Improvement of neck and cheek laxity with a nonablative radiofrequency device: A lifting experience

OBJECTIVE. Laxity of cheek and neck skin is a common cosmetic complaint of patients as they age. Improvement of skin laxity can be difficult to achieve without invasive surgical lifting procedures. The object of this study was to evaluate the safety and efficacy of a novel nonablative radiofrequency device in the treatment of cheek and neck laxity. METHODS. Fifty patients (skin phototypes I to IV) with mild-to-moderate cheek laxity (n=30) or neck laxity (n=20) received one treatment with a radiofrequency device (ThermaCool; Thermage Corp., Hayward, CA). Topical anesthetic cream was applied under occlusion for 60 minutes before treatment of the skin extending laterally and inferiorly from the nasolabial folds to the preauricular regions and mandibular ridge for treatment of the cheeks and from the mandible to mid neck for treatment of the neck. Clinical improvement of treatment areas was independently determined by three masked assessors' evaluations of comparative photographs at baseline, immediately after treatment, at 1 week, and at 1, 3, and 6 months after treatment using a quartile grading scale (0=less than 25%, 1=25% to 50%, 2=51% to 75%, 3=more than 75% improvement). Patient satisfaction surveys were also obtained at each follow-up visit. RESULTS. Significant improvement in cheek and neck skin laxity was observed in the majority of patients. Patient satisfaction scores paralleled the clinical improvements observed. Side effects were mild and limited to transient erythema, edema, and rare dysesthesia. No scarring or pigmentary alteration was seen. CONCLUSIONS. Noninvasive radiofrequency bulk dermal heating of skin can achieve safe and effective tissue tightening of the cheeks and neck. Although tightening continued to be evident 6 months after a single treatment, the longevity of clinical results has yet to be determined.