Novel RF and HIFES Device is Effective for Enhancing Facial Laxity Among Asian Patients

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A novel device combining synchronized radiofrequency (RF) with high intensity facial electrical stimulation (HIFES) is safe and effective for anti-aging.¹ The dual-modality therapy enhanced facial laxity, specifically in Asian patients.

The prospective, pre-post, evaluator-blinded study took place at a single laser center within a university hospital from September 2023 to September 2024. A total of 15 participants (14 female and 1 male) between the ages of 41 and 62 were included. All had a mild/moderate grade between 2 and 4 on the Facial Laxity Scale and over 85% had Fitzpatrick skin type IV.

Noninvasive electrode applicators were placed on the forehead and cheeks, avoiding the facial depressor muscles like the glabella and masseter. The RF component heats the dermis to 40°C in the first 2 minutes and maintains a temperature of up to 42.5°C for the remaining time. Each session lasted 20 minutes and occurred once every 4 weeks.

Clinicians assessed forehead, cheek, and eyebrow lifting as well as skin texture, elasticity, and melanin levels. This was done through 3D photography and imaging software. Patients also filled out self-questionnaires to measure their own perceived level of improvement. These evaluations were conducted at baseline, before the third treatment session, and 1, 3, and 6 months after the final treatment.

Forehead and cheek lifting was noted at the 6-month mark (p < 0.0001). The forehead average lifting increased from 1.447 mm to 2.140 mm while cheek lifting increased from a mean of 1.240 mm to 1.373 mm. Both areas reduced slightly at the 6-month mark.

The mean eyebrow distance was 21.56 mm at baseline and rose to 22.95 mm 3 months post-treatment. Overall, the brows lifted at an average of 1.39 mm at 3 months (p = 0.0087). This lifting distance was sustained at 1.31 mm by the 6-month evaluation (p = 0.0021).

Firmness of the skin increased by 45.68% before the third treatment and 81.24% after 6 months (p < 0.0001). Texture also improved, specifically in the crow’s feet area. A 13.82% progression was noted at 3 months (p = 0.049). This region also saw a 12.39% increase in wrinkle reduction at 3 months, which fell only slightly to 10.70% at the 6-month mark (p = 0.04). Forehead and cheek wrinkles also improved slightly.

Melanin levels and pigmentation were decreased on the cheeks, crow’s feet region, and forehead. In the crow’s feet area, melanin fell by 3.05% at 6 months (p = 0.0257). On the forehead, these levels decreased by 3.53% (p = 0.0172). There were no changes in skin erythema.

The forehead also saw 66.26% reduction in pore volume and skin smoothening (p = 0.0417). Some minor increases in volume were noted in the mid-cheek, jawline, nasolabial fold, and tear trough areas but these were not statistically significant and thus, was not the primary effect of this therapy.

After 6 months, 40% of patients believed they had over 50% improvement in their facial contouring while 27% saw more than 75% improvement. None of the participants expressed that they saw no visible changes. Overall, the therapy was well-tolerated with no serious adverse events. Pain scores decreased with each treatment session, beginning at 3.5 and falling to 1.6 by the fourth session.

As for limitations, the small-sized, predominantly female sample may not represent the broader population. Future trials will need to include larger, more diverse cohorts with a control group and longer follow-up period to confirm these results. It would also be beneficial to compare the effectiveness of this dual-modality therapy with other noninvasive treatments.

Permanent muscle contracture may shift the fat compartments of the face and have a positive impact on skin wrinkling and sagging. This approach selectively tones and alters the deeper facial tissue and muscles while promoting collagen and elastin, which makes the combined RF and HIFU therapy unique from other anti-aging treatments.²

Recent studies have tested this novel device in Caucasian and Thai patients and saw similar positive results, suggesting that the anatomical variations of ethnicities should be considered when administering this treatment.

“This consideration has potential implications for modifying treatment protocols and designing treatment pads specifically tailored to Asian patients, thereby optimizing the efficacy of this novel device for this population,” the authors wrote.

References

1. Manuskiatti W, Wannawittayapa T, Buranaporn P, Wanitphadeedecha R, Lizarondo FPJ, Nokdhes Y. The Efficacy and Safety of Synchronized Radiofrequency and High Intensity Facial Electrical Stimulation in Improving Facial Skin Laxity and Quality in Asians. Lasers Surg Med. Published online January 12, 2025. doi:10.1002/lsm.23878

2. Cotofana S, Fratila AA, Schenck TL, Redka-Swoboda W, Zilinsky I, Pavicic T. The Anatomy of the Aging Face: A Review. Facial Plast Surg. 2016;32(3):253-260. doi:10.1055/s-0036-1582234