evolastin ™ by Wave Plastic Surgery & Aesthetic Laser Center

How it works?

The applicator handpiece on the evolastin device inserts 5 pairs of very fine, electrically isolated, bi-polar Radiofrequency(RF) microneedles 1-2 mm into the skin automatically from a single use cartridge. Distinct, individual zones of thermal injury are created between each pair of needles as Radiofrequency(RF) energy is delivered into the deeper parts of the skin for a specific period of time at predetermined temperature settings. Specialised sensors inserted in each of the needles measures the skin temperature. Thermal injury is assured as real-time temperature monitoring adjusts energy ten times a second to achieve optimal target temperatures. The resulting specific injury to the deeper parts of the skin causes the body’s naturally occurring cascade of healing responses to be initiated, ultimately resulting in both new collagen and new elastin production which helps increase the thickness of the skin, whilst also improving the elasticity and firmness of the skin . Due to the precision of the technology deployed, treatment variability is eliminated and the patient’s individual healing is assured.

About microneedles

A sterile, single-patient-use cartridge houses the microneedle array of 5 pairs of 32 gauge electrodes—similar to those used to deliver neurotoxins (Botox). Sensors within the electrode tips continually measure tissue temperature and impedance(resistance) during treatment for optimal treatment control and effectiveness. With evolastin, we can-for the first time-select tissue temperature and time-at-temperature as clinical end-points. Energy delivery is precisely controlled based on real-time feedback from the sensors rather than subjective patient response. As a result, treatments are automatically customized for each patient based on their skin response, ensuring consistent clinical results.

What happends if the microneedles are placed too deeply?

They are designed not to (at a 20° angle, the target is 1-2 mm into the dermal layer of the skin) but admittedly, the thickness of skin does vary from patient to patient. Studies have shown even when the needles extend into the subcutis layer(layer beneath the skin), the RF energy will continue to follow the path of least resistance (lower impedance in skin vs. fat) and most of the energy will still ultimately be deposited into the deeper parts of the skin.

What happends if the microneedles are placed too superficially?

The evolastin system is designed to recognize differences in impedance and will adjust the energy being delivered accordingly. Superficial insertion is associated with low tissue impedance. In such a case, the system is design to detect this situation, and shut down the RF energy to protect the epidermal layer and prevent superficial heating / burning. If the needles are repeatedly extended into the air, for example, the evolastin console will recognize infinite impedance and identify a cartridge failure and therefore cease the treatment.

Is it painful?

Because there is a need to use the needles to deploy the RF energy effectively, local anaesthesia is used so that the procedure can be performed painlessly. Of course there will be a stinging sensation whilst the local anaesthesia is administered throughout the face, although every attempt will be made to minimise this through careful technique. Once however the local anaesthesia has been injected no further pain will be felt when the treatment is actually performed.

Who is the ideal candidate for the evolastin procedure?

The ideal candidate for the evolastin procedure is typically someone who has some mild to moderate degree of skin laxity that wants to improve their skin firmness and volume and perhaps is not fully ready clinically for a skin tightening procedure such as a facelift. Patients who have more advanced levels of skin laxity are best dealt with via Facelift procedure. Nonetheless patients with more advanced and obvious laxity of the skin-but who have already ruled out an invasive surgical facelift-may also benefit from the evolastin procedure. However these patients will need to understand that the evolastin procedure in these circumstances will never mimic or achieve the results obtained with a surgical facelift.

How should I set my expectations?

It’s important for patients to understand that although the revolumising effects from the new collagen and elastin production in the skin from the evolastin treatment will improve skin laxity and some lines and wrinkles, it is not as obvious an effect or a substitute for a surgical facelift. As a very rough rule of thumb and for comparative purposes, it probably delivers approximately 25% of the effects of a surgical facelift. Therefore patient must adjust their expectations accordingly. The aim is for an improvement in firmness and laxity of the skin but it does not give the exact similar lifting effects that a facelift does. All expectation and limitations, as well as your suitability will of course be discussed during the consultation.

What is dermal heating and importance of it?

Dermal heating is an important concept in rejuvenation. All skin tightening devices work via a similar mechanism. By delivering enough heat through RF or light based energy deep into the dermis, they create a “unique healing process” through both mechanical and biochemical effects that lead to an initial contraction of the collagen fibers followed by a well-documented wound response with dermal(deep skin) remodelling and ultimately new collagen formation. In order to successfully deliver enough energy deep into the dermal tissues to cause an effect however, the skin must also be sufficiently be cooled prior to, during and after the treatment.

Experience have shown that achieving consistent clinical efficacy while maintaining patient comfort during treatment has long been a challenge for non-invasive RF systems. Most users agree that existing Radiofrequency, Infra red and other energy based systems bulk heating approaches to address skin laxity produce variable results, with some patients experiencing significant improvement and others none at all. The evolastin treatments uniquely deliver more energy deeper into the skin than competitive, bulk heating and non-invasive fractional devices, which studies have shown result in greater dermal volume and improved skin elasticity. Since treatment variability is eliminated with evolastin, improved treatment outcomes can reasonably be expected from this new technology.

What makes evolastin different?

Up until now with the existing energy based machines, energy used to heat the skin to stimulate new collagen formation has been primarly surface deployed. The problem was that although a certain amount of energy was released onto the outer surface of the skin, it was never quite certain what precise amount of energy was actually getting into the deeper parts of the skin to stimulate the collagen production. By using the aforementioned fine needles however, e PRIME is the first minimally invasive aesthetic device to precisely target and deliver specific and precise RF energy directly into the deep dermis for significant tone, volumetric and elastic improvements of the skin. Unlike other approaches that require multiple treatments due to uncertain energy delivery, a practitioner can now be assured that evolastin will deliver the treatment temperature they specify in a single treatment. Furthemore evolastin’s patented Intelligent Feedback Systems (IFS) measures impedance and monitors temperature real time to constantly adjust power levels regardless of varying skin conditions or skin types.

Moreover, unlike many other non-invasive treatments that cannot use local anaesthetic because it interferes with the treatment, the evolastin treatment can and must be performed with a local anaesthetic. This allows optimal treatemtn temperatures to be reached to achieve results while managing patient comfort. The patient’s response to pain is not used to determine how much energy is to be delivered, as with other technologies, and there is no need to deliver lower, less effective energy levels to avoid patient discomfort. With evolastin it is also possible to achieve more predictable results in a single treatment while providing a positive patient experience.

What is the risk to the epidermis(top layer of skin) and/or dermal structures?

The design of the evolastin has been developed to minimise risk to other structures. In addition to the integral cooling plate which cools the surface of the skin, the inner end of the needle shaft is sheathed in insulation to protect the top layer of skin during treatment. Furthermore, within the dermal layer of skin, bipolar RF energy takes the path of least resistance, bypassing and protecting other key structures such as adipose tissue (fat cells), sweat glands, sebaceous glands, hair follicles.

How long is the evolastin treatment?

The evolastin treatment is a one-time procedure and to perform the treatment on the face and and neck typically lasts approximately one hour, including pre-treatment anaesthesia delivery.

What can I expect in the immediate post treatment period?

Initially you could expect to see some surface damage to the skin which looks like lines of pin pricks. Your face will be puffy and tender throughout the first day gradually becoming tingly and sore- ice packs however will help to ease this. You may experience some itchiness and pain along the jaw bone and around the front of the ear area. This can take a while to ease. Oral painkillers usually suffice to help this. Intermittent bruising and yellowing of the skin may occur throughout the forthcoming days also along with a hot sensation and itchiness. Bumpy uneven skin and tenderness in the lower areas of the face may also be evident and cause you discomfort.

In the first few days there may be small pimple like spots which can be sore and itchy and look like chicken pox in the treated areas. The swelling can take some time to subside and is especially evident from the 3rd to the 7th day-when you smile you will particularly notice this as this manifests itself predominantly around the mouth area. Bruising can be kept to a minimum by taking arnica pre and post procedure however you may develop small bruises or a yellowish hue in your skin tone which you may wish to cover with make-up in the first few days post treatment.

Are there any side effects?

evolastin has an excellent safety record and the treatment is usually well tolerated by patients. The fractional(specifically targeted) treatment approach protects the tissue surrounding the treatment zones. Side effects are generally mild and include redness, superficial bruising and swelling.

When will I see the results and how long will they last?

Most patients report seeing improvement 6-8 weeks post treatment. Because however new collagen requires time to fully develop, optimal results will not be observed for at least 3 months post-treatment. As occurs of course with all anti-ageing treatments, time never stands still. As a result you will continue to age according to the laws of time and physics, and of course on your lifestyle and skin maintenance routine. However it would be safe to say that after receiving most successful treatments you will always look somewhat better than you would have looked had you never received any such treatment!

How do results differ from other technologies?

As already mentioned, the evolastin treatment triggers a surge of growth activity within the dermis to significantly increase skin thickness and volume. While patients are excited to see improvement in their skin tone within several weeks, the production of collagen continues typically for up to 6 months or more. Patients therefore can expect a lasting, natural, more youthful appearance from evolastin.

It is important to remember however that apart from surgery, no other treatment approach actually “tightens” the skin. All light-and energy-based technologies can only induce an injury to the skin which should initiate a healing response that ultimately leads to an improvement in skin laxity. What separates evolastin apart from all of these other skin tightening technologies is our ability to consistently deliver a fractionated(specifically focused) zone of known thermal injury specific to the deep dermis, where the potential for new collagen and elastin production has been demonstrated. The only variable left in the skin rejuvenation equation with evolastin is the patient’s healing response—some patients will just respond differently than others, regardless of the technology. With all other light- and energy-based approaches, the treatment technology itself remains a variable in the this equation. Since evolastin eliminates treatment variability, clinical outcomes must be based solely upon individual healing responses.

Does evolastin have U.S.A. FDA 510(k) clearance?

evolastin has two FDA indications for use– in dermatologic and general surgical procedures for electrocoagulation and hemostasis and for the treatment of wrinkles.

It also has CE approved marking.