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The demand for non-invasive procedures for skin tightening and wrinkle reduction is increasing. Light-based therapies alone have limited efficacy due to the absorption of light by epidermal melanin and limited dermal remodeling.

To meet the demand for safe, non-invasive procedures for the treatment of photo-damaged skin, a variety of light-based therapies have been developed. Although results are less impressive than those of surgical facelifts, adverse effects are few and post-treatment recovery time is short. For example, the use of non-ablative, infrared (IR) lasers with skin-surface cooling has been explored as a stimulus for dermal remodeling and clinical improvement of wrinkles with few adverse effects.

A major limitation of light-based therapies is that optical energy is absorbed by epidermal melanin, thus limiting the depth of light penetration, particularly in patients with dark skin. Another limitation is wrinkles respond minimally to this treatment because collagen contains no chromophores to absorb the light.

To overcome these drawbacks, selective electro-thermolysis, in which electrical energy from radiofrequency (RF) current selectively heats target tissue without damaging the epidermis, has been introduced. RF current placed on the skin penetrates the epidermis and moves to tissues that offer high electrical conductivity. Since conductivity varies inversely with temperature, cooling the epidermis guides the RF current to deeper tissues which, when pre-heated, has higher conductivity and thus a greater probability of receiving the RF current. The amount of heat generated in the pre-heated tissue varies with the tissue’s resistance (impedance) to the RF current.

The Polaris WR™ Applicator (Syneron Medical Ltd., Yokneam, Israel) is a combination of 900 nm diode laser and RF technologies. The WR applicator can also be found on the Galaxy™,eLaser™,and eMax™. This WR device delivers optical energy to pre-heat the target and RF energy to heat the target (without injuring the epidermis) even more to a temperature that exceeds its therapeutic threshold. This combination of technologies is called electro-optical synergy (ELOS). The Polaris WR has shown efficacy and safety in the treatment of facial rhytides, skin laxity, and skin texture.

The purpose of this study is to evaluate the efficacy and safety of the broadband (700-2000 nm) ReFirme ST Applicator for the non-ablative treatment of skin laxity and mild to moderate rhytides.

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