By Doctor Julien Vivier

Tailor-made solutions finally exist in the medical aesthetic device industry. Cynosure has developed a unique radiofrequency device combining monopolar/bipolar radiofrequency with microneedling. The results and advantages ? Dr Julien Vivier shares his opinion with us.

A new radiofrequency device with four different modes coupled with a unique microneedling technology is revolutionising the treatment of all types of skin issues – both superficial and deep – on the face and body, and at any time of year. This highly accurate and flexible device allows treatments to be adjusted for an unrivalled resurfacing and retexturing effect.

Flawless skin, the new symbol of social success

Today, with increased social pressure driven by social media, the image we project is key. Flawless, smooth and radiant skin has become a communication tool in itself as well as a social and aesthetic symbol. Problems such as acne and acne scarring, pigmentation, wrinkles and loose skin can lead to hang-ups, particularly in people with severe acne scars. The deep scars caused by acne are among the most difficult and time consuming skin issues to treat, and the demand is constant in dermatology and aesthetic medicine practices. Patients want fast, effective treatments and are less and less accepting of complications and down time.

A versatile tool with many possible combinations

Nowadays, thanks to the Potenza medical device (Cynosure), I have access to a radiofrequency device with 4 treatment modes: mono and bipolar, 1MHz and 2MHz. Potenza offer a comprehensive range of tips, ranging from a simple needle to 16, 25 and 49 micro-needles. The ten different needle tips al- low us to propose highly targeted treatments. We can choose the depth of needle penetration (from 0.5mm to 4mm), which means we can treat all areas of the face, even the thinnest and most delicate areas. Cynosure have developed new semi-insulated needles for delivering the radiofrequency at two different depths of the dermis in one go, called Tiger Tips.

What is more, and what is really new, are the Fusion Tips which, in addition to delivering radiofrequency through mi- croneedling, exert positive air pressure in order to help the topical products penetrate into the tiny wells created by the needles (hyaluronic acid, vitamin cocktails, etc.). In one swoop, we combine the effectiveness of microneedling, RF and mesotherapy. Studies have shown that the Fusion Tips boost the penetration of the topical actives into the dermis by 67%.

Potenza combines the thermal effects of RF with the mechanical effects of microneedling. The energy delivered by the needles creates coagulation wells which triggers a cicatricial reaction in the dermis. The fibroblasts reboot their production of collagen and elastin fibres. This leads to dermal densification, which is the result we seek when treating deep acne scars, as well as for smoothing and tightening the skin.

In practice

A topical anaesthetic is required an hour before treatment. For treating acne scars, I plan for between 3 and 4 sessions spaced at least a month apart. All patients have noticed a significant improvement after the very first session.

I prefer to use a 49-needle Tiger Tip, going over the skin for the first time with monopolar 1Hz and the second time with bipolar 2Hz. I set the needles to penetrate 1.5mm deep. The after-effects are mild: redness for a few hours, no downtime. After the treatment, I apply a serum rich in hyaluronic acid. For the neck and lower eyelids, where the skin is thinner, we have to reduce the penetration depth of the needles to around 0.5 to 0.7mm.

Tightening sagging skin on the body requires deeper penetra- tion. I opt for the maximum 4mm.
Potenza has a very ergonomic motorised handpiece, and you can set the needle penetration speed according to the skin thickness.

The new generation RF and its thermal effect combined with the mechanical effect of the needles offers spectacular re- sults, which are visible both by the patient and their entou- rage. The advantage is that we can treat all skin phototypes, even in summer.

Potenza allows us to work using monopolar RF to go deep into the skin, and using bipolar for a superficial action, which offers a multi-layered tightening effect. What is also useful is the mesotherapy function using the Fusion Tips, which per- forate the skin and exert positive pressure in order to literally push the actives into the dermis.

Potenza has enabled me to fulfil my patients’ demands, in particular regarding acne scars, which can cause real hang-ups.

Doctor Julien Vivier.
Aesthetic doctor, graduated from the faculty of Lyon.
European inter-university degree in medical lasers.
Inter-university degree in morphological and anti-aging medicine.
Director of the Centre Laser Lyon and the Centre Laser Sorbonne.

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