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Surgical Pearls
September 13, 2018

Percutaneous Radiofrequency Lower Face and Neck Tightening Technique

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia
  • 2Main Line Center for Laser Surgery, Ardmore, Pennsylvania
JAMA Facial Plast Surg. 2019;21(1):71-72. doi:10.1001/jamafacial.2018.0917

Percutaneous radiofrequency (RF) technologies have recently been introduced to deliver electrothermal energy into the hypodermal skin layers, which have been inconsistently accessible by previous RF devices.1 The hypodermis contains a complex collagen network involving the papillary and reticular dermis, fibrofatty septae, and underlying fascia. These deeper tissue layers act in concert with the more superficial dermal skin layers to create the skin’s tone, quality, and durability. Energy delivery at these depths not only contributes to skin tightening and wrinkle reduction but also ablates subcutaneous fat and increases skin elasticity by remodeling its anchoring mechanism to the deeper fascia and muscle.1 In this setting, percutaneous RF technologies can effectively treat skin and soft-tissue ptosis, ablate subcutaneous fat deposits, and reduce jowling along the mandibular border and cervical platysmal banding.2,3