Skin rejuvenation and wrinkle reduction using a fractional radiofrequency system.

Skin resurfacing has evolved rapidly over the past 15 years from ablative techniques to nonablative methods and most recently fractional ablative resurfacing. The purposes of this study were to analyze the degree of tissue ablation, coagulation, and heating; and to evaluate the clinical efficacy and safety of a fractional radiofrequency (RF) device, for the treatment of wrinkles with fractional skin ablation and coagulation.Individuals scheduled for abdominoplasty received fractional RF treatment to the abdomen area, using different tips at varying energy densities and coverage rates. Biopsies were performed ex vivo following abdominoplasty and tissue samples were routinely processed and stained, using hematoxylin and eosin). Another group of subjects received 3 facial treatments, scheduled at 3 to 4 week intervals. Clinical improvement and response to therapy were evaluated with standardized photography and clinical assessment by the subjects and investigators.Histological findings immediately posttreatment revealed demarcated zones of ablation/coagulation/necrosis and subnecrosis up to a depth of 450 microm. Higher energy levels generated deeper effects. We noticed a tunable balance between ablation and coagulation/necrosis. These effects were coverage mode and energy density dependent. Subjects undergoing facial treatment had minimal pain, no permanent side effects, or significant downtime. Investigators' assessment for improvement in skin texture correlated with subjects' evaluation and was greater than 40% for approximately 50% of subjects. Eighty percent of the subjects were satisfied with the results. Higher energy levels and lower coverage rates produced better aesthetic results along with less pain.The clinical observations and histological findings suggest that fractionated ablative skin resurfacing using a fractional radiofrequency device resulted in a safe, tolerable and effective improvement in skin texture and reduction of wrinkles. The depth of tissue ablation, coagulation and necrosis and the relative proportions of these phenomena were found to be controllable and could be modulated to optimize treatment of variable dermatologic conditions.