Sykor iFrax: The Search for the Fountain of Youth
According to popular legend, Juan Ponce de Leon discovered what is now the State of Florida while searching for the Fountain of Youth. Since Dr. Leon Goldman’s pioneering work treating actinic cheilitis with the CO2 laser in 1968, doctors and scientists have been searching for the technological equivalent of de Leon’s Fountain. Many experts believe that Ponce de Leon’s quest has finally been fulfilled with the advent of fractional radiofrequency (FRF).
Market demand for cosmetic facial enhancement and rejuvenation procedures with minimal down time and low risk spurred the development of a number of technologies for non-surgical skin rejuvenation and “anti-aging” treatments. “Ablative” CO2 laser skin resurfacing was introduced in the mid 1990’s. Ablative devices can be used to precisely remove the upper layers of photo-damaged and aging skin as an alternative to chemical peels.
The earliest models of ablative lasers were found to be capable of impressive clinical results but required considerable skill to operate. In addition, the first generation of laser resurfacing systems were – unfortunately– associated with prolonged healing times and high complication rates, particularly in darker skin patients. These limitations resulted from the fact that the entire epidermis and often the papillary dermis also were removed, often over large skin areas such as the entire face.
A new generation of laser resurfacing systems was introduced in 2003 with the development of the “fractional” laser. Instead of treating the entire skin area, fractional lasers treat only a condensed matrix of small “islets” of tissue, and leave the skin in-between these islets intact. Healing is immediately initiated from these intact skin areas, resulting in reduced downtime and reduced complications. Since the introduction of the first fractional laser system, a myriad of fractional laser systems, utilizing CO2, Erbium:Glass and Erbium:YAG laser technology, have been developed and cleared for marketing worldwide.
The latest advance in aesthetic medicine utilizes radiofrequency (“RF”) energy as opposed to the light energy utilized by lasers. Both light and RF are forms of electromagnetic energy. However, the mechanisms of action used by each to treat the skin are quite different. Light-based devices operate on the basis of selective photothermolysis (photons are absorbed by tissue chromophores and light energy is transformed into heat). When RF energy is applied to the skin surface, rapidly oscillating electromagnetic fields cause movement of charged particles within the skin and the resultant molecular motion generates heat. RF devices are not “new”. In fact, this source of heat has been extensively used in surgery for hemostasis and tissue ablation (electro-surgery) for over fifty years. In the past decade, however, RF has been widely applied in the field of aesthetics for various indications based on skin tightening generated by deep RF dermal heating with resultant collagen remodeling. The latest advance in aesthetic technologies has been the development of micro-fractional RF systems. These devices enable RF energy to be used for controlled fractional skin resurfacing, and can achieve results similar to fractional laser systems without the risk of pigmentary changes resulting from absorption of energy by epidermal melanocytes. By adjusting the operating parameters—depth of needle insertion, energy level and the duration of application of the energy, fractional RF systems allow the practitioner to treat either or both the epidermal and/or dermal skin layers. Fractional RF devices can safely and effectively treat a wide variety of treatment indications, including wrinkles, skin tightening, pigmented lesions, and acne scars. And because RF energy can be entirely concentrated in the dermis if desired—in effect bypassing the epidermis– dermal stimulation of new collagen can be optimized with little or no risk or patient downtime.