Multipass Vector (Mpave) Technique with Nonablative Radiofrequency to Treat Facial and Neck Laxity

Abstract

BACKGROUND. Redundant facial and neck skin is a major feature of aging and historically has been corrected surgically. Recently, monopolar radiofrequency application has been introduced for nonablative tissue tightening of skin by volumetric heating of the deep dermis. It has been able to improve neck and cheek laxity and periorbital rhytides and to elevate eyebrows. However, questions remain as to the ideal parameters needed to optimize the use of radiofrequency. OBJECTIVE. To determine the safety and report on the efficacy of a radiofrequency application that involves a multipass vector (mpave) technique to target facial and neck skin laxity.METHODS. Twenty-five patients (skin types I to V) with mild to severe facial and neck laxity received one treatment session with monopolar radiofrequency. Treatment parameters, adverse events, and digital photographs were recorded. All patients were treated with a multipass vector technique consisting of four to five passes targeted over areas of skin that would most improve facial laxity. The multipass vector (mpave) treatment approach is described. Energy levels ranged from 62 to 91 J/cm 2 per pulse. RESULTS. All patients experienced some immediate erythema and edema, which had completely resolved in most patients within 48 hours. No scarring or dyspigmentation was noted on follow-up at 6 and 12 weeks. Photographic analysis of pre-and posttreatment digital images revealed cosmetic improvement in facial and neck laxity in 96% of patients. The majority of patients demonstrated a moderate or better improvement. Stacked pulses in the submental region were shown to reduce fat.CONCLUSIONS. The direct application of monopolar radiofrequency to facial and neck skin using a multipass vector (mpave) treatment approach was safely tolerated in patients of all skin types. Patient satisfaction correlated well with photographic analysis, and the technique was shown to be efficacious for most patients.

Nonablative Infrared Skin Tightening in Type IV to V Asian Skin: A Prospective Clinical Study

“…Subsequent reports suggest that using multiple passes with lower-energy settings are probably safer, more tolerable, and efficacious. 5,6 Multiple treatments also tended to give better results than a single treatment. 7,8 In darker Asian skin, monopolar radiofrequency has been shown to be effective as well in treating facial skin laxity.…”

Radiofrequency: Thermage

“…Then, additional vector passes are performed in the direction in which the skin tightening/lift is desired ( Table 1). 27,28 Three to 5 vector passes are performed in the direction of the desired lifting. If the upper lip is treated, wet gauze can be placed between the teeth and upper lip for comfort.…”

Animal Model to Explain Fat Atrophy Using Nonablative Radiofrequency

“…NARF has been used to reduce wrinkles and saggy skin in the face. 8,9 With this purpose, areas serving as anchoring points are treated thoroughly in order to induce contraction of the skin and ''lifting'' of the areas pending from it. This is why temple areas are treated to reduce nasolabial folds.…”