The Expansion of Fractional Resurfacing with RF Technology
As fractional devices continue expanding, the possibilities for their use increase in both medical and aesthetic procedures.
Edited by Gary Lask, MD

Fractional resurfacing technologies have become a mainstay among laser treatments. Noted for their ubiquitous use in medical and aesthetic settings, their development appears to track a progression in laser therapies that provide the best possible results with the least amount of downtime. But as aesthetic treatments increase in the market and public demand grows, so too does the desire to treat a variety of skin types and conditions. Ahead, Tess Mauricio, MD, founder of Scripps Ranch Dermatology Cosmetic Center in San Diego, CA, and principal investigator of a study using eMatrix (Syneron) on patients with skin of color, discusses the device's sublative resurfacing and the continued development of fractional devices.

Given the rising interest in fractional procedures, how does eMatrix stand apart from or complement other fractional devices on the market?
Dr. Mauricio notes that the device offers a different approach to fractional devices, particularly with its incorporation of RF technology. "RF technology allows heat to penetrate the dermis with minimal epidermal destruction, resulting in little to no downtime for patients, while resurfacing and tightening skin effectively," she says. This tightening, she notes, is best demonstrated in the jaw line, cheek fat pads, and around the eyes. Dr. Mauricio also points out that since RF technology is non-light based, results can be delivered more safely for patients with skin of color. "Unlike IPL and laser procedures, RF technology is associated with less absorption by the intrinsic epidermal pigment," says Dr. Mauricio.

What is the significance of the SelectPulse feature?
The SelectPulse feature allows physicians to customize the depth and aggressiveness of treatment based on the needs and skin type of the patient. Rather than offering a single uniform treatment, the SelectPulse enables the operator to be more aggressive in certain patients, and gentler in others, Dr. Mauricio says. One can also use different settings for certain areas on the same patient. "For example, for patients with darker skin you can use gentler levels (levels A or B) since you will likely want to minimize any damage to the epidermis" Dr. Mauricio observes. This flexibility is built in to the system, she adds, allowing it to fulfill a variety of functions and perform multiple types of services in one platform.

What does the eMatrix offer patients (and likewise physicians) in terms of treatment quality and comfort?
"For patients, perhaps the greatest benefit of the eMatrix is that it offers rapid, effective results and the ability to return to work the following day," observes Dr. Mauricio. The procedure itself is not without pain, but the level of discomfort will depend on the nature of the treatment. Patients are often given a topical anesthetic and can experience discomfort in certain areas of the face, but not any more than with other fractional or light-based procedures. Dr. Mauricio also notes that the procedure is relatively short (approximately 30 minutes for full face), and unlike other treatments requiring gels and ointment, is not messy. "Any discomfort a patient feels during the procedure is often off-set by the quickness of results and the little to no downtime associated with the procedure," she notes. Importantly, given the mode of delivery, multiple treatments over time are recommended for maximum results, however, most patients see improvement within one to two treatments. The advantage for dermatologists, Dr. Mauricio points out, is that the eMatrix handpiece is very light, easy to use, and treatment is a quick, one-pass technique.

What kind of avenues of exploration for treatment possibilities do you see on the horizon for fractional RF technologies?
Dr. Mauricio believes that the eMatrix represents the first of many devices to emerge in the future to offer physicians the ability to truly treat patients of all skin types safely and effectively. "Treatment of Skin of color is becoming a much more prominent subject at conferences, which reflects the growing focus of developing new technologies in addressing this rapidly growing market," notes Dr. Mauricio. Also, as fractional devices provide more range and possibility, Dr. Mauricio observes that there will be more options allowing treatment to move beyond the face to address the body. "There are a multitude of directions into which fractional RF technology can be taken and harnessed effectively, such as skin tightening for post-childbirth, post-liposuction, and weight loss. Additionally, we will better address aging on hands and arms and scarring anywhere on the body." If and when these possibilities become reality, the stretch of dermatologists' potential in the realm of aesthetic devices will continue to grow larger.