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

Summary

In a nonrandomized prospective cohort (n=37), synchronized RF+HIFES significantly reduced forehead and lateral canthal rhytids and raised brow position by 2–3 mm at 24 weeks without altering frontalis muscle or subcutaneous fat thickness. Objective 3D imaging, EMG, and ultrasound corroborated clinical improvements.

Key Findings

• Significant improvement in forehead and lateral canthal line severity at 4, 16, and 24 weeks (all P<.001).
• Medial/central/lateral brow position increased by 3.18/3.02/2.27 mm at week 24 (P<.001).
• No significant change in frontalis muscle or subcutaneous fat thickness at week 24.

Clinical Implications

Offer synchronized RF+HIFES as a noninvasive option for forehead and periorbital lines, especially in patients contraindicated for or averse to injectables. Use objective imaging and follow-up at 4–24 weeks to monitor response.

Limitations

• Nonrandomized design without a control/sham group.
• Single-arm study with modest sample size (n=37) limits generalizability.

Future Directions

Conduct randomized, sham-controlled trials with larger cohorts and standardized outcomes; explore dose-response, durability beyond 24 weeks, and mechanistic links between neuromuscular activity and clinical effects.