Some lasers are carving a niche within the market. For example, the Fotona4D from Fotona (Slovenia) makes laser-based face lifting a reality via the SP Dynamis. Offering a unique combination of four distinct modes of aesthetic treatment, harnessed in concert to combat facial aging, both the exterior facial and interior oral cavity can be treated, enabling full-thickness contraction of collagen for persistent tightening and volumization without injectables.
With two laser wavelengths (Er:YAG and Nd:YAG), the company says anti-aging is comprehensively approached from four different levels, working on deeper, medialand superficial connective structures of the skin, as well as targeting imperfections. Furthermore, Fotona4D is a popular application among patients because it not only offers effective anti-aging, but also because there is little or no downtime, no anesthesia and the procedure can be performed year-round.
Another option is the novel PICOCARE picosecond laser system from Wontech (Daejeon, Korea), which features dual wavelengths (532 nm and 1064 nm) and a variety of handpieces, including zoom, collimation, 595 nm, 660 nm, and HEXA MLA. In particular, the HEXA MLA fractional handpiece creates plasma-induced cavitation in the epidermis and/or dermis, which activates fibroblast and collagen synthesis without damaging the epithelium and basal membrane. Unlike conventional ablative fractional laser systems, HEXA MLA stimulates neocollagenesis and collagen remodeling via photomechanical effects rather than photothermal, resulting in lower incidence of thermal damage and other adverse effects. With a single treatment, rhytides, fine lines and wrinkles are improved.
When Michael H. Gold, M.D., medical director of Gold Skin Care Center and the Tennessee Clinical Research Center, in Nashville, Tenn., thinks of non-surgical, energy-based facial skin tightening, his go-to device categories are radiofrequency (RF) and ultrasound. “There are a lot of RF devices that achieve tightening,” Dr. Gold said.
RF devices are being used to not only tighten skin, but also reduce small areas of fat.
Among the bulk heating RF devices in his practice are Alma’s Accent Prime, Endymed’s 3Deep, Venus Concept’s Legacy, BTL’s Exilis Ultra 360, Thermi’s ThermiSmooth, Syneron-Candela’s eMatrix and Solta’s Thermage.
“I think they all have a benefit,” stated Dr. Gold. “What I tell people about RF is every company has a story – a way that they deliver their energy a little bit differently than any of the others.” Another differentiator is whether devices are monopolar or bipolar. Thermi, Exilis and Thermage are monopolar; the rest are bipolar, he explained.
Monopolar devices are more powerful, so patient comfort can become an issue. But manufacturers are working on making monopolar treatments less painful.
Dr. Rümmelein uses the eTwo fractionated radiofrequency (RF) device from Candela (Irvine, California, U.S.), to treat skin types IV and V. One of the best indications for using the technology is to address loss of elasticity, she shared.
“I am very impressed by the results of RF technology on the skin,” Dr. Rümmelein said. “It can be used on all skin types. You really see significant differences with diminished nasolabial folds, reduced wrinkles, greater jawline definition and more. I use it for full-face elasticity loss, laxity and volume loss.”
Monopolar RF devices, such as Thermage, achieve a mild level of skin contraction, Dr. Fabi noted.
Thermage FLX from Solta Medical is a new FDA-cleared skin tightening solution that is uniquely indicated for periorbital (including eyelids) and full-facetreatments. Harnessing non-invasive RF energy and delivering it deeply within the dermis to tighten, remodel existing collagen and stimulate neocollagenesis, this system can be used on all skin types, and features patented AccuREP technology, a real-time feedback-controlled per-pulse adjustment of RF delivery that improves precision and predictability.