Radiofrequency for the Treatment of Facial Ligament Laxity: A Split-face Controlled Exploratory Study.

Background: Facial aging is a complex and multilayered process. Facial retaining ligaments play a critical role in maintaining soft-tissue position and resisting gravitational descent. Although radiofrequency (RF) therapy is widely used for noninvasive facial rejuvenation, ligament-targeted RF strategies remain insufficiently investigated. Methods: This prospective, evaluator-blind, split-face controlled study enrolled patients with mild-to-moderate facial laxity. A 1.7-MHz bipolar RF device was used for 3 treatment sessions at 4-week intervals. The left side received conventional full-face RF treatment, whereas the right side underwent ligament-targeted RF treatment. The primary outcome was the change in 3-dimensional facial volume measured using the Vectra M3 imaging system. Secondary outcomes included physician- and subject-rated Global Aesthetic Improvement Scale scores at 1 month and 6 months post final treatment. Safety outcomes were also recorded. Results: A total of 12 patients completed the study (N = 12 per side). One month after the final treatment, no statistically detectable difference was observed between the treatment and control sides in the mean change in 3-dimensional facial volume. Improvements in facial laxity were observed on both sides after treatment. Both physician- and subject-rated Global Aesthetic Improvement Scale scores improved at 1 month and 6 months posttreatment, with no statistically detectable differences between sides. All treatment-related adverse events were mild and transient. Conclusions: No statistically detectable differences in contour outcomes were observed between the 2 treatment approaches in this preliminary study. These findings suggest that an anatomically guided approach may offer a feasible option for noninvasive structural facial rejuvenation and warrant further investigation in larger studies.