Helium Plasma Radiofrequency for Aesthetic Subdermal Treatment: A Systematic Review and Meta-analysis

Abstract Background Helium plasma radiofrequency (RF) technology (Renuvion, Apyx Medical) has emerged as a minimally invasive option for treating skin laxity, either as a standalone procedure or as an adjunct to liposuction. While clinical adoption has expanded rapidly, the literature remains heterogeneous, with variable study designs and outcomes. Objectives To comprehensively evaluate the safety and performance of helium plasma RF for aesthetic subdermal applications through systematic review and meta-analysis. Methods A systematic search was performed from initial device clearance through May 2025, following PRISMA guidelines. Eligible studies included randomized controlled trials, prospective cohorts, retrospective reviews, and case series with ≥10 patients undergoing aesthetic subdermal treatment with helium plasma RF. Safety outcomes were tabulated and weighted incidence rates calculated. Random-effects meta-analyses were performed to generate pooled estimates for performance endpoints, including patient satisfaction, Investigator Global Aesthetic Improvement Scale (GAIS), Patient GAIS, and Independent Photographic Review (IPR) scores. Results Thirty-four studies across 33 publications encompassing 3,508 patients were included. Pooled complication rates were 5% for helium plasma RF-only, 8% for helium plasma RF + liposuction, and 15% for combination procedures involving multimodal excisional surgery; differences between groups were not statistically significant (p = 0.14). The pooled patient satisfaction rate was 92%. Meta-regression demonstrated higher satisfaction with longer follow-up durations (p = 0.003). Conclusions This systematic review and meta-analysis suggest that helium plasma RF is associated with a favorable safety profile and high rates of patient satisfaction and aesthetic improvement in subdermal applications.