The Genius is Truly a Huge Step Forward for RF Microneedling

The initial studies of radiofrequency microneedling (RFM) were performed by Hantash et al. in 2009. What Hantash was able to demonstrate was that RFM produced a fractionated radiofrequency thermal zone (RTZ) with coagulated tissue surrounded by normal tissue. Overtime, multiple growth factors and inflammatory components led to complete replacement of the RTZ with neocollagenesis and neoelastogenesis over the following 10 weeks.

Delivery of the RFM energy varies according to the device used. Unfortunately, there has been a paucity of solid research behind the majority of the devices. There is confusion in the marketplace for both consumers and providers as to what constitutes the best delivery system for outcomes, safety, and comfort. Lutronic decided to breakdown all the components of RFM energy delivery and optimize them in their development of the Genius.

One of the selling points of many of the devices has been that they are comfortable and have minimal downtime. What this actually means is that there is minimal energy delivered to the dermis. Discomfort is directly related to the amount of energy delivered. Lutronic’s research has shown that needle depths and energy settings don’t necessarily correlate to the what really occurs in the tissues.

Needle Depths

Skin intrinsically resists puncture by outside forces. If is especially difficult for 49 needles to penetrate the skin in a small area (1x1cm2). The natural tendency is for the skin to buckle with the needles “bouncing off the surface” and several of the RFM devices tested have been documented to exhibit this phenomenon. Furthermore, needles have a harder time penetrating deeper into tissue than superficially, so deeper depths are even more challenging to accurately place than more shallow treatments. Unfortunately, setting needle depth on the device doesn’t always correlate to actual tissue depth. Requirements for accurate depths include:

  1. Sharp needles –  but not too thin as to bend or dull during hundreds of pulses
  2. Powerful motor – underpowered motors prevent accurate penetration
  3. Quick motor – slower motors will lead to pushing the skin rather than penetrate it

Energy Delivery

One of the fallacies of RFM devices is that higher treatment levels correspond to higher energy delivery. Best results will be related to turning the energy settings “all the way up” is ABSOLUTELY FALSE. Too much energy in too short a period will lead to rapid rises in tissue impedance (resistance) and cut off energy flow immediately. Performance by the operator can affect the energy delivered if handpiece pressure is light or not flush with the skin as well.

Tissue Impedance

Impedance in the dermis is highly variable between patients and even within different areas of the face and body. Variables affecting impedance are: hydration, solar damage, collagen and hyaluronic acid content, and scarring. Using settings based on clinical findings and desired outcomes is not enough precision for optimal energy delivery.

Coated vs Uncoated Needles

Coated (insulated) needles allow the microneedles to penetrate the skin and deliver energy to the dermis while bypassing the heating of the epidermis. Some devices will use uncoated needles which will increase the risk of post inflammatory hyperpigmentation (PIH), particularly in darker skin types. To minimize this risk, uncoated needles use low energies and therefore sacrifice results. There will also be more downtime/wound care with uncoated needles because the skin surface will be more affected than with the coated needles.

The Genius Advantage

  1. Proprietary needle design – sharp and coated for minimal resistance to insertion
  2. Improved motor insertion – high torque and quick needle insertion
  3. Improved protocols – changes to energy and pulse durations to avoid sharp rises in impedance based on Lutronic proprietary research
  4. Impedance Feedback – the needles monitor tissue impedance every 2 msec and give feedback to the device to optimize energy delivery and adjust flow as resistance changes. This is the “brains” of the Genius.
  5. Energy delivered feedback – each pulse is monitored and amount of energy delivered is noted. If energy is not exactly as desired/set, both a visual and audible signal is sent to operator. Adjustments in settings or technique can be made to improve energy output.
  6. Total Treatment Energy – a running total of energy given is kept. This allows the provider to base treatments on energy delivered. Cumulative energies delivered from multiple treatments will become the standard of care to achieve clinical outcomes for a given diagnosis.

With the advancements made with the Genius, suddenly, all other RFM devices are now obsolete. Genius delivers a precise, safe, and efficacious treatment for laxity, wrinkles, neck lines, acne scarring, and hyperhidrosis in all skin types.

 

8 Comments

  1. EC

    Has this received FDA approval? I’m having a difficult time locating where this device is available in my area (Birmingham, AL). Was considering ematrix or infini for acne scaring until your statement.

    Like

    • It has been approved about a month ago. Hardly anyone has the Genius currently. Infini is much better than eMatrix but Genius is better. Don’t do the eMatrix – high complication rate.

      Like

      • EC

        Sounds like I may be best served by waiting for Genius even over Infini. Approximately how quickly might this device be made available to your office and others?

        Like

  2. I live in CT – there is only one MD using Genius in all of New England including NYC, it is so new. However during my consult with this MD Dermatologist he didn’t sound very hopeful for someone who is 65 yo with lax facial skin – I am wondering if it gets better results in younger people and for acne than for older lax skin?

    Like

    • I think that younger patients will do better but it works for mild jowls and neck laxity. Fillers or combination therapies always work better than just Genius

      Like

      • I had a face lift 10 months ago so I don’t have a problem with jowls or neck but I have laxity on either side of my nose toward the edges of my mouth and underneath my mouth on both sides – I don’t think a face lift at 65 can tighten those areas, unless I am wrong about that. Have you experienced Genius helping that area in someone my age?

        Like

      • We treat many people your age. It seems like the area of concern can be treated with fillers. Tightening from RF is real but mild.

        Like

Trackbacks

  1. Top 5 Procedures to Improve Your Jawline in 2019 | Steven F Weiner, MD

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: