'Less Is More' When it Comes To Radiofrequency Treatment

PHOENIX — Adding laser lipolysis to radiofrequency tightening procedures for submental and jowl area fat did not significantly increase patient satisfaction, based on the results of a small study.

"So my take-home message [is] maybe less is more," Dr. Susan Van Dyke said at the joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery.

She and her colleagues studied 36 patients. One group of 13 patients received monopolar radiofrequency treatment alone; 10 were treated with laser lipolysis alone; and 13 were treated with a combination at the same sitting.

The investigators compared patient satisfaction and blinded evaluator assessment among the different fat reduction treatments. Patient satisfaction "in private practice is what it is all about," said Dr. Van Dyke, a cosmetic dermatologist in private practice in Paradise Valley, Ariz.

Monopolar radiofrequency provides immediate collagen contracting with better remodeling over time. The treatment can produce a nice improvement in the neckline and jawline—a better contour, Dr. Van Dyke said. "You get nice tightening with radiofrequency alone." Patients were treated to the usual end point of some discomfort, described as, "It hurts, but I can tolerate it for a while."

The patients and blinded assessors rated submental tightening on a 1- to 5-point scale at 6 months. Radiofrequency treatment alone yielded an average 3.6 patient satisfaction rating. Blinded raters, who gauged response using standardized clinical photos, gave this treatment an average rating of 3.4.

Laser lipolysis uses a laser to heat and dissolve fat cells and a 1- to 2-mm cannula to drain the liquefied fat. The patients in the laser lipolysis monotherapy group were treated with a 10-W device with a 1,064-nm Nd:YAG laser. The treatment end point was a surface temperature of 102°–104°F.

Average patient satisfaction with this approach was 3.1. Blinded observers rated response higher, an average of 3.9. "We had six complications," Dr. Van Dyke said. "All resolved, but this may be why patients were not as satisfied."

Patients in the combined treatment group rated their satisfaction an average of 3.6. "Combined treatment seemed to be just as good as radiofrequency by itself; both were rated 3.6 by patients," Dr. Van Dyke said.

The blinded raters gave the combination an average score of 3.7, slightly below their 3.9 rating for results with laser lipolysis alone.

"I care about the satisfaction of my patients," Dr. Van Dyke said. "From a clinical standpoint, patients like the radiofrequency and the combination, and are a little less enthusiastic about laser lipolysis alone."

Dr. Van Dyke is on the speakers bureau for Solta Medical Inc., Lumenis Ltd., Stiefel Laboratories Inc. (RevaléSkin), and Valeant Pharmaceuticals International and is a stockholder in Medicis Pharmaceutical Corp. and Allergan Inc.

PHOENIX — Adding laser lipolysis to radiofrequency tightening procedures for submental and jowl area fat did not significantly increase patient satisfaction, based on the results of a small study.

"So my take-home message [is] maybe less is more," Dr. Susan Van Dyke said at the joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery.

She and her colleagues studied 36 patients. One group of 13 patients received monopolar radiofrequency treatment alone; 10 were treated with laser lipolysis alone; and 13 were treated with a combination at the same sitting.

The investigators compared patient satisfaction and blinded evaluator assessment among the different fat reduction treatments. Patient satisfaction "in private practice is what it is all about," said Dr. Van Dyke, a cosmetic dermatologist in private practice in Paradise Valley, Ariz.

Monopolar radiofrequency provides immediate collagen contracting with better remodeling over time. The treatment can produce a nice improvement in the neckline and jawline—a better contour, Dr. Van Dyke said. "You get nice tightening with radiofrequency alone." Patients were treated to the usual end point of some discomfort, described as, "It hurts, but I can tolerate it for a while."

The patients and blinded assessors rated submental tightening on a 1- to 5-point scale at 6 months. Radiofrequency treatment alone yielded an average 3.6 patient satisfaction rating. Blinded raters, who gauged response using standardized clinical photos, gave this treatment an average rating of 3.4.

Laser lipolysis uses a laser to heat and dissolve fat cells and a 1- to 2-mm cannula to drain the liquefied fat. The patients in the laser lipolysis monotherapy group were treated with a 10-W device with a 1,064-nm Nd:YAG laser. The treatment end point was a surface temperature of 102°–104°F.

Average patient satisfaction with this approach was 3.1. Blinded observers rated response higher, an average of 3.9. "We had six complications," Dr. Van Dyke said. "All resolved, but this may be why patients were not as satisfied."

Patients in the combined treatment group rated their satisfaction an average of 3.6. "Combined treatment seemed to be just as good as radiofrequency by itself; both were rated 3.6 by patients," Dr. Van Dyke said.

The blinded raters gave the combination an average score of 3.7, slightly below their 3.9 rating for results with laser lipolysis alone.

"I care about the satisfaction of my patients," Dr. Van Dyke said. "From a clinical standpoint, patients like the radiofrequency and the combination, and are a little less enthusiastic about laser lipolysis alone."

Dr. Van Dyke is on the speakers bureau for Solta Medical Inc., Lumenis Ltd., Stiefel Laboratories Inc. (RevaléSkin), and Valeant Pharmaceuticals International and is a stockholder in Medicis Pharmaceutical Corp. and Allergan Inc.

PHOENIX — Adding laser lipolysis to radiofrequency tightening procedures for submental and jowl area fat did not significantly increase patient satisfaction, based on the results of a small study.

"So my take-home message [is] maybe less is more," Dr. Susan Van Dyke said at the joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery.

She and her colleagues studied 36 patients. One group of 13 patients received monopolar radiofrequency treatment alone; 10 were treated with laser lipolysis alone; and 13 were treated with a combination at the same sitting.

The investigators compared patient satisfaction and blinded evaluator assessment among the different fat reduction treatments. Patient satisfaction "in private practice is what it is all about," said Dr. Van Dyke, a cosmetic dermatologist in private practice in Paradise Valley, Ariz.

Monopolar radiofrequency provides immediate collagen contracting with better remodeling over time. The treatment can produce a nice improvement in the neckline and jawline—a better contour, Dr. Van Dyke said. "You get nice tightening with radiofrequency alone." Patients were treated to the usual end point of some discomfort, described as, "It hurts, but I can tolerate it for a while."

The patients and blinded assessors rated submental tightening on a 1- to 5-point scale at 6 months. Radiofrequency treatment alone yielded an average 3.6 patient satisfaction rating. Blinded raters, who gauged response using standardized clinical photos, gave this treatment an average rating of 3.4.

Laser lipolysis uses a laser to heat and dissolve fat cells and a 1- to 2-mm cannula to drain the liquefied fat. The patients in the laser lipolysis monotherapy group were treated with a 10-W device with a 1,064-nm Nd:YAG laser. The treatment end point was a surface temperature of 102°–104°F.

Average patient satisfaction with this approach was 3.1. Blinded observers rated response higher, an average of 3.9. "We had six complications," Dr. Van Dyke said. "All resolved, but this may be why patients were not as satisfied."

Patients in the combined treatment group rated their satisfaction an average of 3.6. "Combined treatment seemed to be just as good as radiofrequency by itself; both were rated 3.6 by patients," Dr. Van Dyke said.

The blinded raters gave the combination an average score of 3.7, slightly below their 3.9 rating for results with laser lipolysis alone.

"I care about the satisfaction of my patients," Dr. Van Dyke said. "From a clinical standpoint, patients like the radiofrequency and the combination, and are a little less enthusiastic about laser lipolysis alone."

Dr. Van Dyke is on the speakers bureau for Solta Medical Inc., Lumenis Ltd., Stiefel Laboratories Inc. (RevaléSkin), and Valeant Pharmaceuticals International and is a stockholder in Medicis Pharmaceutical Corp. and Allergan Inc.