• [Lecture of the Month] Smooth Liner Procedures and Live Surgery Ⅱ


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    Smooth Liner’s Indications


    Smooth Liner’s indications include wrinkle, acne scar (rolling scar), striae and skin tightening, etc. Details of the procedure techniques for each indication are as following.

    A wrinkle procedures follow the order of incision/subcision, radio frequency heating, and collagen remodeling.

    A skin tightening procedure consists of subcision & Injection of tumescent anesthesia, and radio frequency heating. This can bring immediate skin tightening effect.

    Combination with supplement injection involves subcision, tunneling and injection of filler (HA) followed by radio frequency heating for creating collagen denaturation wall. This enhances the effect by providing scaffolding.


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    Clinical cases of Smooth Liner procedures


    <Figure 10>


    <Figure 11>


    <Figure 12>


    The following are photos of before and after the treatment with Smooth Liner.

    <Figure 10> shows a patient who did not respond to other modalities of wrinkle removal such as thread, or injection, etc. This patient benefited from Smooth Liner treatment and wrinkles continuously improved from 30 days to 4 months after treatment. This convinced us that Smooth Liner is particularly effective in wrinkle and rolling scar removal. It is also beneficial in scar adhesions in the face. We are currently applying this device in the under eye bags. This procedure will be shown in Live Surgery following this lecture.

    <Figure 11> shows a patient who showed facial asymmetry after treatment. Her habit of moving one side of the face more may have caused the imbalanced outcome. The right image of <Figure 11> shows the condition a month after treatment. As shown here, the outcome is lopsided.

    <Figure 12> shows a case of combination with filler. High RF energy seemed to have brought a knotted appearance and we had to straighten the surface. As shown here, excessive energy can cause scar tissues to bunch up and using an appropriate level of energy is important.

    I’ll wrap up my talk here. Please feel free to ask any questions. Thank you.


    Q: I heard that Smooth Liner can be combined with various supplemental materials such as filler, PRP, and HA, etc. Is it possible to inject fat as well?

    A: For deep scar lesions, fat injection can be done.

    Q: In wrinkle treatment, which areas should be the focus of treatment?

    A: That depends on the form and thickness of the wrinkle. For example, treatment of perilabial creases should focus on subcutaneous region. For under eye treatment, insertion should be close to the bone. In the forehead the treatment is carried out between the dermis and subcutaneous layer.

    Q: It seems many aspects of neck wrinkle treatment require caution. Especially, I think excessively high energy is risky. What is the correct level of energy?

    A: Treatment using Level 10 or lower do not cause serious problems. Areas other than the neck also showed no problems from Smooth Liner treatment.

    Q: Could you compare the effect of using the filler alone and combining filler with Smooth Liner?

    A: Combination brings longer lasting effect and better elasticity. The amount of filler can be reduced and adhesion can be prevented in combination with Smooth Liner. In Korea, some doctors inject filler first and enhance collagenesis through high-frequency irradiation to heat up the filler.



    Live Surgery Session; Under Eye Fat Removal

    First, lipolysis of the protruding fat is performed followed by injection of filler in the indented area.



    ⓵ Photographing

    ⓶ Marking

    Mark the procedure area.

    ⓷ Sterilization and anesthesia

    Anesthetize the under eye target area. Create a small puncture with a needle and inject anesthetics with a cannula. Anesthetics injection with a needle can leave bruises. You can use the treatment cannula for anesthesia. Inject anesthetics in the fat and subcutaneous layers and prepare the high-frequency.

    ⓸ High-frequency & Filler

    For the procedure, use 27 gauge needle. This needle is very sharp. The heart-shaped cannula is not efficacious in this area and blunt type needle is preferred. Start with the energy level of 10 and adjust accordingly. The energy should be given as the needle is pulled out. The endpoint is set as the point when the needle is pulled without hitting any obstacles. Here, the high-frequency is irradiated to bring coagulation and there is no bleeding.

    The next step is skin tightening with injecting the needle in the subcutaneous layer. Here, the filler is simultaneously injected.

    ⓹ Post-treatment ice pack care

    As this treatment causes no bleeding, ice pack can be applied immediately after treatment without special post-treatment care.

    Smooth Liner allows minimally invasive, effective and efficient treatment through a single opening of the needle.


    -The End-

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