Evaluation of the Effect of Laterality and Age on Pain Perception in Monopolar Radiofrequency Facial Therapy

Ying Wang,* Han Bai,* Congqi Shi, Meng Wang, Shasha Zhao, Xiaodong Lai, Yan Yan Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yan Yan, Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, People’s Republic of China, Email [email protected]: Monopolar radiofrequency (RF) is an established non-invasive modality for facial rejuvenation. Despite its proven efficacy, treatment-related pain remains a major barrier to patient compliance. Previous evidence suggests lateralized differences in pain perception, yet systematic evaluation in RF therapy is lacking.Purpose: To investigate laterality in pain perception during monopolar RF treatment and to explore the influence of age on pain sensitivity.Patients and Methods: A prospective study enrolled 46 patients (45 females, 1 male; age 30– 58 years) with facial laxity undergoing bilateral monopolar RF (Thermage FLX) treatment. Treatment order (left-first or right-first) was randomized, and all procedures were performed by the same right-handed physician. Pain intensity was assessed within 5 minutes post-treatment for each hemiface using a 0– 10 Visual Analogue Scale (VAS, scored to one decimal place).Results: The left hemiface exhibited significantly higher VAS scores than the right (7.12 ± 2.05 vs. 6.62 ± 1.90, p< 0.001), irrespective of treatment order. Stratified analysis revealed that younger patients (≤ 42 years) reported higher VAS scores than older patients (> 42 years) (left: 7.60 ± 1.46 vs. 6.64 ± 2.18; right: 7.07 ± 1.15 vs. 6.16 ± 2.17; both values of p< 0.05). Correlation analysis showed age was negatively associated with VAS scores.Conclusion: Monopolar RF treatment demonstrates a consistent left-side dominance in pain perception, with younger patients exhibiting greater pain sensitivity and age negatively correlated with VAS scores.Keywords: facial pain, pain laterality, age factors, Visual Analogue Scale