Radio frequency (RF) hyperthermia focuses on raising the target area temperature to a value exceeding 45°C. Collagen is stimulated when the temperature rises to 45°C at the dermal layer, resulting in skin tightening. However, most studies on RF hyperthermia have focused on tumor ablation or using electrodes to radiate an electromagnetic field, which is highly inefficient. This study proposed a non-invasive RF hyperthermia skin-tightening system with a compact metamaterial-filled waveguide aperture antenna. The proposed RF system increased the temperature by 11.6°C and 35.3°C with 20 and 80 W of 2.45 GHz RF power, respectively, within 60 s and exhibited a very focused effective area. Furthermore, a metamaterial was proposed to reduce the size of the waveguide aperture antenna and focus the electromagnetic field in the near-field region. The proposed metamaterial-filled waveguide aperture antenna was compact, measuring 10 mm × 17.4 mm, with a peak gain of 2.2 dB at 2.45 GHz. The measured hyperthermia performance indicated that the proposed RF system exhibited better power- and time-efficient hyperthermia performance than other RF hyperthermia systems in the cosmetic skin lifting commercial market. The proposed RF hyperthermia systems will be applied into a new generation of beauty cosmetic devices.

UNASSIGNED: High-intensity focused ultrasound (HIFU) and monopolar radiofrequency (MRF) are common treatment modalities that have shown significant results in skin tightening. Nevertheless, the novel combination of these two treatments is new to the Malaysian landscape. Thus, this study aims to investigate the safety and efficacy of this novel combination treatment for the Malaysian population.
UNASSIGNED: This retrospective study included data on HIFU and MRF combination therapy for skin tightening collected from an aesthetic clinic in Johor Bahru, Malaysia from June 2018 to May 2021. Efficacy was assessed using the Global Aesthetic Improvement Scale (GAIS) and Glogau classification, while the safety of the treatment was analysed using pain scores and adverse events (AEs).
UNASSIGNED: A total of 56 patients with a mean age of 47.7 years old (SD 10.00) were included in this study. The majority of the patients had Fitzpatrick skin types III and IV. Most of the patients were Chinese, followed by Malay, Indian and others. Most patients (96.4%) showed clinically significant improvement in skin tightening after treatment, with 15 patients scoring 1 (very much improved) and 39 scoring 2 (improved). All patients reported transient mild erythema, with no serious AEs, such as burn, swelling, numbness or muscle weakness. Among the patients, 80% reported a pain score of 5, while 10% reported pain scores of 4 and 6.
UNASSIGNED: Combining HIFU with MRF therapy improved GAIS scores by 96.4%, indicating a secure and efficient skin-tightening method. Transient erythema was shown to be the most common side effect of this combination.

Facial skin tightening with wrinkle/fine line reduction is a highly demanded procedure in the aesthetic field. Although there are studies focused on the types of energy sources, the total amount of thermal energy, and the affected depth, there have been no reports examining the relationship between the shape of thermal energy and the directivity of skin tightening. We have developed a specific method to apply thermal energy to the dermis in continuous parallel lines, resembling a thread, perpendicular to the Relaxed Skin Tension Lines (RSTL) for vectorized collagen contraction using synchronous ultrasound parallel beam technology.
To evaluate the safety, tightening capability, and directivity of the Thermal Thread Technique™ utilizing a high-intensity, high-frequency, parallel ultrasound beam.
A total of 34 cases, both males and females aged between 30 and 70 years with Fitzpatrick skin types 2-4, exhibiting mild to moderate skin laxity, participated. All subjects received one treatment using the Thermal Thread Technique™ utilizing high-intensity, high-frequency parallel ultrasound beam to cover the full face and submental area. 3D clinical images were captured before, 8 weeks, and 24 weeks after the treatment. A quantitative image analysis of captured 3D images was performed to objectively measure the direction and distance of contraction.
The average contraction distance from baseline (0 mm) to 8 weeks and 24 weeks posttreatment were 1.91 ± 0.61 mm (p < 0.001) and 1.96 ± 0.67 mm (p < 0.001) respectively. Regarding the contraction direction at 24 weeks posttreatment, the angle formed between the contraction direction and the base axis, which is perpendicular to the RSTL, was + 9.85° ± 32.94°. Out of 34 cases, 28 met the criteria with the angle within ±22.5° of the base axis (p < 0.001). The average pain score on a 0-5 scale (0 being no pain, and 5 being maximum pain) was 2.63 ± 0.78. No side effects were reported during the treatment or observation period.
The Thermal Thread Technique™ utilizing a high-intensity, high-frequency, parallel ultrasound beam was proven to be clinically safe and effective for vectorized facial skin tightening.

BACKGROUND: Ultrasound energy has been used for dermal rejuvenation to treat fine lines, wrinkles and to lift lax skin. High intensity ultrasound waves induce thermal injury in the dermis, stimulating neocollagenesis and neoelastinogenesis.
OBJECTIVE: To assess the efficacy, utility, and safety of a novel ultrasound device that uses high-intensity, high-frequency, non-focused ultrasound parallel beams to lift lax facial skin in the eyebrow, submental, and neck areas.
METHODS: Fifteen subjects aged 40-69 years were enrolled in a prospective clinical trial. Two treatment sessions were performed with the high-intensity non-focused ultrasound parallel beam device followed by 3- and 6-month follow-up visits. Treatment results were assessed by study investigators, evaluating baseline and posttreatment photographs by applying physician global aesthetic improvement scale. Pain was evaluated immediately after each treatment using 0-10 visual analog scale. Any adverse event that occurred during the study period was documented and examined.
RESULTS: Fifteen subjects with a mean age of 55 ± 2 years completed the study. Photographs that were taken at baseline and follow-up visits were compared and examined. An improvement pattern was detected in all treated areas in both follow-up visits and persisted stably throughout the study. The mean pain score was 5.6 according to the visual analog scale.
CONCLUSIONS: The novel ultrasound device that uses high-intensity, high-frequency, non-focused ultrasound parallel beam was shown to improve safely and efficiently facial lax skin resulting in eyebrow, submental, and neck skin lift while experiencing tolerable pain.

Focused ultrasound (FUS) is emerging as one of the most promising, non-invasive treatment techniques. The advancement of transducer technology has paved the way for dermatological applications. A comprehensive review is presented for healthcare practitioners and researchers, summarizing the effect of various operational parameters on the injury zone produced by ultrasound beams for various dermatological applications, which include skin tightening, fat reduction, hyperpigmentation and cancer treatment. In this article, we aim to highlight the efficient operational parameters of FUS to enhance pain relief during surgery and its affordability for skin treatment. Finally, a prospective future technique for efficient FUS is discussed.

Ultrasound energy is delivered to the dermal and subdermal tissue to induce thermal injury, leading to collagen remodeling and resulting in lifting and tightening of the skin. Ulthera and Sofwave are two Food and Drug Administration-approved systems that have demonstrated clinically significant results in providing eyebrow, submental, and neck lift and minimizing facial fine lines and wrinkles. Patient selection and management of expectations are important components to a successful treatment process. Both devices boast high patient satisfaction rates, minimal recovery time, and excellent safety profile. Ultrasound technology is an effective, nonsurgical option for facial rejuvenation.

In recent years, the demand for noninvasive aesthetic treatments has increased significantly. New systems and technological innovations open new possibilities for practitioners and patients in the field of body contouring, noninvasive face lifting, skin tightening and rejuvenation, as well as effective therapies for urinary incontinence or erectile dysfunction. Currently, the most well-known innovations include technologies such as high-intensity focused electromagnetic field (HIFEM™) and radiofrequency (RF), which, after more than 30 years of research, could be combined in the RF-SYNCHRODE™ (BTL Medizintechnik GmbH, Prague, Czech republic) without any health risks for the patient. This allows the reduction of adipose tissue and the building of muscle in a single treatment. The newer HIFES™ technology was developed specifically for the treatment of the facial area and facial muscles. It is used with synchronized radiofrequency for noninvasive, painless face lifting and skin tightening, and is also suitable for botulinum toxin patients. Visible, noticeable, and long-lasting treatment results are achieved without significant side effects after only 4-6 sessions. These noninvasive, FDA(Food and Drug Administration)- and CE-certified systems are used in everyday practice and clinical routine in dermatology, gynecology, urology, and physiotherapy and represent a real alternative to invasive aesthetic plastic surgery.
UNASSIGNED: In den letzten Jahren ist die Nachfrage hinsichtlich nichtinvasiver ästhetischer Behandlungen stark angestiegen. Neuartige Systeme und technologische Innovationen eröffnen dabei Behandlern und Patienten neue Möglichkeiten im Bereich der Körperformung, des nichtinvasiven Gesichtsliftings, der Hautstraffung und Hautverjüngung, aber auch von wirkungsvollen Therapien der Harninkontinenz oder erektiler Dysfunktion. Zu den aktuell bekanntesten Innovationen zählen unter anderem Technologien wie HIFEM™ („high-intensity focused electromagnetic field“) und Radiofrequenz (RF), die nach über 30 Jahren Forschungsarbeit ohne gesundheitsgefährdende Risiken für den Patienten in der RF-SYNCHRODE™ (Synchronisierte Radiofrequenz-Technologie) kombiniert werden konnten. Dadurch werden nun die Reduktion von Fettgewebe und der Aufbau von Muskulatur in einer einzigen Behandlung ermöglicht. Die noch neuere HIFES™-Technologie wurde speziell für die Behandlung der Gesichtspartie und der Gesichtsmuskulatur entwickelt. Sie wird mit synchronisierter Radiofrequenz zum nichtinvasiven, schmerzfreien Facelifting und zur Hautstraffung eingesetzt und ist auch für Botulinumtoxin-Patienten geeignet. Sichtbare, spürbare und lang anhaltende Behandlungserfolge werden ohne nennenswerte Nebenwirkungen nach nur 4 bis 6 Sitzungen erreicht. Diese nichtinvasiven, FDA(Food and Drug Administration)- und CE-zertifizierten Systeme von der BTL Medizintechnik GmbH mit Firmensitz in Prag werden im Praxis- und Klinikalltag u. a. in der Dermatologie, der Gynäkologie, der Urologie oder auch der Physiotherapie angewendet und stellen eine wirkliche Alternative zu invasiven ästhetisch-plastischen Eingriffen dar.

In addition to the laser technology, other physical methods are increasingly being used for medical and therefore medical cosmetic purposes. The most frequently used energy sources include the various application forms of radiofrequency (RF). The aim of the use of RF is to vaporize and coagulate tissue through a tissue temperature of >70 °C and to achieve a temperature of 42-44 °C especially in deeper layers, in order to promote a thermally induced collagen regeneration that enables skin tightening over the dermis. Unipolar, monopolar, bipolar, multipolar and fractional RF are suitable for medical applications. The result to be expected cannot compete with surgical lifting but RF is effective in cases of moderately sagging skin.
UNASSIGNED: Neben der Lasertechnologie werden zunehmend weitere physikalische Methoden für medizinische und damit auch medizinkosmetische Zwecke genutzt. Zu den am häufigsten verwendeten Energieträgern zählen die verschiedenen Applikationsformen der Radiofrequenz (RF). Ziel der Anwendung von RF ist es, durch eine Gewebetemperatur von > 70 °C Gewebe zu vaporisieren und zu koagulieren, aber v. a. in tieferen Schichten eine Temperatur von 42–44 °C zu erreichen, um eine thermisch induzierte Kollagenneubildung zu fördern, die eine Hautstraffung über die Dermis ermöglicht. Für die medizinische Anwendung sind die uni- und monopolare, die bipolare, multipolare und fraktionale RF geeignet. Das zu erwartende Ergebnis kann zwar mit operativen Liftings nicht konkurrieren, die RF ist aber bei mäßiger Hauterschlaffung wirksam.

Focussed ultrasound is capable of heating tissue in small microscopic areas up to 65-70 °C and is a technique that can be used not only for destruction of superficial tissue but also for fat reduction. The focussing of sound waves according to the principle of a bundling of rays is carried out without injury to the skin. The penetration depth of the coagulation depends on the wavelength. Wavelengths that reach penetration depths of 6mm, 9mm and even 13mm and therefore deeper layers of the dermis and fat tissue are new. These enable fat cells to be eliminated and ultimately lead to girth reduction and also additionally to tightening. The effectiveness has been confirmed by several studies.
UNASSIGNED: Fokussierter Ultraschall ist in der Lage, Gewebe bis auf 65–70 °C in kleinen mikroskopischen Bereichen zu erhitzen, eine Technik, die nicht nur zur Zerstörung von Oberflächengewebe, sondern auch zum Fettabbau eingesetzt werden kann. Die Fokussierung von Schallwellen nach dem Prinzip einer Strahlenbündelung erfolgt ohne Verletzung der Haut. Die Penetrationstiefe der Koagulation hängt dabei von der Wellenlänge ab. Neu sind Wellenlängen, die Penetrationen von 6 mm, 9 mm und sogar 13 mm und damit auch tiefere Schichten der Dermis sowie das Fettgewebe erreichen, dadurch ermöglichen, Fettzellen zu beseitigen und letztlich zur Umfangsreduktion, aber auch zusätzlich zur Straffung führen. Die Wirksamkeit ist durch mehrere Studien belegt.

UNASSIGNED: With many treatments available for managing cellulite, non-invasive procedures are increasingly sought after. Radiofrequency (RF) and targeted pressure energy (TPE) are new techniques developed to counter aesthetic signs of aging. The combination of RF and TPE for cellulite thus requires a more robust investigation.
UNASSIGNED: We sought to determine the effectiveness and safety of combined/simultaneous RF and TPE for skin tightening and reducing the appearance of cellulite.
UNASSIGNED: Thirty subjects aged 46.5±9.0 (31-74) years, BMI 19.8-36kg/m2 were enrolled and treated for cellulite on the hips, thighs, abdomen and arms. Each subject received four treatments, over 2 to 4 consecutive weeks. The circumference of the treated areas was measured at baseline, after the final treatment session, and at follow-up visits one month, three months and six months following treatment. The efficacy of the therapy was evaluated based on the Cellulite Severity Scale, Global Aesthetic Index Scale, and the Subject Satisfaction Questionnaire. Occurrence of side effects and adverse events was monitored, therapy comfort was analyzed.
UNASSIGNED: Cellulite severity improved from moderate to mild cellulite (p<0.001) in 95 percent of patients. Blinded, independent, evaluators reported aesthetic improvement in 90 percent of subjects. Significant circumference decrease in the abdomen, hips, and thighs was observed six months after treatment (p<0.01). Eighty-six percent of subjects were satisfied with improved cellulite appearance, and 82 percent of patients reported improved skin laxity. No severe side effects or adverse events occurred.
UNASSIGNED: The simultaneous TPE+RF procedure was able to non-invasively improve cellulite appearance in the majority of subjects and may be recommended for skin tightening on various body parts.