Synchronous Fractional Radio-Frequency Ablative and Non-Ablative Treatment for Comprehensive Rejuvenation of Aging Skin

Facial aging is a combination of intrinsic, hereditary and extrinsic forces. Extrinsic factors, including UV light exposure, smoking and diet, combined with the heretics and intrinsic aging factors results in facial deflation (loss of fat), descent (laxity) and deterioration (aging skin). Skin aging and deterioration is characterized by reduced and abnormal collagen, elastin and ground substances, together with discoloration, both in increased melanin based lesions and vascular proliferation. Anti-aging physicians have generally had to combine various lasers, intense pulsed light (IPL), infrared (IR) and radio-frequency (RF) energy systems to treat the combination of these aging dermal and epidermal elements. (Table 1). Fractional and non-fractional radio-frequency energy systems have become popular options in the treatment of skin laxity and wrinkles, but have not been generally effective in treating vascular and melanin based dyschromia of the aging skin. This paper reports on the comprehensive anti-aging effects of a novel new fractional radio-frequency device, the Fractora (Invasix, Yokneam, Israel).

An analysis of the technologies listed in Table 1 reveals the following therapeutic interventions are required for the wide array of aging effects we see in the skin:

• Pigmented malformation treatment requires superficial ablation or coagulation
• Vascular lesion treatment requires coagulation of blood vessels in papillary and reticular dermis
• Wrinkle treatment requires ablative and/or sub-necrotic heating of the reticular dermis
• Skin laxity improvement requires deeper heating of the reticular dermis and dermal-fat junction

The ideal situation for the aesthetic professional would be to have one technology with the tunable ability to address all the clinical manifestations of aging skin. The principal difference between the ablative and non-ablative RF in the novel device used in the current study, when compared with light based deep fractional ablation is that the action of RF is not limited by the ablation crater and adjacent tissue based upon a chromophore, but rather, RF current flows through the ablative lesion and the entire reticular dermis, creating the potential for additional anti-aging effects [10].

This current study describes the results of the clinical evaluation of a novel fractional radio-frequency ablative and semi-ablative treatment used to treat the multiple aging pathologies of the skin.