Dual-depth 25-pin insulated microneedle radiofrequency for moderate-to-severe periorbital wrinkles.

To evaluate efficacy and safety of dual-depth 25-pin insulated microneedle radiofrequency (RF) treatment for periorbital wrinkles and skin elasticity. This observational study included 32 adults aged 30-60 years with baseline Fitzpatrick Wrinkle Assessment Scale (FWAS) scores of 4 or higher. Patients underwent three microneedle RF treatment sessions at 4-week intervals. The protocol employed a duty-controlled, dual-shot mechanism to sequentially deliver thermal energy to 1.5 mm and 1.0 mm depths within a single needle insertion. Outcomes were assessed at baseline and weeks 16 and 24 using blinded FWAS grading, Antera 3D imaging, Cutometer R2/R5/R7, patient satisfaction, and safety monitoring. The mean FWAS score decreased from 5.44 ± 0.80 at baseline to 3.38 ± 0.61 at week 24 (p < 0.001). Quantitative imaging revealed relevant reductions in average wrinkle depth, maximum wrinkle depth, and the indentation index, while R2, R5, and R7 increased throughout follow-up (all p < 0.001). At week 24, 90.63% of patients were satisfied or very satisfied. The mean procedure time was 7.2 ± 1.4 min, and the mean pain score was 3.3 ± 0.9. Adverse events were limited to transient mild erythema and edema, resulting in an average downtime of 1.5 ± 0.5 days. The dual-depth, 25-pin insulated microneedle RF protocol demonstrated clinical utility and a favorable safety profile as a minimally invasive option for periorbital rejuvenation. By delivering targeted dermal thermal stimulation without repeated mechanical passes, the procedure improved wrinkle severity and skin elasticity with short treatment time and limited recovery burden.