How Profound RF works

Profound is a radiofrequency microneedling system made by Candela. A handpiece carries a cartridge of fine needle pairs, and each pair works as a tiny electrode. Usually under local anaesthetic, the needles pass through the skin to a set depth, and radiofrequency energy flows between each pair. It heats the tissue around the needle tips to a temperature the doctor sets, 65 to 75 degrees Celsius in the US clearance, for three to five seconds. The heat causes a controlled injury deep in the skin, and the body repairs it with new collagen, elastin and hyaluronic acid over the following months. That is what firms the skin and softens wrinkles. Every treatment is given by Dr Marie Duggan, GMC 7488383, at Profound RF London Clinic, 8 Devonshire Place, after a free consultation.

What makes Profound different

Two things set it apart from the radiofrequency microneedling devices people compare it with. The first is the dose: the maker calls it a "real-time, temperature-controlled" device, in which sensors read the tissue temperature and the system adjusts the power to hold the set point, rather than delivering a fixed amount of energy. The second is that it is planned as a single treatment, not a course of three or four. The Profound or Morpheus8 page sets the two side by side.

The two cartridges

The US clearance describes two handpieces with their cartridges: a 25-degree Dermal one with five needle pairs for facial wrinkles, and a 75-degree SubQ one with seven pairs for the appearance of cellulite. The SubQ needles go in more steeply and reach deeper. The doctor explains at the consultation how your area is treated.

What the clearance says

The Profound System is FDA-cleared under record K161043 of September 2016, which added the cellulite indication to a facial wrinkle clearance from 2009 (K082391). The 25-degree Dermal handpiece and cartridge are "used for percutaneous treatment of facial wrinkles". The 75-degree SubQ handpiece and cartridge are "used to improve the appearance of cellulite in patients with Fitzpatrick skin types I-III as supported by long-term clinical data (6 months)". A 510(k) clearance is a finding of substantial equivalence to devices already on the market, not an approval, which is why we call Profound FDA-cleared. We make no claim about a UK or European registration for Profound.

The session

1. Free consultation. Dr Marie Duggan examines your skin, agrees the areas, explains the depth and temperature she will use, and gives you the price in writing. In our practice, photographs are taken.
2. Numbing. Profound is routinely given under local anaesthetic. The documented method in the trials is a dilute lidocaine solution infiltrated into the area, with a numbing cream or inhaled gas added in some protocols; the doctor plans comfort with you. In the cellulite trial, pain averaged 3.7 out of 10.
3. Treatment. The handpiece places the needle pairs through the skin and heats each point for a timed pulse. The face and neck take about an hour in all; the trial average was 32 minutes of treatment time. Body areas are planned by size.
4. Straight after. In our experience the skin is red and swollen and feels tight and sore, like sunburn with a bruise. You go home the same day.
5. The first week. Redness settles over hours to a day or two, and swelling and bruising usually settle within five to ten days. Most people are back to normal activities within 24 hours.
6. Results. The skin firms gradually as the swelling clears and the new collagen forms, and in the face trials the result was still improving at six months, the last point measured.

Which areas

Every area the device is used on, we treat. The face and neck, the lower face and jawline and the skin under the chin have published trials. Smaller series with a temperature-controlled device of this type, the brand not named in their summaries, cover the cheeks and midface, the lines around the mouth and the brow. Cellulite on the thighs, the upper arms, the skin above the knee and the bra line have published series. The forehead, around the eyes, the jowls, the chest, the abdomen and the legs are areas we are asked about. No published series gives a figure for them, so the doctor tells you at the consultation whether Profound can be done on yours. The face and neck page and the body and cellulite page explain each.

Who it suits

In our practice, Profound suits an adult with mild to moderate loose skin or wrinkles who wants one treatment rather than a course and a natural improvement in their own skin over months. It does not replace a facelift, and the doctor will say so where surgery is the better route. The doctor reviews your history at the consultation. In our practice that means caution or a no in pregnancy and breastfeeding, with an active skin infection or cold sore in the area, or with a pacemaker or other electrical implant. The same applies to a history of keloid scarring, or a condition or medicine that affects healing or bleeding. The full guide covers the rest.