SMAS described
Mitz and Peyronie described the superficial musculoaponeurotic system in the parotid and cheek area by dissection, radiographs and histology.[1]
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History
From the SMAS in 1976 and the first radiofrequency clearance in 2002 to the helium plasma clearances of 2022: the steps that made the treatment.
Timeline
Mitz and Peyronie described the superficial musculoaponeurotic system in the parotid and cheek area by dissection, radiographs and histology.[1]
On November 5, 2002, the FDA cleared the ThermaCool TC system for noninvasive treatment of periorbital wrinkles and rhytids.[1][2]
Ruiz-Esparza reported improvement in 14 of 15 patients after one radiofrequency treatment of the face. A multicenter study of 86 subjects found wrinkle improvement in 83.2% of periorbital areas.[1][2]
Electron microscopy after Thermage treatment showed collagen fibrils with larger diameter, and collagen type I messenger RNA rose in treated skin.[1]
White made thermal injury zones in the SMAS of cadaver faces up to 7.8 mm deep while sparing the epidermis. Laubach made confined lesions up to 4 mm deep in the dermis.[1][2]
On September 11, 2009, the FDA granted De Novo classification to the Ulthera System under regulation 878.4590, to lift the eyebrow.[1][2]
Paul and Mulholland described bipolar radiofrequency applied to the fat and the underside of the skin during liposuction.[1][2]
In 35 subjects treated over the face and neck, masked raters found a clinically significant brow lift in 86% at 90 days.[1]
The FDA cleared Ulthera to lift lax submental and neck tissue on October 2, 2012, and to improve lines and wrinkles of the decolletage on June 20, 2014.[1][2]
In 12 patients, the side treated with radiofrequency plus liposuction shrank 25.8% in skin area at 1 year, against 8.3% with liposuction alone.[1]
Both were cleared on September 22, 2017: Thermage FLX for wrinkles and rhytids, and TempSure Portrait handpieces for mild to moderate facial wrinkles.[1][2]
The Sofacia System was cleared for facial lines and wrinkles on September 9, 2019. On November 15, 2021, SofWave added eyebrow lift and lax submental and neck tissue.[1][2]
The FDA warned in March 2022 against Renuvion for dermal resurfacing and skin contraction, then cleared the Dermal handpiece on May 25, 2022, the APR handpiece for neck laxity on July 15, 2022, and post-liposuction use on April 27, 2023.[1][2][3]
People
Their studies set the methods in use today.
Reported a series of facial tightening with nonablative radiofrequency: 14 of 15 patients improved.[1]
First author of the 86-subject multicenter Thermage study of periorbital tightening.[1]
Showed collagen fibril changes and raised collagen type I messenger RNA after radiofrequency treatment.[1]
Reviewed over 600 monopolar radiofrequency treatments and found temporary side effects in 2.7%.[1]
Showed in cadavers that focused ultrasound can heat the SMAS and spare the surface.[1]
Showed focused ultrasound can make confined lesions within the dermis up to 4 mm deep.[1]
Led the rater-blinded study of ultrasound brow lift, mean brow elevation 1.7 mm.[1]
Described radiofrequency-assisted liposuction and three-dimensional tissue tightening with R. S. Mulholland.[1][2]
Measured skin area contraction 1 year after radiofrequency-assisted liposuction of the arm and abdomen.[1][2]
Reported 247 patients treated with FaceTite and fractional radiofrequency for lower face and neck laxity.[1]
Wrote systematic reviews of subsurface radiofrequency and helium plasma that question their evidence and safety.[1][2]