency. The buccal fat pad contains a rich source of stem cells, and M2 macrophage polarization is predominant in this region.

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