Agnes RF Microneedling: What You Should Know

Pros

• The Agnes RF device can sculpt and contour the jowls, neck, and chin, and reduce under-eye bags, without the cost, downtime, or risks of surgery.
• In addition to reducing unwanted fat and tightening mildly loose skin, Agnes RF treatments stimulate new collagen production to improve skin texture and reduce fine lines and wrinkles, like those around the eyes and mouth.
• It can also treat acne, sebaceous hyperplasia, and hyperhidrosis.
• Treatments can be customized for all skin types and tones.
• The fat reduction is permanent, assuming no significant weight changes.

Cons

• Two or three treatment sessions may be required to see optimal results. “Most of my patients receive two treatments and, very rarely, three treatments,” says Dr. Morno.
• New collagen can take up to 12 weeks to generate in the skin.
• Like other nonsurgical treatments, Agnes RF facial contouring and skin tightening results can’t match what you’d get from a surgical facelift, and the benefits aren’t permanent. Occasional touch-ups are recommended to maintain results.
• Some RealSelf members reported poor results and/or prolonged side effects, including swelling, bruising, pain, and numbness—even after more than two weeks. 
• As with any nonsurgical collagen-stimulating or fat-reducing treatments, the Agnes RF can cause scar tissue to form beneath the skin, especially when used on more aggressive settings. This scarring can potentially complicate future facial surgeries. 

RealSelf Tip: The results of energy-based treatments like this one can be very technique-dependent, so it’s essential to find an experienced, board-certified dermatologist or plastic surgeon who understands how to customize it appropriately for your skin tone and concerns.   

Related: Does RF Microneedling Live Up to the Social Media Hype? Doctors Weigh In

A good candidate for Agnes treatment is someone who has mild to moderate skin laxity, plus fat to spare, and isn’t interested in surgical solutions. Reasonable expectations are key. “They must understand that Agnes will improve their condition but will never give a surgical result,” says Dr. Morno.

Dr. Petropoulos says that the results can still be impressive. “If we’re talking about a mini lift for a 45-year-old, then, yes, absolutely, Agnes can do that,” she says. For a very jowly 75-year-old, “the fastest, easiest way for them to get a 45-year-old neck is with a [surgical] facelift,” she says.

On the day of your appointment, here's what you can expect.

• First, your provider will cleanse the skin (to prevent infection) and mark the target area. 
• They will apply a numbing cream, and you'll wait about an hour for it to work. This is usually sufficient to manage discomfort. For treatments involving deeper punctures or a higher RF energy setting, your provider may also administer an injectable anesthetic.
• Once you're numb, the procedure takes between 15 and 30 minutes, depending on the size and number of target areas.
• Your provider will select the correct needles to address your specific skin concerns. They may use more than one needle type to deliver heat at different depths and energies.
• Once the appropriate needle is inserted, the device will deliver a precise number of RF energy pulses.
• You might feel a warm pressure, but you can expect little to no discomfort as they work their way across the treatment area, inserting the needles in a grid-like pattern.

Your provider will send you home with aftercare instructions.

Your recovery time will depend on the intensity and location of your treatment, so be sure to discuss this with your provider during your initial consultation. Some patients quickly return to normal activities, while others take a few days of social downtime while redness and swelling resolves.

Especially if you're having an eye bags treatment, recovery can take much longer. In a company-sponsored study, lower eyelid swelling and bruising lasted for about a week. Because the under eye area is so delicate, full recovery can sometimes take up to two weeks.

Applying ice and taking over-the-counter pain relievers can help ease swelling or redness after the treatment. 

After a few days, the treated area can be covered with tinted sunscreen or make-up.  

Dr. Morno recommends avoiding strenuous activity for one week post-treatment.

Your provider may recommend topical skin care products to help with healing. They’ll likely advise you to avoid active ingredients like retinoids, glycolic acid, and salicylic acid for one week, as well direct sun exposure for at least two weeks.

RealSelf Tip: To minimize recovery time, be sure to follow your provider’s pre-treatment advice. This includes avoiding aspirin, non-steroidal anti-inflammatory drugs like naproxen and ibuprofen, acetaminophen, and supplements like vitamins C and E and ginkgo biloba for two weeks prior to your appointment. 

You may see some improvement immediately after the procedure, but the most noticeable results will gradually emerge over the course of about six weeks, as the fat cells shrink and the skin remodels itself as new collagen develops. 

Over this time, you may see an improvement in skin tone and texture, with less sagging, fewer fine lines, and improved facial contour.

In the aforementioned study on under eye bag treatment, researchers reported that “the severity of fat bulging decreased significantly after the first session, decreased further after the second session, and maintained this level throughout the 24-week study period. Moreover, the mean satisfaction score of all subjects was greater than five out of 10 throughout the study period, and only increased over time.”

Fat reduction results from this treatment are permanent, assuming no significant weight changes. “Once you remove a fat cell, it will never come back,” explains Dr. Petropoulos.

If you gain weight, the remaining fat cells in and around the area may get larger. The upshot: “It behooves a patient who’s making an investment in their looks to lead a healthy lifestyle,” says Dr. Petropoulos.

Beyond that, however, “it’s hard to know exactly how long the treatment lasts because each patient differs,” says Dr. Morno. “So far, patients treated three years ago [in my office] still look great.”

To maintain the benefits of Agnes RF, some providers recommend annual treatments. “Agnes will lift you and tighten your skin, but you will continue to age unless you do maintenance radiofrequency microneedling treatments once a year,” says Dr. Petropoulos.