Profound® Results: Targeting Facial Wrinkles

My experience with the Profound device is extensive. I was the first to pioneer micro-needle radiofrequency (RF) with a team of engineers staring in 2006 with the Primaeva Medical company. Together, we designed the needle array and tested a large range of parameters, which ultimately culminated in the version of the device called the Profound. The Profound device offers temperature-controlled RF that delivers energy directly to the deep dermis to stimulate neo-elastogenesis, neocollagenesis, and hyaluronic acid deposition. It also delivers fractional RF energy to the subcutaneous layer, enabling treatment of adipose tissue and the septae. Initially, the treatment was FDA cleared for reduction of facial wrinkles in 2010. Since then, it has also been cleared for the treatment of cellulite when using the SubQ handpiece and cartridge, based on a study I led.

Improving the Appearance of Cellulite

The FDA clearance for Profound to improve the appearance of cellulite using the SubQ cartridge and handpiece is based on positive data from utilizing the device in an institutional review board (IRB) approved, multi-center study that measured success by analyzing the dimples and/or undulation irregularities in the thighs of 50 women with Fitzpatrick skin types I-III. Profound showed improvement of cellulite (dimples and/undulation irregularities) severity in 94 percent of treated thighs assessed at a three-month follow-up by blinded review. Sustained improvement was observed at six-month follow-up in 93 percent of the treated thighs. Profound is an optimal treatment for patients looking to improve the appearance of areas impacted by cellulite in a single treatment. Patients can start to see improvement starting at one month after treatment.

Figures 1a-c, 2a-c, and 3a-c. Patients before (top photos) and after one treatment, one pass, 150 insertions, where the parameters were 67oC, 3 seconds. Treatment duration was 25-30 min treatment for each patient (not counting the anesthesia required before treatment).

Facial Wrinkles

Treatment with the Profound device is ideal for the face in patients who have wrinkles and who want to have younger looking skin but have ruled out a facelift. Surgical facelift is the gold standard, but for patients who do not yet have severe enough wrinkling and laxity, or who otherwise cannot or do not want to undergo a facelift, treatment with Profound can offer excellent outcomes. In fact, in a 2010 study, we found that a single, minimally invasive fractional RF treatment demonstrated a 0.44-laxity grade improvement, or 37 percent that of the surgical facelift, without the adverse effects and complications of surgical procedures.¹ Profound adjusts energy delivery to attain the target temperature required to induce new collagen and elastin and hyaluronic acid in all patients in a single, non-surgical treatment for facial wrinkles.

Treatment Tips 

Before the procedure, patients are instructed to use no blood thinners for two weeks and to avoid foods and supplements that cause bruising. On the day of treatment, I numb my patients with topical anesthetic and use minimal infiltration with injectable lidocaine so that the collagen is not spread when I inject the RF.

I space my insertions exactly 3mm apart with no overlap. Immediately after finishing an area, I apply ice and have the patient ice for 45 minutes and this almost eliminates swelling. I then treat the patient with pulsed dye laser to prevent bruising. All my patients can go back to social activities and work five to seven days after treatment. And, results continue to build out to one-year post treatment—it's the gift that keeps on giving. (See Figures)

All my patients are extremely happy with the outcomes from the Profound treatment. I have mastered the numbing technique to make it painless. But it is a technically challenging device, hence the fact that many plastic surgeons have adopted this tool.

1. Alexiades-Armenakas M, Rosenberg D, Renton B, Dover J, Arndt K. Blinded, randomized, quantitative grading comparison of minimally invasive, fractional radiofrequency and surgical face-lift to treat skin laxity. Arch Dermatol. 2010 Apr;146(4):396-405. doi: 10.1001/archdermatol.2010.24.