KISSIMMEE, FLA. Focal radiofrequency ablation of the neural innervation of the glabella muscle complex provided an effective and possibly more durable alternative to botulinum toxin in a series of 10 patients with concerns about glabellar frown lines.
The procedure, which is known as glabellar frown relaxation (GFX) radiofrequency ablation, was approved by the Food and Drug Administration for tissue ablation last year and has been touted as a new and improved means of relaxing frown lines without the use of toxins.
Of the 10 patients who underwent the treatment, 6 had an immediate complete response and 4 had partial attenuation of their frown lines, as judged by the inability to frown, said Dr. Cameron Rokhsar of Albert Einstein College of Medicine, New York.
Additionally, medial brow elevation occurred in five of the patients, he noted at the annual meeting of the American Society for Laser Medicine and Surgery.
The effects remained apparent at 3-month follow-up.
All patients tolerated the procedure; side effects were limited to bruising and moderate pain during treatment.
The GFX radiofrequency ablation procedure, which is performed under local anesthesia, involves insertion of a probe at the lateral canthi on each side and the use of mild electrostimulation to identify the rami of the temporal branch of the facial nerve innervating the corrugators.
A 20-second radiofrequency pulse is applied to cause the focal nerve injury, and the probe is then advanced on the nasal sidewall to identify and ablate the branches of the angular nerve innervating the procerus.
Although both botulinum toxin and GFX radiofrequency ablation target the nerves that cause frown lines, botulinum toxin therapies block signals sent from the nerves to the muscles while GFX radiofrequency energy is used to create focal damage to effectively weaken the motor nerves, Dr. Rokhsar explained.
As a result, the duration of effect is increased with GFX radiofrequency; some reports suggest that the duration can be up to 2 years, compared with 34 months for botulinum toxin treatments. Studies to review long-term efficacy are underway, he said, adding that "the procedure has a learning curve."