What is INFINI?
The INFINI is the brand name of a machine that produces Radiofrequency energy and can deliver that energy through a special micro needle system into the deeper layers of the skin to rejuvenate skin, correct scarring and tighten and lift sagging skin.
What is Radiofrequency Energy?
Radiofrequency energy is a type of electric energy that consists of a very high frequency current in the millions of cycles per second called Mega Hertz (abbreviated as MHz). The term Radio Frequency (RF) has come to be used to describe very high frequency energy because the soundwaves used in radio broadcasting and communications are very high frequency.
Why does skin wrinkle and sag?
The skin consists of 2 main layers, the outer Epidermis and the inner Dermis. The Dermis is the supporting structure of skin and provides skin fullness, firmness and elasticity because of 2 main proteins, Collagen and Elastin and the sugar Hyaluronic Acid.
As we age the Dermis becomes thinner and the skin loses elasticity and sags because of reduced Collagen, Elastin and Hyaluronic Acid levels. Not only is there a breakdown of existing Collagen and Elastin but new Collagen and Elastin are produced at a much slower rate as we get older. There is also a reduction in the quality of Collagen and Elastin with environmental factors playing a major role. For example studies have shown that UVB sun exposure increases the production of enzymes that can result in damage to Collagen and Elastin.
How does Radiofrequency improve skin?
Living tissue such as the skin, offers resistance to the passage of electric currents and when an electric current such as Radiofrequency energy meets resistance heat is generated. Radiofrequency energy has been used in medicine for over 70 years as a means of producing heat with multiple applications such as electrocautery.
It has been shown that heating up the deeper layers of the skin (Dermis) to a high enough temperature will create collagen contraction and a wound healing response which results in old and lax Collagen and Elastin fibres being replaced by fresher new Collagen and Elastin.
For the last 10 years various devices applying radiofrequency energy to the surface of the skin have been used to try and heat up the deeper layers of the skin with the aim of stimulating new collagen formation and hence reduce wrinkles and fine lines. Radiofrequency devices such as the THERMAGE which heat up the skin from the surface have had unpredictable results as many factors influence how much heat can get down to the deeper layers of the skin without burning the surface of the skin.
The big advancement in using Radiofrequency for wrinkle reduction and skin tightening came when it was combined with skin needling. By inserting fine needles into the skin and then sending the radiofrequency energy down the needle it enabled the energy to be accurately delivered to the desired depth and spared the surface of the skin from damage. The INFINI uses a series of insulated microneedles (0.2mm) to deliver radiofrequency energy up to 3.6mm below the skins surface.
What conditions can the INFINI treat?
A wide variety of conditions can be treated on both the face and body but in particular
Scars: All types of scars can be treated but particularly acne scars and INFINI is especially safe in darker skin types.
Wrinkles: Fine lines and wrinkles on the face, neck and around the eyes. Particularly good results can be achieved with cheek lines.
Skin Tightening: Loose skin can be tightened on the face (non surgical face lift) with neck and jawline being most popular. Other body areas such as chest, knees abdomen and arms can also be treated.
Skin Rejuvenation: Skin will look fresher and revitalised by improving fine lines and wrinkles, reducing pore size and tightening.
Hyperhidrosis: Excessive sweating of the underarms can be permanently reduced by targeting the sweat glands
Acne: Acute acne can be treated by targeting the sebaceous glands.
Stretchmarks: Whilst good improvement can be achieved in some patients results can be unpredictable and it remains one of the most difficult conditions to treat.
What are the advantages over laser treatments?
The micro needling technology of the INFINI enables the needle to be inserted at variable depths and hence the energy can be delivered at different levels. This is important to individualise treatment as some areas of the skin are different in thickness than other areas and also some skin conditions require deeper treatment levels than others.
The INFINI is able to treat at a much deeper skin level than Lasers. By using microneedles the INFINI can reach up to 3.5 mm below the surface of the skin which is why it can reach the deep dermis layer of the skin and result in Collagen production and skin tightening. Lasers used in Cosmetic Medicine target structures in the epidermis and upper dermis of the skin and do not have much effect below about 1.5mm depth. This means Lasers are best for treating the surface of the skin and are the treatment of choice for such things as removing unwanted pigment, blood vessels, hair and tattoo ink.
The other big advantage of Radiofrequency energy is that it is ‘colour blind’ which means it doesn’t matter how dark the skin is or even if the skin is tanned at the time of treatment. In contrast, Laser energy is very colour dependent, and great care needs to be exercised when using Lasers to treat darker skin types and tanned skin, because of the risk of unwanted side effects such as increased pigmentation (Post Inflammatory Hyperpigmentation).
Why use needles?
The INFINI uses microneedle technology primarily because by delivering Radiofrequency energy through a needle the heating can be accurately and safely directed and localised into the dermis of the skin.
Various devices in the past have tried to apply Radiofrequency energy onto the surface of the skin to heat below the surface but results were disappointing. This is because to heat the deeper Dermis to a high enough temperature to stimulate Collagen is difficult without damaging the surface of the skin. Differences in skin thickness, hydration, Collagen and fat make the depth of heating unpredictable. If tissue heating doesn’t occur at the right level at the right temperature then minimal Collagen stimulation occurs and inadequate results are achieved.
The secondary benefit of micro needling is that the trauma from the needles penetrating the skin causes mechanical stimulation to fibroblast cells in the skin to also help in producing Collagen. This is why needling techniques such as DERMAPEN can be effective even without the added benefit of Radiofrequency energy.
What type of needle is used?
The needles used with the INFINI are gold plated to minimise any chance of allergy. The needles are very fine, only 200 microns (0.2mm) thick, and because they are so tiny the term micro needling is used. The INFINI uses a tip that has 49 tiny needles (also called pins) and they deliver the energy in what is called a fractional mode. The needles used with the INFINI are insulated which means that the energy is directed through the tip of the needle and heating is able to be accurately targeted and controlled.
What is fractional treatment?
The INFINI is a fractional Radiofrequency machine. The idea of fractionating energy was first used in the FRAXEL laser in 2005 and essentially what it means is multiple discrete points of skin are treated surrounded by unaffected skin. Fractionated treatment assists wound repair and results in faster skin healing, less discomfort and greater safety for the patient. Typically in an INFINI treatment about 30% of skin in an area is treated with each treatment which is why 2-3 treatments can be needed for the best result. If too much skin is treated in a single session the downtime and risk of reaction significantly increases.
Can anyone have an INFINI treatment?
No, everyone cannot have INFINI, but in practice very few patients need to be excluded.
Patients with cardiac pacemakers or implanted defibrillators should not have any electric type treatments including INFINI. Patients with cochlear implants should also avoid radiofrequency treatments because of potential damage to the implant.
If there is a metal implant in the area being treated, the skin overlying the metal implant should not be treated. If someone has a known allergy to metals then caution needs to be exercised as the INFINI uses metal pins, however the needles used in the INFINI are gold tipped to reduce the chance of any metal sensitivity.
Patients with acute skin disease should not have any cosmetic treatments including INFINI.
Patients who are pregnant or breast feeding are as a general rule advised against all elective procedures including the INFINI. Whilst there is no evidence it is not safe there is also no evidence to prove it is completely safe. Also it does involve the use of quite strong topical anaesthetics and we recommend deferring INFINI treatments until after breastfeeding.
Patients with serious medical conditions such as uncontrolled Diabetes, Autoimmune diseases or Cancer can have INFINI but will not get as good a result because of impaired skin healing. Similarly, patients who are unwell or are smokers, will not tend to respond as well to INFINI compared to healthy patients.
Patients on certain medications need to be more cautious before having INFINI treatments such as patients on blood thinners who might bruise more easily and medications that cause photosensitivity who might have a more severe reaction after treatment.
Proper medical assessment including current medical conditions, medications and allergies is important before INFINI to provide realistic expectations.
Is the treatment painful?
The INFINI needles are virtually painless as they are inserted into the skin because they are so fine and are inserted very fast. Also the 49 micro needles in the tip of the INFINI handpiece do not all punch into the skin at the same time but are inserted serially in rows. However, when the Radiofrequency energy is delivered through the needles, it can be felt and cause discomfort from the heating below the surface of the skin. Hence for an INFINI treatment topical anaesthetic is applied before treatment. When topical anaesthetic is used most people rate the procedure as only 4 out of 10.
If someone has metal pins, implants or artificial joints in other parts of their body, they can experience a tingling sensation in those areas during an INFINI treatment. This is caused by the electric current used in Radiofrequency energy but is not painful.
Patients do not report pain after the INFINI procedure.
What does an INFINI treatment involve?
Topical anaesthetic cream is applied 60 minutes before treatment. During treatment a cooling machine (such as a Zimmer cooler) can be used but is not essential as the insulated needles used with the INFINI avoid heat damage to the surface of the skin. Treatment of a full face takes about 45 minutes and face and neck about 60 minutes. Each area is typically treated at different depths with 2 passes for each depth. There can be some pin point bleeding when the micro needles penetrate the skin and occasional bruising. After treatment a cold pack is used and then a soothing cream applied. Recovery time can be reduced by the use of a special LED light straight after treatment.
How long is the downtime?
The usual expectation is to have some downtime for about 48 hours after an INFINI treatment. There is some initial redness and swelling after the treatment, this reduces quite quickly in the first few hours then some residual redness typically lasts for about 2 days. There is a sun burn like sensation after treatment due to the heating beneath the skin and this also gradually dissipates over the first 48 hours.
There are no restrictions on activity after INFINI, but whilst sun exposure can occur immediately after treatment, it is generally advised to minimise sun exposure whilst the skin is red and feeling warm.
Some skin reaction can persist for several days longer after treatment in certain circumstances such as very sensitive skin types, when on certain medications, impaired immunity or if smokers. The use of phototherapy immediately after treatment with LED light, has been reported to reduce recovery time by as much as half, and is recommended if increased skin reaction is more likely, or if downtime needs to be kept to a minimum.
What is the aftercare?
After treatment the skin can be cleaned with cool water and a soothing cream may be recommended. LYCOGEL, which is a breathable makeup, can be applied immediately after treatment, but we advise avoiding usual makeup for 48 hours. In the first 2 days it is also recommended that care should be used when touching the skin with dirty hands or towels. A gentle moisturiser (eg Cetaphil) can be used frequently, but alcohol based products should be avoided for at least 1 week. Shaving and showering can be recommenced the day after treatment.
How soon are results seen after an INFINI treatment?
Typically some early improvement is seen due to Collagen contraction and tissue swelling then further gradual improvement continues to occur over the next few months. Full results take 4-6 months as this is how long it takes Collagen remodelling to be completed.
Most patients see improvement with only one treatment but optimal results in facial rejuvenation, skin tightening and Hyperhidrosis typically takes 3 treatments. It is important to remember that the INFINI is fractional technology, with areas of normal skin left surrounding the areas being treated to minimise downtime and side effects, and allow for rapid healing. These areas of untreated skin are targeted in subsequent treatments.
It is usual that the best results with acne scarring can take 5-6 treatments.
The usual interval between INFINI treatments is 3-4 weeks, but they can be spaced further apart if necessary, and this will not adversely affect the final results.
In facial rejuvenation and skin tightening it is usually recommended to have a follow up treatment every 12-18 months to maintain results.
How much does an INFINI treatment cost?
It depends on the area being treated but as a guide a face treatment is usually $660. If both the face and neck are treated the cost is $880. Packages of 3 treatments can be purchased at a discounted rate.
Can INFINI be combined with other treatments?
The INFINI is an ideal treatment to combine with lasers because it is so targeted without damaging the surface of the skin. One example is in rejuvenation of sun damaged skin, we can treat with the INFINI to improve the elasticity and wrinkles followed with the 1927 FRAXEL Laser to treat surface pigmentation.
Topical treatments can also be combined with the INFINI. The micro needling creates an opening in the skin for topical products to penetrate and be more effective compared to when they are just applied to normal skin. Products that have been used successfully include Vitamin A, Vitamin C, Hyaluronic Acid, Growth factors and Hydroquinone.
Treatments such as anti-wrinkle injections are best not performed on the same day as INFINI if they are in the same area. The heat from the Radiofrequency can reduce the effectiveness of the anti-wrinkle injections and also tissue swelling after INFINI treatment can potentially result in migration of the anti-wrinkle product and unwanted side effects. Dermal fillers based on Hyaluronic Acid can also potentially be broken down more quickly if the INFINI is used in the same area.