Tightening of the eyelids with monopolar radiofrequency in Asians

Eyelid laxity is a visible sign of aging that can significantly affect appearance and comfort; however, many patients remain reluctant to undergo surgical blepharoplasty. Monopolar radiofrequency (RF) offers a non-invasive alternative. This study evaluated the efficacy and safety of a 0.25 cm² monopolar RF tip for upper eyelid tightening in Asians. Fourteen subjects received a single session of treatment with a 0.25 cm² tip monopolar RF device. Multiple passes were applied to the upper eyelid and lateral orbital regions. Topical anesthesia was applied 30 min before treatment, and a protective plastic contact lens was used during the procedure. Standardized digital photography, physician assessments, and patient-reported outcomes were obtained at each visit. All subjects demonstrated clinical improvement. At 2 months, 73% of patients reported more than 50% improvement in eyelid tightening, increasing to 86% at 6 months. Physician Global Aesthetic Improvement Scale (GAIS) ratings corresponded to "much improved" at both time-points. Mid-pupillary brow elevation increased by 1.18 mm at 2 months and 1.45 mm at 6 months. Lateral canthal brow elevation increased by 1.23 mm and 1.21 mm, respectively. Superior palpebral crease elevation improved by 0.54 mm and 0.41 mm, while the eyebrow angle decreased by - 4.12° and - 5.67°, indicating a more elevated brow contour. No adverse events were observed. In conclusion, monopolar RF treatment with a 0.25 cm² tip appears to be a safe and effective non-surgical option for upper eyelid tightening in Asians.