DISCUSSION
hyperemia, paresthesia, erythema, bipolar
HYPEREMIA, MINOR, ERYTHEMA, PARESTHESIA, FACIAL PARALYSIS, SKIN LAXITY, COLD
The short‐term effects obtained both after a single treatment or after three treatments by bipolar RF device for skin ageing and laxity are described.The RF administration was well tolerated with very few minor side effects. One case had a moderate vascular active hyperemia with face erythema, lasting less than 3 h, and another one complained of a short‐term paresthesia on the right cheek, the side that had been previously involved in cold incomplete (fully recovered) facial paralysis.The results suggest that RF significantly improved the skin quality, mainly in terms of total water content, elasticity, and sebum, with a slight increasing trend between pre‐ and 1 h post‐treatment. Furthermore, the increased sebum levels observed after treatment suggest that RF technology restores the microvascular environment and the balance between local lipidic film coating and serum lipidic levels. Total water content (hydration), elasticity, and sebum levels were selected as the most representative indications of beneficial effects.In fact, total water content indicates the capacity of the skin tissue to be moisturized due to the presence of GAGs (e.g., hyaluronic acid). Optimal percentage values should stand above 50%, has achieved for these patients, especially after three treatments.Elasticity is referred as the skin resilience under environmental stress inputs, while tonicity (turgor) is related to the skin structural protein content, such as collagen fibrils. Elasticity and tonicity should be as high as possible (>26%), indicating correct levels of hydration, sebum, elastin and collagen content. A recent research showed that RF improves skin laxity and determines gene activation in a panel of proteins that are relevant in the extracellular matrix of dermal connective tissue.Obviously, the sequence of three RF sessions on a monthly basis achieved more appealing and prolonged cosmetic effects compared with the single treatment, due to a more prolonged intermittent dermal conditioning when the biological effect of the previous RF administration disappears. The rationale for this protocol is supported by histological and ultrastructural studies, in fact the remodeling of collagen bundles with formation of new collagen and expression of messenger RNA for collagen type 1 continues for months after the treatment.In conclusion, our data confirm that the Med‐RF technology represents an important tool to achieve face rejuvenation in the field of non‐invasive cosmetic procedures, and because of the safety and effectiveness of the treatment, it should be administered as a not invasive cosmetic treatment in the great majority of the ageing population, which is constantly and actively looking for a painless, conservative, and appealing approach.