In Histologic Effects of Fractional Laser and Radiofrequency Devices on Hyaluronic Acid Filler, Sarah Ham Hsu, MD, Hye Jin Chung, MD, MMS, and Robert Weiss, MD, divided abdominoplasty skin samples into eight zones. They administered HA filler intradermally into seven zones, leaving the eighth zone untreated to act as control. Following injection, they proceeded to treat six of the zones with a 1,540nm, 1,550nm, 1927nm or 10,600nm fractional laser, or fractional bipolar RF delivered through insulated microneedles, or fractional bipolar RF delivered through non-insulated microneedles. Biopsies were collected post-treatment for H&E (Haemotoxylin and Eosin) staining.
There were no morphologic changes to the filler following treatment with 1,540nm, 1,550nm, 1927nm and 10,600nm lasers, although researchers did observe thermal changes from the 1,540nm and 1,550nm lasers in very close proximity to the filler. Both RF devices caused thermal damage to the filler along the microneedle tracks. The authors concluded that the deeper dermal penetration from the RF energy will result in damage to fillers administered in the mid to lower dermis, and advised caution in using microneedle RF devices over recently injected HA fillers.
Authors note that obvious study limitations include testing on non-facial skin and lack of inflammatory response.
Currently in Australia it is common practice for most practitioners to advise clients to wait between 2-6 weeks after injectables before receiving any laser resurfacing or RF microneedling treatments. There are also other providers who subscribe to the school of thought that injectables should be administered after completion of laser treatment, since the laser treatment can change the contour of the face as collagen is stimulated, thereby changing the volume or location of fillers needed. Choice of treatment plan and amount of time in between injectables and laser treatments varies between clinics/practitioners.
Hsu, Sarah Hahn, MD; Chung, Hye Jin, MD, MMS; Weiss, Robert A., MD. (2019). Histologic Effects of Fractional Laser and Radiofrequency Devices on Hyaluronic Acid Filler. Dermatologic Surgery, [online] 45(4), pp.552-556. Available at: https://journals.lww.com/dermatologicsurgery/Abstract/2019/04000/Histologic_Effects_of_Fractional_Laser_and.10.aspx