Skin tightening by an insulated microneedle radiofrequency device combined with lower blepharoplasty: a randomized fellow eye comparison study

Background : : Aging in the lower eyelids creates bags under the eyes from the protruding orbital fat, and periorbital wrinkles. Therefore, lower blepharoplasty should be combined with a skin tightening procedure to enhance the results.Objective: To compare the effects between lower blepharoplasty combined with an insulated microneedle radiofrequency (RF) device and lower blepharoplasty alone.Methods : : Twelve Asian (24 eyes) patients with baggy eyelids were included. One eye per patient was randomized for lower blepharoplasty combined with insulated microneedle RF devices (RF group), and the other eye for lower blepharoplasty alone (LB group). All patients underwent transconjunctival lower blepharoplasty with fat transposition and orbicularis oculi suspension. The primary outcome was the difference between both groups on the five-point Wrinkle Assessment Scale (WAS), assessed at baseline and at 2 months post-surgery. The secondary outcome was patient satisfaction using the Global Aesthetic Improvement Scale (GAIS).Results : : The WAS improvements were 75.0% (9/12 eyes) and 58.3% (7/12 eyes) in the RF and LB groups, respectively. The GAIS showed high patient satisfaction in both groups, with an average of 4.12 (3-5) in the RF group and 4.0 (2-5) in the LB group (p=0.157). There was no difference in the postoperative inflammation between both eyes at 1 week; and no decrease in the WAS score at 2 months or any adverse effects at 6 months were observed.Conclusion : : Wrinkle improvement was observed post-lower blepharoplasty with or without microneedle RF treatment. The insulated microneedle RF device proved safe when performed concurrently with lower blepharoplasty