Does Radiofrequency, RF Microneedling, or Lasers Affect Hyaluronic Acid Fillers?

While there are number of studies suggesting that lasers and RF do not affect fillers, a recent article by Dr. Weiss opened up the debate again. In his paper he stated that biopsies showed evidence of heating around the filler. It did not evaluated the changes in the filler volume over time. He concluded that the filler was at risk to be affected by the heat. Dr. Davin Lim’s recently published study contradicts Dr. Weiss, and showed with RFM, there was no affect on fillers (biopsy proved) at multiple different energy levels.

The heat from RF Microneedling reaches approximately 65-75 C for 100 msec to up to 3-4 seconds depending on the device and parameters used. This is the “hottest” version of RF delivery used in aesthetics.  This compares to the sterilization process of the fillers at the (Galderma) manufacturing plant of 110-120 C for 15-20 minutes.

Lasers can heat the tissue to a higher level, up to 100 C, but again, it is for milliseconds at best.

Conclusion: There should be no concern regarding placement of HA fillers with RF Microneedling or lasers, at any level of the dermis or subcutanous planes on the same day. Furthermore, there will be no effect on previously placed HA filler. As a side note, PMMA has to be heated to 160 C to cause changes to it’s structure. While the exact temperature is unknown for calcium hydroxyapatite, it is significantly higher than HA, so it too is safe from RF and lasers.

2 Comments

  1. C Henchman

    Dear Dr Weiner, I had four Resurfx laser treatments early this year and it has given me dark discolouration patches/spots since, I never had any discolouration problems before, not even the odd freckle. My dermatologist suggested Resurfx for some collagen building and very fine lines that I had started developing on my forehead. Unfortunately, that has left me with brown/dark discolouration and even broken capillaries (blue/red). I have been reading many of your articles and watching your videos and I think they are melasma? Anyhow, you stated that the Spectra q-switched laser is the best for melasma and also among others, the use of Retinol, Hydroquinone, Lytera and vitamin C, can you please advise as to how many days/weeks we need to stop using these before the laser and how long to wait after the laser to restart using them? Thanks in advance for your very valuable advice. By the war, I’m 32, Eurasian and have very light skin. Thanks again.

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    • I don’t stop the topicals for laser treatments. I think the Picosecond lasers are better now. Must use 1064 wavelength.

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