Efficacy and safety of Dynamic Quadripolar RadioFrequency, a new high-tech, high-safety option for vulvar rejuvenation

Background: The flow of papers about surgical and non-surgical vulvar rejuvenation techniques parallels the steadily increasing interest by the general public and the market. All vulvar rejuvenation procedures share the goal of correcting vulvar aesthetic imperfections and alleviating the related physical and psychological burden experienced by the woman in her everyday life (irritations, discomfort, possibly unrewarding couple relationship). Dynamic Quadripolar RadioFrequency (DQRF) is the latest-born technology in the evolving world of lightand energy-based therapies as effective alternative options to traditional techniques of aesthetic and cosmetic surgery. Methods: More than 500 complete DQRF vulvar rejuvenation cycles were performed between March 2016 and June 2017 according to the proprietary “EVATM Vulvar Rejuvenation” treatment protocol in an advanced international centre of plastic and aesthetic medicine and surgery. The evolution of vulvar aesthetics and the subjective level of gratification of women for aesthetic and daily life benefits were retrospectively evaluated in a random sample of 25 DQRF cycles by the same EVATM operator. As regards efficacy, for each woman the authors retrospectively scored, on 10-cm visual analogue scales (VAS), the photographic documentation of the vulvar area before and at the end of the DQRF rejuvenation cycle and after 3 months of follow-up without further treatments. While scoring, authors were blind to the history and demographic details of women. The outcomes (VAS scores) of standardised-format interviews conducted by the EVATM operator at the end of each vulvar rejuvenation session were also analysed. Investigated issues: wellbeing during the procedure and aesthetic and functional benefits experienced by the woman up to that moment of the vulvar rejuvenation cycle. Results: Improvements of vulvar aesthetics were objectively apparent in all women at the end of the DQRF rejuvenation sessions, often after the first one. Mean scores attributed to the photographic documentation of the vulvar area significantly improved between the beginning and the end of treatments (4.1 vs. 7.8; p<0.05). Aesthetic objective improvements persisted over the following months (score at the end of the no-treatment follow-up: 7.6). The level of individual gratification of treated women, already significantly increased before the second DQRF session, steadily increased over the following weeks and after the end of their vulvar rejuvenation cycle. No woman experienced clinically significant adverse effects; only a slight degree of transitory hyperaemia was commonly reported. Conclusions: A short vulvar rejuvenation cycle of four 10-min sessions based on the new DQRF technology significantly improves vulvar aesthetics and helps to suppress the problems and discomfort in the woman’s everyday life that are commonly related to her vulvar atrophy. Aesthetic and functional progress is seen in all treated women; relief of discomfort and irritations was often reported even before the end of the DQRF sessions. The procedure is comfortably office-based, technically simple and devoid of disturbing adverse effects. Development of the DQRF technology in the next future will have to focus on cytological and histological studies to deepen understanding of biological effects, as well as on expanding the number of treated women and the documented follow-up period (so far, one year in published clinical studies). Validated questionnaires will have to be used to assess the subjective level of gratification of treated women. Correspondence to: Mauro Raichi, Clinical Pharmacology and Biophysics Consultant, Milan, Italy, E-mail: mraichi@gmail.com