Helium plasma–radiofrequency in esthetic and reconstructive surgery: A narrative review on its clinical utility and constraints

Helium plasma radiofrequency (HP-RF), c ommercially known as Renuvion®, is a minimally invasive modality for skin tightening and soft tissue contouring as a response to the limitations of traditional surgical and esthetic treatments. Skin laxity due to aging and environmental factors continues to be a therapeutic issue because noninvasive treatments frequently yield inconsistent results, and excisional procedures are often linked to scarring, anesthesia risks, and a longer recovery period. Helium plasma-RF produces fast cooling after rapid heating (60–85°C in ms), resulting in up to 38% collagen contraction immediately. It also promotes neocollagenesis and elastin remodeling over the following months. Clinical studies have shown that when used in conjunction with liposuction, contraction rates range from 26% to 36%, and the Food and Drug Administration reviewed data show that 92.7% of patients improved by at least one point on the Fitzpatrick Wrinkle scale after 90 days. Hematoma, seroma, neuralgia, thermal damage, and gas-related events, including subcutaneous emphysema, are among the reported complications, which vary from 10% to 15%. This emphasizes the significance of meticulous patient selection. Inconsistent treatment parameters and operator-dependent techniques across the literature complicate cross-study comparisons and reinforce the need for clearer procedural standards. Overall, HP-RF is a promising development in esthetic medicine. Yet, the available data are still insufficient, and more randomized controlled studies are needed to prove the long-term safety, comparative effectiveness, and cost-efficiency of this cosmetic procedure.