Mixter, who has treated approximately 75 patients with the technique. Creating Buzz GFX has earned high patient satisfaction from the start, he adds, although patients initially expressed concern that results of the original GFX technology only lasted a few months. We needed to make results last longer than Botox, and we're in that range now.
Kotlus says that ultimately, RF nerve ablation could provide effective treatment for benign essential blepharospasm, and for other areas in which physicians use neurotoxins, including crow's feet and the corners of the mouth, he says. At Allure Medical Spa, Dr. The staff is excited, and patients see that. Virtually every new technology creates a buzz that's not necessarily commensurate with the device's effectiveness, he notes. Kotlus concludes. Disclosures Dr. Kotlus reports no relevant financial interests.
Mixter is an investigator in ACI's ongoing longevity trial, but receives no financial compensation from the company. For more information www. Hide comments. By Sharon Worcester. PDF Download. The effects remained apparent at 3-month follow-up. Several studies looking at various aspects of this procedure are ongoing at the writing of this chapter. The presence of glabellar frown lines is a common complaint for which patients seek out treatments from their plastic surgeon.
Surveys from the American Society of Plastic Surgery and the American Academy of Facial Plastic Surgery list the use of botulinum toxin A as the most common aesthetic office based treatment of the past 2 years. There has been a heightened public awareness of glabellar frown lines and the use of neurotoxins for their treatment since botox was approved for cosmetic indications to reduce glabellar frowning in These treatments go beyond simple frown reduction and treat lax skin.
These surgical procedures have a high level of patient satisfaction when thoroughly performed and when the resulting void is replaced with autologous graft material ,.
The use of endoscopic approaches has also allowed surgeons to not only perform myectomies and myotomies but also neurotomies providing long-term relaxation of the glabellar complex ,. The concept of percutaneous nerve ablation for branches of the facial nerve was first reported by Herndadez-Zendejas and Guerrero-Santos in They showed significant reductions in glabellar frowning with long-term follow up to 18 months and a similar study at Stanford showed shorter term results.
The current presentation reflects improvements of this original concept by applying a more sophisticated engineered device with a more thorough understanding of facial neuroanatomy. The goal of the GFX procedure is to provide the surgeon with a minimally invasive approach to glabellar frowning without the use of temporary neurotoxins.
The use of this technology to ablate only the efferent pathway of the distal branches of the facial nerve branch as they enter the glabellar musculature can yield a very selective relaxation of the forehead depressor function. This selective efferent nerve ablation provides a non-pharmacologic relaxation of the corrugators, medial orbicularis, depressor supercillii and procerus muscles and thus, produces a relaxation of glabellar frowning.
The application of optimized radiofrequency energy has a long history of success in treating various conditions including cardiology applications such as ablation of tachyarrythmias.
Previous studies have demonstrated efficacy of application of radiofrequency energy in the human forehead to produce acute and long-term reduction of glabellar furrowing. The depressor muscle group is made up of the corrugator supercillii, procerus, orbicularis oculi and depressor supercilli muscles.
The corrugator supercillii muscle has both an oblique medial head and lateral transverse head. The lateral transverse head and the lateral orbicularis oculi muscle are innervated by the temporal branch of the facial nerve and are approached through the lateral eyebrow skin as described below. The medial depressors including the medial oblique head of the corrugator, procerus, and depressor supercillii muscle are innervated by the angular nerve.
As the motor nerves to these muscles come from the facial nerve, they run in parallel directions to the facial musculature. The sensory supply to the soft tissue comes from the trigeminal system and emerges from foramina in close proximity to the depressor muscles and are running in a more perpendicular direction to the depressor muscle group to pierce the musculature and then run in a parallel direction to the soft tissues.
The differences in the orientation of the sensory and motor nerve supply allow the surgeon to find zones of vulnerability to damage the motor nerves while preserving the sensory nerve supply. Then, nerves are stimulated to find the ones that cause furrows.
The probe is heated to damage each nerve, and break the 'frown' signals. According to Doctor Rokhsar, the results last about a year; that's four times as long as Botox. And there's another reason people are eyeing this "no-tox" technology, as Dr.
Rokhsar explains, "And there's a group of patients that are kind of opposed to the idea of having a toxin in their face, even though it's perfectly safe. Right now, the eyebrow area is being targeted with GFX, but Doctor Rokhsar expects it will be used for other muscle-related wrinkles in the future.
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