Thermo‐Mechanical Fractional Injury Therapy for Facial Skin Rejuvenation in Skin Types II to V: A Retrospective Double‐Center Chart Review

Abstract

Background and Objectives: Thermo-mechanical fractional injury (TMFI) therapy (Tixel®; Novoxel®, Netanya, Israel) is an innovative technology. Along with its drug delivery enhancement features, it is widely used for facial skin rejuvenation. Our study explores the beneficial effect of the Tixel® on the different features of facial skin rejuvenation along with patients′ satisfaction rate, aiming to suggest practical recommendations for an optimal aesthetic result. Study Design/Materials and Methods: A retrospective chart review of 24 patients (20 women, 4 men, average age 56 years old) with skin types II-V who received 2 or 3 Tixel® treatments, 3-5 weeks apart in two medical centers (12 from Israel, 12 from the United Kingdom). Four experienced dermatologists compared standardized clinical photographs taken before each treatment and 3 months after the final treatment based on seven parameters that were set by 10 physicians and rated the difference on a scale of −1 to 4. Furthermore, epidemiology, treatment data, satisfaction, and safety were reviewed. Results: Out of the seven parameters that were compared (blood vessels and erythema, skin complexion, periorbital wrinkles, pigmentation and toning, pore size, vitality, wrinkles, and laxity), all features demonstrated an overall improvement, with the greatest improvement demonstrated in skin complexion (2.1± 0.49) and periorbital wrinkling (2.09 ± 0.65) followed by vitality (1.7 ± 0.49). Side effects were transient, including erythema and hyperpigmentation, and the average downtime was 1.7 days. Conclusion: TMFI is a safe and effective method for improving facial skin quality. Addressing patient′s expectations while maximizing the benefits of this novel technology will provide superior aesthetical results.

Treatment of periorbital wrinkles using thermo‐mechanical fractional injury therapy versus fractional non‐ablative 1565 nm laser: A comparative prospective, randomized, double‐arm, controlled study

“…It has been previously shown that pulse durations around 6 milliseconds are used for drug delivery and those greater than 10 milliseconds are used for rejuvenation; common settings for rejuvenation are 12-14 milliseconds. 11,25,26 As the periorbital region is a sensitive area, coordinating treatment at two centers in different countries with diverse populations warranted more conservative treatment parameters. The depth was chosen based on the depth of the periorbital skin to the reach the papillary dermis ~300 µm (Figure 1).…”

“…TMFI technology is an excellent modality for drug delivery owing to its formation of micronsized wells in the epidermis lined by a thin rim of coagulation. 11,[27][28][29] As wrinkling in the periorbital region is exacerbated by constant contraction of the orbicularis oculi muscles with facial expression, the use of TMFI technology to deliver botulinum toxin may achieve a more profound improvement, by both diminishing muscle contraction and stimulating collagen production and remodeling in a region where the skin is thinnest.…”

“…In this study, we chose a more conservative approach with a pulse duration of 10 milliseconds and 500 µm protrusion. It has been previously shown that pulse durations around 6 milliseconds are used for drug delivery and those greater than 10 milliseconds are used for rejuvenation; common settings for rejuvenation are 12–14 milliseconds 11,25,26 …”

“…Such technology offers an user-friendly method for performing fractional skin treatment, including the periorbital region and was recently demonstrated to moderately improve periorbital wrinkling as well. 11 The purpose of this clinical trial is to compare the efficacy and adverse event (AE) profile of TMFI with 1565 nm Er:glass fiber laser in the treatment of periorbital wrinkling.…”

“…Safety goggles are not required. Such technology offers an user‐friendly method for performing fractional skin treatment, including the periorbital region and was recently demonstrated to moderately improve periorbital wrinkling as well 11 …”