Novel Monopolar Radiofrequency Device is Effective and Safe for Facial Wrinkles

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A novel monopolar radiofrequency device with a 5 cm² tip is safe and effective for reducing the appearance of mild to moderate fine wrinkles on the eyes and cheeks.¹ Patients and clinicians observed aesthetic improvement 4 and 16 weeks after just a single monopolar session.

The multicenter, prospective pilot study took place from July 2023 to August 2023 at Asan Medical Center, Severance Hospital, and Chung-ang University Gwangmyeong Hospital. Thirteen female patients between the ages of 35 and 62 years were eligible based on scores from the Crow’s Feet Grading Scale (CFGS) and Cheek Line Grading Scale (CLGS). The mean age was 50.2 and all participants were Asian.

A single session of the 10THERMA® device at a 6.78 MHz frequency was administered, with multiple overlapping passes. The periorbital region received 50 shots, and the remainder of the face received 550 shots, for a total of 600. Investigators measured wrinkle reduction and aesthetic improvement at the 1 and 4-month mark, based on the 5-point CFGS, CLGS, and the Global Aesthetic Improvement Scale (GAIS) evaluations. Images were taken using a digital camera and Mark-Vu® and Antera 3D® when applicable. Adverse effects were also reported, with pain severity being measured using the Visual Analogue Scale (VAS).

Periorbital wrinkles on both eyes were reduced at week 4 (0.96 ± 0.65) and week 16 (1.04 ± 0.59), demonstrating significant improvement compared to baseline (p < 0.01). Right and left facial wrinkles decreased at week 4 (1.00 ± 0.55) and week 16 (1.12 ± 0.64), which was also statistically significant (p < 0.01). Interestingly, wrinkles on the right side showed better levels of improvement than those on the left side.

“This is probably because most people are right-handed, making it easier for physicians sitting at the patient’s head to perform procedures on the right side,” the authors wrote. “Moreover, when compared with the right cheek, the left cheek has a thicker dermal layer, which may partially contribute to the wrinkle improvement differences observed between the sides in this study.”

Participants also rated their own aesthetic improvement, which was 2.23 ± 0.80 at week 4 and 2.31 ± 0.61 at week 16. All were > 2, which equals to a “much improved” response. The investigator-based scores were similar with 2.31 ± 0.61 and 2.46 ± 0.63 at weeks 4 and 16, respectively. Additionally, sagging jowls and skin roughness were improved after 16 weeks, based on the Antera 3D imaging system.

The average VAS score for pain was 5.46 ± 1.99, making it a tolerable treatment for patients. Scores ranged between a 3 and an 8. No mild adverse events like erythema or bullae, or severe adverse effects like burning or scarring, were reported.

Energy devices have grown popular for slowing skin aging in a minimally invasive way. Monopolar radiofrequency technology works by passing current through the patient from a single active electrode to a distant return electrode, generating heat through tissue resistance.² Compared to typically smaller tips, the larger tip of this device also penetrates deeper into the dermis.³

The study has several limitations including a small and less diverse sample size, a lack of comparative devices, and the use of the large 5 cm² tip on the eyelids. To combat these, the researchers are planning a blinded, controlled study with an eye-specific tip and a large-scale, split-face study with both male and female participants that will blindly compare the 5 cm² tip to other conventional ones. It is also inferred that longer follow-ups with multiple sessions will have even better results.

References

1. Yang HJ, Choi SY, Jung JM, et al. A multicenter pilot study of the effectiveness and safety of a monopolar radiofrequency device for improving periorbital and facial fine wrinkles. J Dermatolog Treat. 2025;36(1):2469633. doi:10.1080/09546634.2025.2469633

2. Dierickx CC. The role of deep heating for noninvasive skin rejuvenation. Lasers Surg Med. 2006;38(9):799-807. doi:10.1002/lsm.20446

3. Suh DH, Ahn HJ, Seo JK, Lee SJ, Shin MK, Song KY. Monopolar radiofrequency treatment for facial laxity: Histometric analysis. J Cosmet Dermatol. 2020;19(9):2317-2324. doi:10.1111/jocd.13449