Aesthetic evolution drives birth of minimally invasive surgery subgroup.

[BACKGROUND] Facial and neck skin tightening, and rejuvenation began decades ago with maximally invasive incisional face-lift surgery. Aesthetic trends, patient demands, and innovative technology brought about minimally invasive and noninvasive interventions-such as radiofrequency, ultrasound, laser and intense pulsed light as well as dermal fillers and other injectables-to address facial and neck skin laxity. These procedures reduce facial and neck skin laxity with less risk and less downtime than maximally invasive face-lift or face-lift plus liposuction; however, these interventions are often deemed to offer reduced results.

[AIMS] To evaluate the safety and efficacy-as well as patient satisfaction-of Rotational Fractional Resection (RFR) in subjects with mild-to-moderate submental fat and mild-to-moderate submental skin laxity.

[MATERIALS] Rotational fractional resection with the Nuvellus (Recros, Inc) platform, which uses 1.5 mm in diameter rotating scalpels-termed scalpets-to resect lax skin followed by a rotating cannulas to perform focal lipectomy through resected access ports.

[METHODS] Thirtyone patients were evaluated 30 days after RFR, in an ongoing prospective, multi-center, nonrandomized study.

[RESULTS] The majority of subjects had a ≥1-grade improvement in investigator-evaluated skin laxity and lipodystrophy; 84% of subjects were satisfied with their neck and jawline appearance and 97% of subjects they would likely recommend the procedure. Minimal procedural and post-procedural pain, minimal scarring in 94% of subjects, and no severe skin-related adverse effects.

[DISCUSSION] Rotational fractional resection is essentially a new concept that has a risk and side effect profile that is comparable or better than-surgical skin tightening, with measurable permanent results approaching that of surgical skin tightening. This investigational procedure advances the evolution of facial and neck aesthetic procedures with results approaching those of surgery in a single treatment.

[CONCLUSION] Early RFR results are promising but, yet to be conclusive. However current outcome reports identify a procedure that meet patient demands for a minimally invasive office- based procedure to look better with limited downtime.