Comparative Study of Monopolar Radiofrequency and High-Intensity Focused Ultrasound for Facial Rejuvenation: A Split-Face Approach

BACKGROUND The increasing demand for nonsurgical antiaging treatments has popularized monopolar radiofrequency and high-intensity focused ultrasound. Although both skin laxity and wrinkles improve, the optimal treatment sequence is unclear. OBJECTIVE To evaluate the efficacy and safety of sequential monopolar radiofrequency and high-intensity focused ultrasound treatments for facial rejuvenation by specifically examining the impact of the treatment sequence on clinical outcomes. MATERIALS AND METHODS A split-face study of 24 Korean adults compared monopolar radiofrequency followed by high-intensity focused ultrasound and high-intensity focused ultrasound followed by monopolar radiofrequency. Clinical assessments were conducted on days 30 and 90, and a three-dimensional camera was used to evaluate changes in wrinkles and pores. RESULTS Both treatment sequences resulted in clinical improvements with minimal side effects; however, the three-dimensional camera analysis indicated that monopolar radiofrequency followed by high-intensity focused ultrasound demonstrated slightly better wrinkle reduction. The histological results indicated increases in collagen I, III, and IV and laminin; however, marked differences between sequences were not observed. CONCLUSION Monopolar radiofrequency and high-intensity focused ultrasound are safe and effective for facial rejuvenation. However, wrinkle reduction with monopolar radiofrequency followed by high-intensity focused ultrasound was better than that with high-intensity focused ultrasound followed by monopolar radiofrequency.