The human skin aging process is characterized by thinning dermis, atrophy of the extracellular matrix, and reduced collagen synthesis. Loss of collagen in the dermis is of aesthetic concern, as it is the main structural support in the dermis and its loss results in skin laxity. Photo-damaged skin, mostly due to UVR, causes degradation of elastic fibers. This is histologically seen as disorganized tangles of elastin. Additionally, as humans age, skin tends to appear more dry due to its poor hydration and turgor capacity. The use of minimally invasive aesthetic treatments in reducing signs of aging has been gaining in popularity over surgical treatments in recent years. Several energy types including, laser, radiofrequency, infrared, and ultrasound, have been developed for facial rejuvenation. These treatments induce controlled thermal damage into the dermis and cause collagen contraction and neocollagenesis resulting in skin tightening over several months. For improving appearance of other anatomical areas, micro-focused ultrasound has been the preferred method, but has shown limited success in tightening the suprapatellar skin. As with facial skin aging, the suprapatellar skin loses elasticity with age and begins to sag. Noninvasive treatments used for the face may also be used in other anatomical areas to produce the same effects of tightening. Minimally invasive bipolar radiofrequency produces a controlled thermal injury in a fractional manner without damaging the dermal-epidermal junction, epidermis or subcutis. Radiofrequency, unlike lasers, are chromophore-independent providing better penetration than lasers, and spare sweat glands, sebaceous glands, and hair follicles.
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Photographic Knee Laxity and Texture Evaluation
Timeframe: baseline and 6 months
Epidermal Thickness
Timeframe: baseline, 7 Days, 3 Weeks, 3 Months and 6 Months
Dermal Thickness
Timeframe: Baseline, 7 Days, 3 Weeks, 3 Months and 6 Months
Change in Blood Flow at 0.25mm
Timeframe: Baseline, Day 7, Week 3 Month 3 and Month 6
Transepidermal Water Loss
Timeframe: Baseline, Day 7, Week 3, Month 3 and Month 6
Skin Elasticity
Timeframe: Baseline, Day 7, Week 3, Months 3 and Months 6
Change in Skin Laxity
Timeframe: baseline, 7 days, 3 weeks, 3 months and 6 months
Histological Analysis- Collagen 1
Timeframe: Baseline. Day 7 and 3 Months
Gene Expression- Collagen 1
Timeframe: Day 7, Month 3
Epidermal Density
Timeframe: Baseline, Day 7, Week 3, Month 3 and Month 6
Histological Analysis- Collagen 3
Timeframe: Baseline, Day 7, Month 3
Histological Analysis- Elastin
Timeframe: Baseline, Day 7, Month 3
Gene Expression- Collagen 3
Timeframe: Day 7, Month 3
Gene Expression- Elastin
Timeframe: Day 7, Month 3
Gene Expression- Interluekin 6
Timeframe: Day 7, Month 3