Radiofrequency Energy for Denervation of Selected Facial Muscles: Clinical Experiences at Six Months

摘要

The goal of treatment with a unique, bipolar radiofrequency (RF) ablation device is to provide the surgeon with a minimally invasive and neurotoxin altrernative, percutaneous approach to glabellar frowning. Therapeutic RF energy delivered via the probe tip area produces thermal effects that inhibit the designated nerve and produce selective conduction block. In our prospective study, significant glabellar frown reduction was immediately achieved in 80% of patients (40). All 40 of these patients maintained significant results at the 3-month time period, and 78% at the 6-month time period. Bruising and swelling were seen in 6% and 92% of patients respectively, mostly during the first week and resolving within two weeks. The cohort continues to be followed for longer term follow up. Further studies will help determine mass market viability of thermal deneveration as an alternative to injectable nerve paralytic agents. Introduction Radiofrequency (RF) energy has been used successfully in cardiac arrhythmias1 and facial pain conditions such as trigeminal neuralgia.2,3 Recently, a unique bipolar RF ablation device has been developed to produce selective thermal denervation of the eyebrow depressor muscles including the corrugator and procerus muscles. The goal of the procedure is to provide the surgeon with a minimally invasive, percutaneous approach to glabellar frowning without the use of temporary neurotoxins, such as botulinum toxin A (Botox?). The procedure uses an RF needle and generator specifically designed for peripheral motor nerves (RELAXED EXPRESSIONS? System, BioForm Medical Inc., San Mateo, California; Figure 1). Thermal denervation can be performed in an office-based setting or in conjunction with aesthetic facial surgery.