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Fractional Radiofrequency Microneedling: A Novel And Non-invasive Treatment For Festoons
Nicholas Elmer, BS1, Garrett Ni, MD2, Roselind Ni, BS1, Morris Hartstein, MD3, Allan Wulc, MD4.
1Sidney Kimmel Medical College, Philadelphia, PA, USA, 2Temple University Hospital, Philadelphia, PA, USA, 3Ophthalmic Plastic and Reconstructive Surgery, Tel Aviv, Israel, 4W Cosmetic Surgery, Plymouth Meeting, PA, USA.

PURPOSE: Festoons are characterized by laxity of the skin and orbicularis muscle between the medial and lateral canthi. There are numerous surgical and nonsurgical options for the treatment of festoons with varying efficacy. Recently, fractional radiofrequency miconeedling (FRM) has gained popularity as an efficacious treatment option for facial rejuvenation and skin tightening, but has only been described in small case reports for the treatment of festoons. Our study is the largest to demonstrate the safety and efficacy of FRM in the treatment of festoons.
METHODS: We performed a retrospective chart review of patients treated with FRM at a single-surgeon private practice from 2010 to 2021. Photographs of festoons pre- and post- treatment were scored individually by four separate physicians. Scoring of festoons was based on previously described classification system.
RESULTS: 25 patients and 50 individual festoons were included in this study. 92% (23/25) patients were female. All patients had a history of prior festoon treatment including toxin, filler, or both. 44% (11/25) had prior surgical intervention for festoon treatment including blepharoplasty, facelift, ptosis repair, or liposculpture. The mean (SD) pre- and post-treatment festoon scores were 1.35 (0.95) and 0.46 (0.60) (p < 0.05). The mean time between the most recent FRM treatment and post-treatment follow-up was 70 days.
CONCLUSION: Non-invasive cosmetic treatments and technologies have recently gained immense popularity. FRM represents a novel technology with many applications including festoons. This is the largest study to detail the safety and efficacy of FRM in the treatment of festoons.


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