Effect of Synchronized Radiofrequency and High-Intensity Facial Electrical Stimulation (HIFES) of the Upper Face

Background: Effects of upper facial aging can present as static forehead and periorbital rhytids as well as soft tissue volume loss. The latter can prompt in conjunct with bony changes of the calvaria eyebrow and eyelid ptosis. Injection-based treatments can yield positive outcomes but are not free of procedural risks. Objectives: To assess the clinical outcome of synchronized radiofrequency (RF) and high intensity facial electric stimulation (HIFES) when targeting the upper face with special focus on the effects of musculature, subcutaneous fatty layer, and eyebrow position. Methods: This non-randomized, prospective study included 37 subjects with a mean age of 45.46 years and a mean BMI of 21.84 kg/m2. Subjects received four synchronized RF and HIFES treatments spaced seven days apart. Efficacy measurements were taken at 4-, 16-, and 24-weeks post-treatment using three-dimensional surface imaging, surface electromyography (EMG), and high-resolution facial ultrasound. Results: Forehead and lateral canthal line severity improved statistically significantly at each follow-up visit when compared to baseline with all p<0.001. At week 24, the position of medial/central/lateral eyebrows increased by 3.18/3.02/2.27 mm when compared to baseline with p < 0.001, respectively. At week 24, no statistically significant changes were observed in the thickness of frontalis muscle or of the overlying fatty layer. Conclusions: The application of synchronized RF and HIFES to the frontal region reduced frontal and lateral canthal rhytids and elevated the position of the eyebrow until week 24 after the initial treatment. Based on the results obtained, this non-invasive energy-based treatment option could be a viable alternative to injectable treatments of the upper face when trying to ameliorate the signs of upper facial aging.