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January 21, 2011

5) Removing Wrinkles with Lasers: Novel Skin Tighteners

Although some in the fourth class of skin tighteners are not actually lasers, I have grouped...

radiofrequency devices

and

infrared lasers

together because they function similarly:

  • deep tissue heating
  • subsequent collagen production
  • subsequent tightening
  • with a goal of creating true lifting without surgery
  • but uniformly falling very short relative to surgical facelifting or traditional (15-year-old) ablative laser technology

Radiofrequency devices are like microwaves.  They emit low-frequency light energy (radio waves and microwaves) to create heat in deeper tissues.  The most popular in this new class is the Thermage....

  • Advantages:
    • minimal post-procedure redness
    • minimal side effects
  • Disadvantages:
    • quite uncomfortable during the treatment
    • inconsistency of results
      • about 1/3 will have significant improvement--but only after waiting months for full collagen production and tightening
      • the other 2/3 will obtain minimal if any improvement, no matter how long they wait
      • In at least one study, only 5 of 15 Thermage patients reported satisfactory results, and the photographic analysis by experts did not yield any statistically significant results.
  • Recent modifications may have improved the technology.  The final verdict is still out.

Infrared devices also produce deep penetration.  A popular model is the Titan.

  • Advantages:
    • safe
    • not much downtime
    • not too uncomfortable
  • Disadvantages:
    • poorly studied--even worse research than for Thermage
    • absolutely no long-term research
    • At least one preliminary study showed less improvement with an infrared device compared to a radiofrequency device.  (And, as mentioned above, radiofrequency devices are, at best, minimally effective.  So, this is a pretty damning comparison.)

Combinations devices may produce augmented effects relative to either radiofrequency or infrared alone.  The Galaxy is the most well known combination device.

  • Combination of...
    • bipolar radiofrequency
    • infrared laser
    • intense pulsed light
  • Advantages:
    • apparently safe
    • minimal downtime
    • radiofrequency and infrared energies may be synergistic to produce real improvements
  • Disadvantages:
    • The radiofrequency portion of the treatment may hurt (like Thermage).
    • the least well studied of all
    • almost no good quality research documenting efficacy
    • almost no long-term research

The bottom line:  I don't own a radiofrequency device, an infrared laser, or a combination machine.  And I don't plan to buy one any time soon.  The non-surgical facelift remains elusive.

However, skin tightening using radiofrequency or infrared energy sources is a compelling area of active research.  I think that it is worth my time to keep abreast of this technology.  As newer, more effective devices are rapidly becoming available, the objective of achieving the non-surgical face lift may become a reality during my career.

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