Radiofrequency-Based Treatments for Facial Rejuvenation: A Systematic Review of Efficacy, Safety, and Patient-Centered Outcomes.

Background: Radiofrequency (RF) devices are widely used for noninvasive facial rejuvenation, but evidence on patient-centered outcomes remains heterogeneous and variably reported. Objectives: To synthesize evidence on the aesthetic, safety, tolerability, and psychological outcomes of RF treatments for facial rejuvenation. Methods: A systematic review was conducted in accordance with PRISMA and JBI guidelines. Databases (PubMed, Embase, CENTRAL, and LILACS) were searched for studies published between 2015 and 2025. Risk of bias was assessed using a JBI tool. A thematic synthesis was performed for aesthetic outcomes, patient satisfaction, and safety. The confidence of findings was evaluated using the GRADE-CERQual approach. Results: Fifteen studies were included, comprising a total of 1230 participants. RF treatments consistently improved aesthetic outcomes. Skin texture improved in 71% to 100% of patients (4 studies), and skin firmness improved in 52.9% to 100% (2 studies). High patient satisfaction was demonstrated, with rates ranging from 82% to 100% (13 studies). The safety profile was favorable; adverse events were mild and transient (erythema: 17.6%-100%; edema: 5.3%-26.5%), and no serious complications were reported. Mean pain scores were low (1.94/10 VAS). GRADE-CERQual assessment showed moderate confidence in these findings. A key limitation was the universal underreporting of downtime. Conclusions: Evidence indicates RF treatments for facial rejuvenation yield meaningful aesthetic improvements, high patient satisfaction, and an excellent safety profile. However, these conclusions are tempered by methodological limitations in the primary literature. Future research should employ rigorous designs, standardized outcome measures, and report on downtime to strengthen the evidence base. Level of Evidence 4: