Impact of Synchronized Radiofrequency and High-intensity Facial Electrical Stimulation on Facial Muscles and the Superficial Fascial System in the Midface.

Summary

In a 24-week prospective study (n=37), synchronized RF with HIFES increased zygomaticus major thickness, EMG activity, and midface volume, with supportive porcine histology. The multimodal assessments suggest functional and structural rejuvenation of the midface.

Key Findings

• Zygomaticus major thickness increased from 2.06 mm to 2.80 mm with 39.3% EMG signal rise, indicating improved muscle function.
• 3D analysis showed horizontal (0.90 mm) and vertical (1.01 mm) skin displacement, with midface volume gain of 1.43 cm³ at 24 weeks.
• Porcine histology demonstrated increased muscle fiber size, myonuclei, and mass density supporting the human findings.

Clinical Implications

Clinicians may consider synchronized RF+HIFES for patients seeking noninvasive midface rejuvenation, while counseling on the need for further randomized data and long-term durability evidence.

Limitations

• Nonrandomized, single-arm study with modest sample size.
• Follow-up limited to 24 weeks; no durability beyond 6 months or comparative effectiveness data.

Future Directions

Randomized controlled trials comparing RF+HIFES to sham or RF-only, dose–response optimization, and long-term durability/safety assessments.