Percutaneous selective radio-frequency neuroablation in plastic surgery

A new technique in aesthetic plastic surgery called Percutaneous Selective Radio-frequency Neuroablation (PSRN) is proposed. Radio-frequency energy is applied via the percutaneous route to interrupt selected terminal fibers of the facial nerve in order to modify the facial dynamics. An easy-to-construct electronic system is used to perform both three-dimensional perioperative location (by means of electrical stimulation) and percutaneous electrofulguration of the target nerve. PSRN was found useful in ameliorating noticeable forehead and frown wrinkles caused by muscular hyperactivity as well as in achieving a more balanced face in cases of unilateral postrhytidectomy facial paralysis of the temporal branch of the facial nerve. Twenty-one patients underwent PSRN with encouraging results. In this report, the electrophysiological bases, technique, animal experiments, and initial clinical experience of PSRN are presented.