KISSIMMEE, FLA. (FRONTLINE MEDICAL NEWS)Three treatments with a noninvasive radiofrequency device significantly improved mild to moderate laxity of the lower face and neck, a prospective study of 30 patients showed.

Downtime after treatment ranged from 2 to 4 days, and adverse effects included mild stippling and purpura at the treatment sites, Dr. Girish Munavalli reported at the annual meeting of the American Society for Laser Medicine and Surgery.

Aging causes progressive loosening of the tissues of the lower face and neck, which manifests as narrowing of the cervicomental angle (between the neck and the lowest point under the chin) and the gnathion angle (between the lowest point under the chin and the most anterior or prominent point on the front of the chin). Historically, patients resorted to invasive surgical lifting procedures to restore these angles, said Dr. Munavalli of Wake Forest University, Charlotte, N.C.

To explore noninvasive alternatives, he and his associates conducted a pilot study of a bipolar fractionated microneedle radiofrequency device that consisted of a handpiece and a 1 cm2 square disposable microneedle tip with 49 proximally insulated 34-G microneedle electrodes. The study comprised 7 men and 23 women aged 37-71 years. One physician treated all patients, and each patient underwent three treatment sessions lasting about 45 minutes and spaced a month apart.

Each session included three passes across the lower face and submental area at a maximum tissue depth of 1-3 mm, Dr. Munavalli said. Thicker skin requires deeper needle penetration, which in turn requires more treatment energy and longer pulse duration, he noted. Therefore, the physician performed the first pass at a depth of about 2.5 mm with an energy setting of 9-11 and a pulse duration of 280-320 msec, the second pass at a depth of 1.5 mm with a setting of 8-9 and a pulse duration of 230-250 msec, and the third pass at a depth of 1 mm with a setting of 6 and a pulse duration of 160 msec.

Six months after the end of treatment, patients underwent computerized measurements of the cervicomental and gnathion angles, and a panel of blinded investigators compared pre- and posttreatment photographs, Dr. Munavalli said. On average, the cervicomental angle increased by 27 degrees (range, 18 to 36 degrees; P < .01), and the gnathion angle increased by 16 degrees (range, 12 to 20 degrees; P < .01). The blinded assessors correctly chose the posttreatment photographs 90% of the time. Taken together, the results suggest that the device is a safe and effective option for improving laxity of the lower face and neck, Dr. Munavalli concluded.

Lutronic Corp is the maker of the Infini device, which the FDA approved for dermatologic use in July 2013. Dr. Munavalli reported no funding sources or financial disclosures.

dermnews@frontlinemedcom.com

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