Ligament-Focused Advanced Monopolar Radiofrequency: A New Approach to Face and Neck Skin Laxity.

Facial and neck skin laxity due to aging represents a major aesthetic concern among women. Despite this, most patients prefer non-invasive treatments that may offer natural results, minimal downtime, and low risk of complications. Advanced monopolar radiofrequency (RF) technology addresses these needs through continuous low-temperature epidermal cooling, enabling safe delivery of maximal energy (140 W) to superficial and mid-dermal layers and facial retaining ligaments without burns, lesions, or discomfort. This protocol presented a novel ligament-focused approach for adults aged 35 years or older with mild-to-moderate facial and/or neck skin sagging. Applying 1,000 shots in one session across facial, submental, and neck regions, targeting ligaments and fibrous septa, the protocol was delivered in a hashtag pattern with 50% overlap at energy levels 8-10. Clinical observations demonstrated an improvement in skin thickness, texture, elasticity, facial and neck contour, and wrinkle reduction, achieving lifting effects with minimal/no pain and high patient satisfaction. Reapplication is recommended after six months to optimize and maintain the results and, for moderate and severe cases, we recommend a combination of new monopolar RF with fillers or microfocused ultrasound. In conclusion, the protocol offers versatile skin rejuvenation by promoting collagen remodeling and contraction of fibrous septa and ligaments, providing a good alternative treatment for facial aging with an interesting balance between results and comfort.