{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T17:39:45Z","timestamp":1783186785117,"version":"3.54.6"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"vor","delay-in-days":41,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title\/>\n                  <jats:p>Skin laxity and dynamic rhytids that signify facial aging are due, in part, to atrophic changes and volume redistribution in the underlying layers of the face: the bone and soft tissue. A microneedling device that delivers bipolar radiofrequency (RF) energy directly to the reticular dermis has been shown to yield rejuvenated, tighter skin in 100% of patients. Herein, the author describes a modification to the standard dermal technique in which the skin is gently gathered with the nondominant hand, and the microneedling device is tilted to deliver RF energy to the mimetic muscles\u2014including the frontalis, orbicularis oculi, and orbicularis oris\u2014as well as the dermis. Muscle penetration was inferred by intraoperative bleeding and postoperative bruising, neither of which is typical of standard RF microneedling. Preliminary findings suggest that the modified procedure may yield greater aesthetic benefits than achieved with dermal application alone, including subtle lifting of the brow and oral commissure, upper-lip shortening with vermilion eversion, tightening of the lower-lid fat pads, and reduction in lateral-canthal rhytids. Although this modified technique will need to be optimized and evaluated in large, controlled studies, the initial results presented herein are encouraging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 5<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asjof\/ojz035","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T14:07:16Z","timestamp":1594994836000},"source":"Crossref","is-referenced-by-count":7,"title":["Intramuscular Insertion of a Radiofrequency Microneedling Device for Facial Rejuvenation: A New Technique and Case Reports"],"prefix":"10.1093","volume":"2","author":[{"given":"Andrew N","family":"Kornstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"issue":"1S","key":"2024070210041098700_CIT0001","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/j.asj.2005.09.012","article-title":"The anatomy of the aging face: volume loss and changes in 3-dimensional topography","volume":"26","author":"Coleman","year":"2006","journal-title":"Aesthet Surg J"},{"issue":"8","key":"2024070210041098700_CIT0002","doi-asserted-by":"crossref","first-page":"e500","DOI":"10.1097\/GOX.0000000000000470","article-title":"Fat grafting to the forehead\/glabella\/radix complex and pyriform aperture: aesthetic and anti-aging implications","volume":"3","author":"Kornstein","year":"2015","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2024070210041098700_CIT0003","first-page":"52","article-title":"Facial rejuvenation with fat cells.","volume-title":"Encyclopedia of Aesthetic Rejuvenation through Volume Enhancement","author":"Kornstein","year":"2014","edition":"1"},{"key":"2024070210041098700_CIT0004","doi-asserted-by":"crossref","first-page":"e1175","DOI":"10.1097\/GOX.0000000000001175","article-title":"Three-dimensional facial anatomy: structure and function as it relates to injectable neuromodulators and soft tissue fillers","volume":"4","author":"Beer","year":"2016","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"1","key":"2024070210041098700_CIT0005","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/jocd.12128","article-title":"Facial dynamics and emotional expressions in facial aging treatments","volume":"14","author":"Michaud","year":"2015","journal-title":"J Cosmet Dermatol"},{"issue":"2","key":"2024070210041098700_CIT0006","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/dsu.12065","article-title":"Prospective multicenter clinical trial of a minimally invasive 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bipolar fractional radiofrequency skin treatment","volume":"41","author":"Berube","year":"2009","journal-title":"Lasers Surg Med"},{"issue":"5","key":"2024070210041098700_CIT0010","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/DSS.0000000000000347","article-title":"Randomized, blinded, 3-arm clinical trial assessing optimal temperature and duration for treatment with minimally invasive fractional radiofrequency","volume":"41","author":"Alexiades","year":"2015","journal-title":"Dermatol Surg"},{"issue":"4","key":"2024070210041098700_CIT0011","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1001\/archdermatol.2010.24","article-title":"Blinded, randomized, quantitative grading comparison of minimally invasive, fractional radiofrequency and surgical face-lift to treat skin laxity","volume":"146","author":"Alexiades-Armenakas","year":"2010","journal-title":"Arch 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