In each issue, Modern Aesthetics® magazine asks top cosmetic physicians about the devices that they are introducing to their patients. Here, Macrene Alexiades-Armenakas, MD, PhD, Founder and Director of Dermatology at Laser Surgery Center of New York in Manhattan, talks up Candela Medical’s Profound, a microneedling/radiofrequency skin tightening device that provides one-third of the result of a surgical facelift minus the downtime.

What is Profound, and how are you using it in practice?

Macrene Alexiades-Armenakas, MD, PhD: Profound is the world’s first microneedling radiofrequency device. Using hair-fine needle electrodes, we inject radiofrequency energy directly into the skin. Thermometers in the needle tips allow for the precise delivery of energy until a specified target temperature is obtained. This results in collagen, elastin, and hyaluronic acid formation in the skin that reduces wrinkles and laxity.

How does Profound compare to other devices that address the same/similar issues?

Dr. Alexiades-Armenakas: My research has shown that the ideal temperature is 67 degrees Centigrade; this is the optimal temperature to induce collagen, elastin, and hyaluronic acid formation in the skin, which correlates with maximal wrinkle and laxity reduction. Profound is the only device with real-time temperature feedback. No other device has this feature. Therefore, Profound has a 100 percent response rate, whereas other devices “guess” the temperature and sometimes do not work.

Is there a learning curve?

Dr. Alexiades-Armenakas: It is a procedure that requires technical skill, which is why I have mainly trained plastic surgeons on the technology. It’s the most effective non-surgical procedure that is an alternative to the facelift. It gives one-third the result of the facelift.

Please share your treatment protocol/s and any pearls?

Dr. Alexiades-Armenakas: I use minimal injected anesthesia so that the collagen fibers are packed together when I treat, and I get maximal results. I make sure the needles are fully inserted at a 3mm distance between insertions. I insert the device in vectors where I want the tightening to occur to maximize beautiful outcomes. The mandible, jowls, lower face, under the chin, and lateral neck yield the best outcomes.

How has the ROI been?

Dr. Alexiades-Armenakas: Excellent. The device costs the patient one-tenth the cost of a facelift without the downtime or risk and gives one-third the result.

How are you marketing Profound?

Dr. Alexiades-Armenakas: My patients defer to me as to what they need. I recommend Profound for patients who have skin laxity and have ruled out the facelift or for whom a facelift would be too aggressive.