Sequential Monopolar-Bipolar Pulsed Radiofrequency for Non-Invasive Periorbital Rejuvenation: A Case Series

Purpose: Periorbital aging manifests early due to thin dermis and reduced collagen. While surgery remains standard for advanced cases, patient demand for non-invasive rejuvenation has grown. Sequential monopolar-bipolar pulsed radiofrequency (RF) represents an emerging non-ablative technology capable of delivering controlled, uniform dermal heating for skin tightening and rejuvenation. Our aim is to assess the clinical outcomes of a sequential monopolar-bipolar pulsed RF system for non-surgical eyelid tightening and wrinkle reduction. Patients and Methods: Three Asian patients (aged 48-77 years) with varying degrees of periorbital laxity and rhytides underwent treatment using the DENSITY NOIR High Eye Tip (Jeisys Medical Inc, Seoul, South Korea) operating at 6.78 MHz. Each case received a single session with 200 shots to the upper eyelid and 100 shots to the lower eyelid, for a total of 300 shots per side, at energy level 5. Approximately 100 shots were delivered to the lateral canthal area to enhance tightening and lifting. Clinical outcomes were assessed through photographic documentation and subjective evaluation at follow-ups up to five months. Results: All patients showed moderate to marked improvement by month 5, consistent with collagen remodeling timelines. Maximal improvement occurred between the fourth and fifth months, consistent with the expected timeline for collagen remodeling. Patients expressed high satisfaction with the gradual, natural rejuvenation achieved. No adverse effects were reported. Conclusion: Sequential monopolar-bipolar pulsed RF (DENSITY NOIR) demonstrated clinically meaningful outcomes for periorbital skin tightening and wrinkle reduction after a single session. This technology may be a non-invasive option for patients seeking subtle, natural rejuvenation with minimal discomfort and downtime.