RU2755695C1 - Radiofrequency eyelid correction method - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to plastic surgery. At the first stage of the operation, the end of the inner electrode is inserted through a puncture in the skin, 1-1.5 cm away from the lateral corner of the eye, to a depth of 2-3 mm, the outer end of the electrode is placed on the skin surface in the projection above the inner electrode. Then, point heating of the medial, central and lateral fatty packs of the lower eyelid is performed, and then, similarly to the medial and central upper eyelids, if necessary, to a predetermined temperature of the internal electrode, in particular 60°С. At the second stage, the skin is treated over each hernial packet using a radiofrequency handpiece with a microneedle nozzle, the needles of which are supplied with radio frequency energy of 5-15 mJ/p, while the handpiece is moved from the treated zone to the untreated one with a partial 40-50% overlap of the treated zone.

EFFECT: method provides a high cosmetic effect, a quick rehabilitation period, the absence of skin sutures, the exclusion of general anesthesia.

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Description

The invention relates to medicine, namely to plastic surgery, and can be used to correct the lower and upper eyelids (blepharoplasty).

The leading mechanism of skin aging is atrophy. Atrophic and dystrophic changes during skin aging occur as a result of genetically determined changes in cells caused by a decrease in metabolism, a weakening of the immune system, impaired microcirculation and neurohumoral regulation.

Any swelling of the eyelid tissues that occurs during diseases contributes to the stretching of the skin, weakening of its connections with the underlying structures and the appearance of sagging and wrinkles. This clinical picture progresses with the development of age-related degenerative changes in the skin of the face itself. The direction of the forming wrinkles is almost always parallel to the direction of the fibers of the circular muscle of the eye.

Recently, many innovations have been proposed in cosmetic blepharoplasty, where simplification of the operation technique gives a large number of cases of recurrence of skin sagging, uneven relief and “round eyes” syndrome (partial inversion of the lower eyelids).

The standard method for blepharoplasty of the lower eyelids is that the configuration of the skin flap to be excised is marked with a marker, the latter is separated from the circular muscle of the eye, while making a wedge-shaped excision of the skin at the outer corner of the eye, the edges of the wound are separated and sutured with thin hair sutures (Zaykova M.V. . Plastic ophthalmosurgery. M .: Medicine, 1980, p. 97).

The disadvantages of this method are the high invasiveness of the operation and the possibility of postoperative complications in the form of edema, hemorrhage and partial inversion of the lower eyelids.

Currently, aesthetic medicine uses high-frequency RF current to rejuvenate and tighten aging skin.

A known method of processing human skin using a system containing a radio frequency source and an applicator with a roller. The method includes the steps: determining the perimeter of the embossed skin element, rolling the roller over the element in its longitudinal and transverse directions. The treatment with the system is suitable for tightening and rejuvenating the skin by heating the skin tissue with RF energy by supplying RF energy by contacting the skin with one or more radio frequency electrodes (patent RU 2637104 C2, publ. 11/29/2017).

The disadvantages of this method are the possibility of side complications, since the heating of the area of the skin tissue is carried out to a temperature of 70 ° C, as well as the unsuitability for blepharoplasty.

Closest to the claimed method - the prototype is a method of two-stage radio frequency skin remodeling using high-frequency current with a frequency in the range from 0.5 MHz to 20 MHz. At the first stage, the dermis is heated to a depth of 2-3 mm using a bipolar manipulator electrode applied to the patient's skin surface. Moving the manipulator electrode from the treated area to the untreated one is carried out by transferring it without overlapping the treated areas. Before starting the treatment, a radio frequency test is determined - the minimum erythemal dose (MED). In one procedure, no more than 8% of the patient's skin surface is treated with a total exposure time from 20 minutes to 2 hours. At the second stage, immediately after radiofrequency heating of the dermis, a medicinal substance of immunomodulating action, mainly Actovegin, is applied to the treated skin. Then, the drug is deposited by a pulse-periodic radio-frequency current supplied to the patient's skin using a monopolar or bipolar manipulator electrode, smoothly moving along the massage lines with a total exposure time of 15 to 20 minutes. The duration of the RF current pulses is selected in the range of 50-500 μs, and their repetition rate is in the range of 100-1000 Hz. The total number of procedures up to 12 with a frequency of 1 time in 7 days (patent RU 2389516 C2, publ. 20.05.2010).

The disadvantages of this method are the duration, the need to determine the MED, the complexity and unsuitability for blepharoplasty.

The objective of the invention is to create a minimally invasive method for correcting the eyelids, which allows you to obtain a high cosmetic effect without scar damage to the skin and tissues, as well as to exclude the associated complications.

EFFECT: reduced duration and labor intensity of the method, exclusion of cicatricial damage to the skin of the eyelids.

The task is achieved by the proposed method, which consists in a two-stage radiofrequency effect on the skin and hernial packs (the fatty body of the orbit) using the BodyTite apparatus.

The invention is illustrated by the following figures.

FIG. 1 is a general view of the BodyTite RF device.

FIG. 2 - AccuTite two-electrode RF cannula.

FIG. 3 - automatic radiofrequency fractional needle handpiece (Morpheus), having a microneedle nozzle with 12 needles.

The first stage of the operation is performed using a two-electrode radio-frequency cannula (AccuTite), with the specified temperature parameters - an external electrode of 37 ° C, an internal one - 60 ° C, connected to the BodyTite apparatus (Fig. 1). The thin (inner) end of the electrode (Fig. 2) is inserted through a puncture in the skin, 1-1.5 cm away from the lateral angle of the eye under the circular muscle of the eye and the septal plate to a depth of 2-3 mm, and the wide (outer) end of the electrode is placed on the surface of the skin in projection over the thin end. Further, using the pedal of the apparatus, radiofrequency energy is supplied to the electrodes and by means of point movements of the cannula parallel to the surface of the skin, sequentially, point heating of the fatty body of the orbit is performed, the distance between the points is 1-2 mm, in the projection of the medial, central and lateral fatty packets of the lower eyelid, and then the medial and central fatty packets of the upper eyelid, to a predetermined temperature of the internal electrode (60 ° C). The criterion for the sufficiency of heating is the total amount of energy accumulated by the soft tissue component of the eyelids. The amount of energy for each eyelid should not exceed 0.4-0.5 kJ (measured by the apparatus). After treatment, sterile strips are applied to the punctures.

At the second stage, immediately after radiofrequency heating of the dermis, using the Morpheus radiofrequency fractional needle maniple (Fig. 3), a two-stage treatment of the eyelid skin surface is performed by applying a nozzle with needles perpendicular to the skin surface, while at the 1st stage the length of the needles is adjusted per 1 mm of immersion in the dermis and radiofrequency energy is supplied to the needles - 5 mJ / p, and at the 2nd stage the length of the needles is adjusted to 3 mm of immersion in the dermis with an energy of 15 mJ / p. The handpiece is moved from the treated area to the untreated one by transferring it with a partial 40-50% overlap of the treated skin area of each eyelid. The surface of the eyelid skin is treated 2-3 times. After the operation, a thin layer of epithelial cream is applied to the surface of the eyelid skin. An hour later, the patient is discharged from the clinic for outpatient follow-up care and observation. In the postoperative period, it is recommended to continue treating the skin of the eyelids with an epithelial cream for 2 weeks, with a frequency of 2 times a day, and also to carry out lymphatic drainage procedures in order to combat edema.

The method can be used for the simultaneous correction of the upper and lower eyelids in one procedure, as well as for the correction of only the upper or only the lower eyelids, depending on the indications of a particular patient. To achieve the aesthetic effect of the operation, one surgical intervention is enough. The method provides a high cosmetic effect, a quick rehabilitation period, the absence of skin sutures, the exclusion of general anesthesia.

It is known to use the Body Tite apparatus for performing radiofrequency liposuction by exposing body fat to radio frequency signals. The Body Tite device (see Fig. 1) consists of a high-frequency current generator, a control unit, where the necessary settings are set, and special nozzles with two electrodes, between which radio wave energy circulates. However, in the publicly available sources, no information was found about the use of this device for blepharoplasty (eyelid surgery).

The conducted patent search and analysis of scientific and medical information, reflecting the existing level of technology in this area, did not reveal the known methods identical to the proposed one, and therefore it can be concluded that the proposed technical solution meets the criterion of the invention "novelty".

The invention is illustrated by the following examples of a specific implementation of the method.

Example 1.

Patient M., 40 years old, came to the Hartman clinic with complaints of hernial protrusions in the lower eyelids.

The patient underwent radiofrequency correction of the lower eyelids using the claimed method.

After careful marking of the lower eyelids, under sterile conditions, under local anesthesia, using an 18G needle, the skin was punctured in the lateral corner of the right eye with an indent of 1 cm from it. Through this puncture, an infiltration cannula with a thickness of 20-22G was inserted under the circular muscle of the eye and the septal plate. Further, a solution of lidocaine 0.5% with the addition of adrenaline (0.2 ml per 100 ml of total solution) was injected into the fatty body of the orbit in the projections of the hernial packets of the lower eyelid. The solution was injected at the rate of 1 to 3 ml per one hernial packet, depending on the area.

At the first stage of the operation, using the internal electrode of the AccuTite two-electrode radiofrequency cannula connected to the BodyTite device, a puncture was made under the circular muscle of the eye and the septal plate, 1 cm away from the lateral angle of the eye, to a depth of 2 mm, and the external electrode was placed on the skin surface at projection over the inner electrode. Then, using the pedal of the apparatus, we applied radio frequency energy to the electrodes with the specified temperature parameters - the external electrode 37 ° С, internal 60 ° С, and we carried out a point treatment of the fatty body of the orbit in the projection of the hernial packets (medial, central, lateral) of the lower eyelid of the right eye , while heating was carried out by point effects, the distance between the points was 1–2 mm. After treatment, sterile Steri-strips were applied to the punctures.

The fatty body of the orbit of the left eye was treated in a similar way.

At the second stage, using the Morpheus automatic radiofrequency fractional needle maniple, a two-stage treatment of the skin surface of the lower eyelids of the right and left eyes was carried out, while at the 1st stage, the length of the needles was adjusted to 1 mm immersion in the dermis, with a radio frequency energy of 5 mJ / p , and at the second stage - the immersion depth of the needles was 3 mm, the energy was 15 mJ / p, while the nozzle was applied

perpendicular to the skin surface and pressed the pedal of the apparatus. The handpiece was moved from the treated area to the untreated one by transferring it with a partial 40% overlap of the treated skin area of each lower eyelid. The skin surface of each lower eyelid was treated 2 times.

After the operation, a thin layer of epithelial cream Bepanten PLUS was applied to the surface of the skin of the lower eyelids. An hour later, the patient was discharged from the clinic for outpatient follow-up care and observation. Figure 4 shows a photograph of the patient before surgery, and figure 5 - 5 days after surgery. The patient is satisfied with the aesthetic result of the operation, no side complications were observed.

Example 2.

Patient K., 35 years old, came to the Hartman clinic with complaints of hernial protrusions in the medial corners of the upper eyelids, excess skin of the upper eyelids, hernial protrusions in the lower eyelids.

The patient underwent radiofrequency correction of the upper and lower eyelids using the claimed method.

After careful marking of the eyelids, under sterile conditions, local anesthesia of the eyelids was performed, similarly to example 1. At the first stage of the operation, using the end of the internal electrode of the AccuTite two-electrode radiofrequency cannula connected to the BodyTite device, 1.5 cm away from the lateral angle of the right eye, a puncture was performed under the circular muscle of the eye and the septal plate, to a depth of 3 mm, and the external electrode was placed on the skin surface in the projection above the internal electrode. Then, using the pedal of the apparatus, they applied radio frequency energy to the electrodes with the specified temperature parameters - the external electrode - 37 ° С, the internal electrode - 60 ° С, and a point treatment of the fatty body of the orbit in the projection of the hernial packets (medial, central) of the upper eyelid and hernial packages (medial, central, lateral) of the lower eyelid, while warming

carried out by point effects, the distance between the points was 1–2 mm. After treatment, sterile Steri-strips were applied to the punctures.

The fatty body of the orbit of the left eye was treated in a similar way.

At the second stage, using the Morpheus radiofrequency fractional needle maniple, a two-stage treatment of the skin surface of the upper and lower eyelids of the right and left eyes was carried out, while at the 1st stage, the length of the needles was adjusted to 1 mm immersion in the dermis, with an energy of 5 mJ / p , and at the second stage, the immersion depth of the needles was 3 mm, the energy was 15 mJ / p, while the nozzle was applied perpendicular to the skin surface and the pedal of the apparatus was pressed. The handpiece was moved from the treated area to the untreated one by transferring it with a partial 50% overlap of the treated skin area of the upper and lower eyelids. The skin surface of each eyelid was treated 3 times.

After the operation, a thin layer of Bepanten PLUS cream was applied to the surface of the eyelid skin. An hour later, the patient was discharged from the clinic for outpatient follow-up care and observation. Figure 6 shows a photograph of the patient before surgery, and figure 7 - 2 months after surgery. The photograph clearly shows a decrease in the area and overhang of the upper eyelid, as well as the absence of a hernial protrusion of the lower eyelid.

The proposed method in one procedure allows you to reduce hernial protrusions due to point-concentric contraction of the connective tissue septa and the septal plate, as well as coagulation of the adipose tissue of the orbit.

Claims (4)

1. A method of radiofrequency eyelid correction, including treatment of the eyelid skin surface using a radio frequency electrode, characterized in that at the first stage, the eyelid skin is treated using a two-electrode AccuTite radio frequency cannula connected to the BodyTite apparatus, for which the end of the inner electrode is inserted through a puncture in the skin, departing 1-1.5 cm from the lateral angle of the eye, to a depth of 2-3 mm, the outer end of the electrode is placed on the skin surface in a projection above the inner electrode, then RF energy is supplied to the electrodes and by point movements of the outer electrode, parallel to the skin surface, with with a distance of 1-2 mm between the points, point heating of the fatty body of the orbit is performed in the projection of the medial, central and lateral fatty packets of the lower eyelid, and then the medial and central fatty packets of the upper eyelid to the specified temperature of the internal electrode, then, at the second stage, a two-stage skin treatment is performed eyelid using a radiofrequency handpiece Morpheus, which has a microneedle nozzle, on the needles of which radiofrequency energy is supplied, while at the 1st stage the skin is processed by immersing the needles into the dermis to a depth of 1 mm, and at the 2nd stage - to a depth of 3 mm, and the handpiece is moved from the treated area on the untreated one is carried out by transferring it with a partial 40-50% overlap of the treated zone. 2. The method according to claim 1, characterized in that at the first stage the temperature of 37 ° C is set on the outer electrode, and 60 ° C on the inner electrode. 3. The method according to claim 1, characterized in that at the first stage the amount of energy for each eyelid should not exceed 0.4-0.5 kJ. 4. A method according to claim 1, characterized in that at the second stage, the skin of the eyelids is treated 2-3 times.

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