The use of radiofrequency (RF) in medicine is ubiquitous and dates back over 75 years. In 2002, the first RF device was approved for cosmetic use (lines/wrinkles around the eyes) and, in 2004 approval for treatment of facial wrinkles and rhytids was given. Dozens of RF devices have since been approved for aesthetic use with various methods used to deliver the energy to the dermis and fibroseptal network in the subcutaneous fat.

Radiofrequency has become a popular option for skin rejuvenation and tightening. Using electrothermal energy versus photothermal energy with lasers, RF is not chromophore dependent and therefore considered applicable for all skin types. Radiofrequency offers little to no downtimes, which is desirable in the current environment of patients’ active lifestyles and busy work schedules. 

To further enhance dermal heating, RF microneedling (RFM) was developed. RFM delivers the desired energy through pins/needles that penetrate the skin to a predetermined desired depth. With this technology, dermal heating was improved to the critical level of 65degC to 70degC with epidermal heating minimized when using insulated needles. A reverse thermal gradient is created, with the temperatures highest in the deeper levels, contrasting laser’s skin heating. Hence RFM is a significant advance over traditional RF devices for skin tightening with improvements in safety and efficacy. Energy delivery is efficient into the dermis with minimal disruption of the epidermis, particularly for the insulated needle devices.

Differences between the Radiofrequency Microneedling (RFM) machines

With so many similar devices in the market, it is normal to feel overwhelmed. What is important is to go by scientific and clinical evidence in deciding which RFM machine to go with.

• Insulated vs Noninsulated needles: It is important to choose a machine with insulated needles, like the Morpheus8. Insulated needles allow for RF energy placement into the dermis while protecting the epidermis from most of the heat. In contrast, noninsulated needles produce a larger RF thermal zone (RTZ) throughout the entire length of the electrode. These will heal slower  than multiple small RTZs. Epidermal injuries may occur with the unprotected needles, thus leading to higher risks of post inflammatory pigmentation. In addition, wound care and downtime are potentially prolonged as these superficial wounds heal.
• Manual vs motorized insertion: With mechanical motorized insertion, user variability is reduced. With manual insertion devices, there is operator fatigue.
• Treatment parameters: In general, higher-energy treatments yield better results. Studies have shown that the amount of collagen produced is directly dependent on the intensity of heating of the connective tissue. The Morpheus8 has a maximum power of 65W, one of the highest in the market.
• Maximum depth: The Morpheus8 has one of the highest, if not the highest, depth penetration in the market. It has a programmable 1-7mm penetration depth with additional 1mm heat profile. It also has different tip configurations for a wide range of conditions like scars, wrinkles, acne, rejuvenation, hyperhidrosis, cellulite reduction and more. The greatest depth penetration makes it the most efficient machine not just for face treatments, but for melting adipose (fat) in the body.