Radiofrequency - Skin Rejuvenation Procedures: Skin Health

Content provided by the Faculty of the Harvard Medical School

Radiofrequency

Radiofrequency's claim to fame is its ability to tighten lax, sagging skin on cheeks, jowls, and brows. It is also effective on other areas of the body, such as the abdomen, hands, and feet. Unlike laser or light treatments, radiofrequency does not affect the surface quality of the skin, so it will not improve the appearance of fine lines or pigmentation problems.

The ThermaCool radiofrequency device is FDA-approved for treating fine lines around the eyes, forehead wrinkles, sagging jowls and cheeks, and other areas on the body. This device is made by Thermage Inc., and the term thermage is sometimes used to identify the radiofrequency treatment itself.

A radiofrequency device delivers an electromagnetic current to the skin, while a cooling spray protects the epidermis. The doctor can control the amount of energy delivered by the device. The skin's natural resistance slows the flow of electrons, which creates an intense, uniform, and sustained heat to the tissues underneath the skin's surface. The heat penetrates more deeply into the dermis and subdermal layers than lasers do in resurfacing. The dermis contains collagen fibrils, which give the skin its strength. When the dermal tissue is heated, the collagen fibrils become disrupted, then contract and thicken, tightening the skin layer below the surface. As the fibril layers heal, they are reshaped, and new collagen forms. This tightens the skin even more. The skin tightens in the three dimensions of the face — horizontally (from side to side), vertically (from top to bottom), and in depth (from the surface to the interior) — the way a wet sponge shrinks three-dimensionally when it dries.

Radiofrequency is one of the best ways to tighten the skin and change the contour of the face. Therefore, it's often touted as an alternative to a facelift. It is less expensive than a facelift, and it takes little to no recovery time, compared with two to three weeks for a facelift. But it doesn't offer the same amount of lift that surgery does. Unlike a traditional surgical facelift, radiofrequency doesn't lift muscle, so it's not likely to be as useful for people with advanced wrinkling and very saggy skin. It is more helpful to people in their late 30s to early 60s who have mild skin looseness and wrinkling.

It's impossible to predict exactly how much radiofrequency will tighten any individual's skin. According to experts, the success of radiofrequency depends heavily on the doctor's skill and familiarity with the latest techniques, which are evolving rapidly. Data on the technique's effectiveness are limited. One small, six-month study of ThermaCool that involved 86 patients who were treated on the forehead and temple area found improvement in 83% of those treated for wrinkles around the eyes, and reported that 50% of the patients were satisfied with the treatment.

Preparing for radiofrequency is simple. You may be asked to apply an anesthetic cream one hour before your procedure. Just before the procedure, your doctor may give you an injection or medication for the burning or pinching you'll feel when the machine fires. The sensation lasts only seconds, but it can be uncomfortable. Treatment takes about an hour or two, depending on the size of the area being treated and the number of passes the doctor makes. When first introduced, doctors believed that one pass over the face sufficed, but experience shows that additional passes over specific areas significantly improve results.

You can get back to your daily life immediately. You may have a little redness for an hour, but rarely any swelling, bruising, or pain. You won't need any special care, unless you're the unusual patient who has some crusting. In that case, your doctor will give you ointments to speed healing. Side effects are uncommon and usually temporary, but risks include blisters, burns, scars, and temporary bumps. Rarely, patients develop small, permanent indentations or dimples in the skin.

Usually only one treatment is needed. You may see immediate improvement, but the full benefits appear gradually over four to six months as the fibril layers heal and collagen production continues. Results may last for up to two years. Treating the lower face costs approximately $3,000, the upper face $2,000, and the full face $5,000.

Last updated:	July 20, 2007