Navigating the Intersection of Radiofrequency Microneedling and Surgical Facelifts: Scoping Review

Background: Optimal management of facial skin laxity requires a nuanced approach by health care providers working in aesthetics. Radiofrequency microneedling (RFMN) devices have emerged as a popular noninvasive treatment for facial rejuvenation and improving skin laxity. While RFMN has demonstrated efficacy in enhancing skin tightening and complementing aesthetic procedures, its long-term impact on subsequent surgical facelifts remains uncertain. Objective: The objective of this scoping review is to explore the interplay between RFMN and surgical facelift outcomes, with a focus on potential complications such as excessive skin tightening, dermal scarring, and altered tissue planes that may pose surgical challenges. Methods: A search using PubMed and Google Scholar was conducted, and articles were selected from peer-reviewed journals based on specific inclusion and exclusion criteria. Only articles available in English were selected. In total, 21 articles were included in this scoping review. Results: Papers included in this review discussed the mechanisms of action involved with RFMN, RFMN-related tissue changes, and how these changes could impact future facelift procedures. Most of the papers found that RFMN may drastically alter multiple tissue planes involved in facelift procedures due to collagen deposition through multiple tissue layers and increased tissue fibrosis. Patient factors influencing the effectiveness of RFMN and its role in facial rejuvenation were also examined, emphasizing the importance of navigating patient-specific demographics as a future consideration when creating an individualized treatment plan for each patient. Conclusions: Patients should be informed that RFMN may lead to dermal fibrosis, tissue adhesions, and altered superficial musculoaponeurotic system composition, which could interfere with future facelift procedures and the patient's desired treatment goals. This emphasizes the importance of detailed discussion between the patient and health care provider to improve pretreatment consultation, increase patient education, and set realistic expectations. Further research is needed to determine optimal timing and treatment strategies for patients considering both RFMN and surgical facelifts to achieve the best aesthetic outcomes.