If old memories stir up after hearing the word "fire injection," you must be in your 40s or older. In the past, when needles were valuable, BCG vaccinations, in particular, were called so as needles were heated with an alcohol lamp to sterilize and reuse on multiple people. But now, the forgotten name, "fire injection," has returned as a new medical device to restore aged facial skin.
The most observed phenomena in facial aging are sagging and wrinkles due to aging collagen fibers and abnormalities in elastic fibers in the dermis. When treating this, a method to restore skin tension by promoting new collagen production is used. When treating this, a method to restore skin elasticity by promoting the formation of new fibers is applied.
At that, only the aged fibers should be selectively destroyed while the surrounding normal tissues such as the epidermis are left undamaged, and the method is different for each medical device. As mentioned before in the series, electricity can damage all tissue; thus, it is difficult to give selectivity. However, using electricity is the cheapest, most convenient, and most reliable treatment if it accurately hit the targeted area.
Radio frequency device (RF device) is the most used medical device in modern medicine, and there are three major types.
The first one is a monopolar device that passes electricity entirely between the electrode that touches the skin and the ground plate. "Thermage" is using this system and is most widely known as a monopolar RF device. The second method is a bipolar device, and both the anode and the cathode touch the skin. For better efficacy, usually suck the skin up between the two electrodes and pass electricity.
The third is a method called fractional RF (radio frequency), which makes scattered small dot-shapes like fractional lasers and allows them to recover fast from surrounding normal tissues. All these RF electrodes are in needle-forms.
In other words, several needles poke the skin and generate heat with electricity inside of the skin to destroy aged dermal collagen fibers. It is the most reliable treatment because it damages by direct contact; but, if the contact is not uniform, the treatment intensity is too strong, or the depths of needles are uneven, it may cause unwanted burns. Thus, more caution is needed when you treat a patient with RF devices.
Most devices are equipped with a cooling device or insulated in the epidermal contact area to pass the electricity only on the tip of the needles to protect the epidermis and create selective dermal damage.
The method of using electricity can damage all tissues—so if the needle tip is precisely positioned on the targeted tissue and carefully treated, it will not only restore younger skin, but also can be applied in the various indications of treating large pore, acne, acne scars, periorbital fat bulging, and syringomas.
I have also reported good results by conducting a study on periorbital fat bulging and wrinkle treatment with a fractional RF device, AGNES. With Korean companies dominating the global market for fractional RF devices, many doctors lead the standardization of procedures and expansion of indications.
