A Systematic Review of Radiofrequency and Helium Plasma Radiofrequency Alternatives to Mastopexy

Energy-based devices have been promoted as an alternative to surgery. Recent publications have advocated their use as an off-label nonsurgical breast lift. However, objective measurements on standardized photographs are lacking. Complications are unreported. A systematic review has not been published.

A literature search was conducted to identify publications using energy-based devices for cosmetic breast applications. Photographs in the studies were matched for size and orientation and evaluated. Sternal notch-nipple measurements and lower pole levels were compared.

Three publications were found. Two studies used the InMode radiofrequency device. A third study used the Renuvion helium plasma radiofrequency device. All three studies reported high rates of patient satisfaction and no complications. Two studies reported a decrease in sternal notch-nipple distances. Photographs were compared by the author after computer-assisted matching to correct existing disparities in magnification and tilt. The mean sternal notch-nipple distances were shortened by 2 mm on each side. There was no change in the mean right lower pole level; the left lower pole was raised 1.9 mm after treatment. None of these incremental differences were significant. All three studies were heavily affected by commercial bias. An improvement in asymmetry in a patient who also received breast implants disappeared after correction for tilt.

Measurements on matched photographs reveal that energy-based alternatives to a mastopexy are ineffective. Patients incur additional cost, and are exposed to additional risks. Conflict of interest is a major factor. Surgical treatment of breast ptosis remains the gold standard.

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