SecretRF needs no introduction (the irony!) and immediately comes to mind in any discussion of RF microneedling. Secret RF is a skin rejuvenation and resurfacing treatment combining microneedling and radiofrequency energy to improve skin tone and texture, with minimal downtime. SecretRF treatments can address fine lines, wrinkles, acne scars, pores, loose skin on the face and neck, and improve stretch marks (striae), cellulite and loose skin on the body. For the delicate eye area, SecretRF treatments can improve droopy eyelids, crows feet wrinkles, eye bags and fine lines. SecretRF radiofrequency microneedling works by remodeling existing collagen and boosting collagen production, resulting in rejuvenated skin. During the SecretRF treatment, microneedles penetrate the dermis and deliver fractional radiofrequency energy at precise depths. This triggers a controlled wound healing process resulting in skin regeneration and new collagen deposition. 

What is SecretDUO?

SecretDUO builds upon the legacy of SecretRF technology to combines two types of skin rejuvenating treatments: SecretRF radiofrequency microneedling and a 1540nm fractional non-ablative Erbium Glass laser. These two treatments work together to stimulate new collagen and elastin production in the deeper layers of the skin. 

How does SecretDUO  work?

• Radiofrequency microneedling (RFM)
  Simply put, microneedling works by pricking the skin to create controlled microscopic wounds , which trigger the body’s natural healing process, encouraging collagen and elastin production. This, in turn, tightens the skin and reduces fine lines, acne scars, pores and wrinkles. 
  
  RF microneedling is the “big brother” of microneedling- with  the addition of radiofrequency technology, fine gold-tipped needles, with accurate depth control of up to 3.5mm, emit radiofrequency energy into the skin. These waves of energy produce heat, reaching up to 65 – 70 °C, which is the critical level for collagen remodeling. This process will then stimulate the skin to produce new collagen, gradually improving skin elasticity and appearance [1]. RF microneedling treatments are able to target deeper layers of the skin up to 3.5mm, as compared to microneedling which is max ~1mm.
• 1540 nm non-ablative Erbium Glass laser
  The 1540 nm fractional non-ablative Erbium Glass laser emits pulses of laser energy to create columns of controlled heat injury, stimulating new collagen production and dermal remodelling. Erbium lasers operate at a particular wavelength that is well-absorbed by water and biological tissue, increasing its efficacy. It is also safe for all skin types, including darker skin tones.
  
  Unlike ablative lasers, non-ablative lasers do not harm the epidermis, which results in fewer side effects with a shorter downtime between procedures [2].
  
  SecretDUO: Two clinically proven technologies working in synergy
  To quote Taylor Swift… “Two is better than one”
  
  So it is with SecretDUO, with the SecretRF microneedling component targeting the deeper layer of skin (deep dermis) and the 1540 nm fractional non-ablative Erbium Glass laser focusing on the superficial layer of the skin (epidermis and superficial dermis) for comprehensive skin rejuvenation.

What concerns can SecretDUO treat?

SecretDUO treatment can be done for a variety of skin concerns including:

• Fine lines and wrinkles  
• Loose or sagging skin
• Acne scars
• Active acne
• Enlarged pores
• Uneven skin texture
• Stretch marks
• cellulite

What is Radiofrequency(RF)? What are the different types of RF used in aesthetics?

Radiofrequency is type of technology utilising an oscillating electrical current (millions of cycles per second) that causes charged molecules to collide in order to generates tissue heating. Following Ohm’s law, electrical energy converted to thermal energy as tissue resistance is met. RF has been in medical use for decades, RF cautery and tissue destruction has been used to tighten pharyngeal tissues in sleep apnea, reduce nasal congestion in allergic rhinitis, ablate abnormal cardiac conduction pathways, ablate tumours in the lungs and liver

RF has been used in medical aesthetics for over 20 years- in 2002 the first monopolar RF device Thermage was US FDA approved for treatment of wrinkles and sagging skin.

Earlier RF devices relied on monopolar or bipolar RF to generate bulk heating of tissues. In monopolar RF, energy flows from an active electrode on the operators handpiece to a grounding pad on the patient’s body, hence energy penetrates deeper. 

With bipolar RF energy flows between 2 adjacent electrodes both contained on the operator handpiece- resulting in a more superficial treatment. Monopolar and bipolar RF carried a high risk of epidermal burns and post inflammatory hyperpigmentation (42C for neocollagenesis, 45C for burns). In addition, heating to 70C is required for significant neocollagenesis in the dermis- skin biopsies show that at lower temperatures only collagen contraction occurs, while higher temperatures are required achieve a wound healing response with increased cellularity, fibroblast proliferation and new collagen deposition. Hence, monopolar and bipolar RF devices were only modestly effective in skin tightening and had a risk of epidermal burns. In comparison, RF microneedling delivers energy through needles that target a predetermined depth, targeting the dermis effectively while sparing the epidermis, this translated into better results with lower risk of burns/post inflammatory hyperpigmentation.

What can I expect from a SecretDUO procedure?

A detailed medical consultation is performed to better understand the your concerns and assess your suitability for the treatment. 

Topical anaesthetic is applied for 20-30 minutes, thereafter, the SecretDUO procedure takes about 20 to 30 minutes. Expect some skin redness and sensitivity for 1-2 days after the procedure, it is possible to return to normal activity the next day. Results can be seen 1-2 weeks after the treatment, it is recommended to do 4-6 treatments a month apart with maintainence treatment every 3-4 months thereafter.