CClinicalTrials.gg
CompletedNCT06243744Updated Mar 24, 2026Results posted

Histological Evaluation of Human Skin Bx to Assess the Effects of APR Tx as an Adjunct Procedure in Facelift Surgery

An interventional study of Renuvion APR System in Skin Laxity, Tissue Degeneration and Tissue Breakdown, sponsored by Apyx Medical. Completed at 2 sites in United States. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-03-24.

Sponsored by Apyx Medical · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
7
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The goal of this prospective, single-arm clinical study is to gather quantifiable data on Renuvion's impact on skin elasticity and hydration, indicators of skin quality and estimate the biological skin age using DNA methylation in males and females between 18 and 75 years of age who plan to receive a lower facelift surgery. The main purpose is to quantify the effect of the Renuvion device on skin elasticity (collagen density, elastin, fibrillin-1), hydration (aquaporin-3, acidic glycosaminoglycans, HA), and DNA methylation to estimate the biological age of the skin.

Participants will receive a lower facelift surgery per the Investigator's standard clinical practice and treatment with the Renuvion APR System.

Read the detailed description

The purpose of this study is to gather quantifiable data on Renuvion's impact on skin elasticity and hydration, indicators of skin quality and estimate the biological skin age using DNA methylation.

This study is a prospective, single-arm clinical study to be conducted at up to three clinical sites in the US. Up to 10 subjects will be enrolled and treated if they meet the inclusion/exclusion criteria and provide written informed consent.

Enrolled subjects meeting all entrance criteria and confirmed eligible for study treatment will be asked to participate. Subjects will receive a lower facelift surgery per the Investigator's standard clinical practice and treatment with the Renuvion APR System. The mid/upper-face area will not be treated with Renuvion and the lower face/neck area will be treated with Renuvion. Treatment will consist of subdermal coagulation of soft tissue using the Renuvion APR handpiece.

02

Conditions studied

  • Skin Laxity
  • Tissue Degeneration
  • Tissue Breakdown
  • Collagen Degeneration
  • Collagen Shrinkage

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03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Male or female subjects, ages 18 - 75 years old.
  • ASA Physical Status Classification System Class I and Class II subjects.
  • Planning to undergo a lower facelift procedure, with or without a neck lift, at the investigator's site.
  • Understands and accepts the obligation not to undergo any other procedures or treatments in the areas to be treated during study participation.
  • Absence of physical conditions unacceptable to the investigator.
  • Females of childbearing potential who are sexually active must be willing to use an approved method of birth control during study participation.
  • Willing and able to comply with protocol requirements, including study-required images/photos, assessments/measurements, and returning for follow-up visits.
  • Willing to release rights for the use of study photos, including in publication.
  • Able to read, understand, sign, and date the informed consent.
  • Able to communicate with the site via video and/or photographs, in the event of a virtual follow-up visit.

Exclusion criteria

Exclusion Criteria:

  • Subjects presenting with ASA Physical Status Classification System Classes III or higher.
  • Pregnant, lactating, or plans to become pregnant during study participation.
  • Known hypersensitivity or allergy to tumescent anesthetic (lidocaine/ epinephrine).
  • Known hypersensitivity or allergy to ibuprofen or other NSAIDS.
  • Active systemic or local skin disease that may alter wound healing.
  • Significant or uncontrolled medical condition that in the opinion of the investigator participation in the study may compromise the patient's health.
  • History of autoimmune disease (excluding Hashimoto's thyroiditis).
  • Known susceptibility to keloid formation or hypertrophic scarring.
  • Cancerous or pre-cancerous lesions in the area to be treated.
  • Possesses a surgically implanted electronic device (i.e. pacemaker).
  • Serious mental health illness such as dementia or schizophrenia; psychiatric hospitalization in the past two years.
  • Participation in any other investigational study within 30 days prior to consent and throughout study participation.
  • Subject who, in the opinion of the investigator, is not an appropriate candidate for the study.
  • Subject who has had a prior facelift, neck lift, or Renuvion treatment in the face/neck area
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
7 participants (actual)

Study arms

  • Other
    Procedure with the Renuvion APR System in lower facelift area

    Subjects will receive a lower facelift surgery per the Investigator's standard clinical practice and treatment with the Renuvion APR System.

    Device: Renuvion APR System

Interventions

  • DeviceRenuvion APR System

    The Apyx Medical Corporation Renuvion/J-Plasma helium plasma family of products has received FDA clearance under 510(k) numbers K191542, K192867 for the cutting, coagulation, and ablation of soft tissue.

05

What researchers measure

Primary outcomes

  1. Analysis of Elasticity (Collagen & Elastin)

    To assess Elasticity (collagen \& elastin) evaluation will be based on the qualitative histology in samples at baseline and Day 180 follow-up. Two samples from each time period were analyses - control and treatment area. The H\&E, trichrome, and van Gieson-stained slides were evaluated via light microscopy for any abnormalities and extracellular matrix changes. The results of histopathological assessment were scored using the industry standard 5-point scoring system. 0=Normal, 1=Minimal, 2=Mild, 3=Moderate, 4=Severe.

    Time frame: Baseline, Day 180

  2. Analyzing Days of Duration for Bruising, Swelling

    Analysis days of duration of overall facial bruising and swelling post-treatment through the 180-day visit. The reported data is for the lower face treatment area only; the control area was not evaluated for bruising/swelling.

    Time frame: Post-Treatment, Day 1, 7, 14, 45, 90, 180

  3. Percentage of Lower Face Area Healed

    Percentage of the lower facial treatment area assessed as healed at each post-treatment time frame (Days 1, 7, 14, 45, 90 \& 180) based on investigator clinical evaluation documented in Case Report Forms. The reported data is for the lower face treatment area only; the control untreated mid/upper-face area was not evaluated for healing.

    Time frame: Post-Treatment, Day 1, 7, 14, 45, 90, 180

  4. Bleeding

    Analysis of bleeding during surgery measured in cubic centimeter. The reported data is for the lower face treatment area only; the control area was not evaluated for bleeding.

    Time frame: During Procedure (Day 0)

  5. The Principal Investigator Will Complete a PGAIS Assessing Overall Aesthetic Improvement in the Treatment Area at Day 180 Post-treatment.

    Global Aesthetic Improvement Scale Evaluation (PGAIS) rating by investigator \[Very much improved, Much improved, Improved, No change, Worse, Much Worse, Very much Worse\]. The reported data is for the lower face treatment area only; the control area was not evaluated for GAIS as it was not treated.

    Time frame: Day 180

  6. The Subject Will Complete a SGAIS Assessing Overall Aesthetic Improvement in the Treatment Area at Day 180 Post-treatment.

    Subject Global Aesthetic Improvement Scale Evaluation (SGAIS) rating by subject \[Very much improved, Much improved, Improved, No change, Worse, Much Worse, Very much Worse\]. The reported data is for the lower face treatment area only; the control area was not evaluated for GAIS as it was not treated.

    Time frame: Day 180

  7. Patient Satisfaction

    The subject will complete a Patient Satisfaction Questionnaire (PSQ) while referring to their image in a mirror and current post-treatment photos compared to baseline photos to rate how satisfied they are, and if they note any improvement in the treatment area. The reported data is for the lower face treatment area only; the control area was not evaluated for PSQ as it was not treated.

    Time frame: Day 180

06

Results

Posted Mar 24, 2026

Participant flow

Participant flow — Overall Study
MilestoneRenuvion APR System (Lower Face)Untreated Control (Mid/Upper Face)
Started77
Completed66
Not completed11
Withdrew: Subject missed day 180 visit11

Outcome measures

PrimaryAnalysis of Elasticity (Collagen & Elastin)

To assess Elasticity (collagen \& elastin) evaluation will be based on the qualitative histology in samples at baseline and Day 180 follow-up. Two samples from each time period were analyses - control and treatment area. The H\&E, trichrome, and van Gieson-stained slides were evaluated via light microscopy for any abnormalities and extracellular matrix changes. The results of histopathological assessment were scored using the industry standard 5-point scoring system. 0=Normal, 1=Minimal, 2=Mild, 3=Moderate, 4=Severe.

Time frame:
Baseline, Day 180
Reported as:
Mean · units on a scale
Analysis of Elasticity (Collagen & Elastin)
units on a scaleTreatment AreaControl
Histological Findings Collagen Deposition Baseline1.7 (0 to 4)0.5 (0 to 4)
Histological Findings Collagen Deposition D1801.5 (0 to 4)0.5 (0 to 4)
Histological Findings Elastin Density Baseline2.3 (2 to 3)2.2 (2 to 3)
Histological Findings Elastin Density D1803 (2 to 4)2.3 (2 to 4)
PrimaryAnalyzing Days of Duration for Bruising, Swelling

Analysis days of duration of overall facial bruising and swelling post-treatment through the 180-day visit. The reported data is for the lower face treatment area only; the control area was not evaluated for bruising/swelling.

Time frame:
Post-Treatment, Day 1, 7, 14, 45, 90, 180
Reported as:
Number · participants
Analyzing Days of Duration for Bruising, Swelling
participantsProcedure With the Renuvion APR System in Lower Facelift Area
With Brusing D16
With Bruising D75
With Bruising D145
With Bruising D450
With Bruising D900
With Bruising D1800
With Swelling D17
With Swelling D77
With Swelling D146
With Swelling D450
With Swelling D900
With Swelling D1800
PrimaryPercentage of Lower Face Area Healed

Percentage of the lower facial treatment area assessed as healed at each post-treatment time frame (Days 1, 7, 14, 45, 90 \& 180) based on investigator clinical evaluation documented in Case Report Forms. The reported data is for the lower face treatment area only; the control untreated mid/upper-face area was not evaluated for healing.

Time frame:
Post-Treatment, Day 1, 7, 14, 45, 90, 180
Reported as:
Mean · percentage of lower facial area healed
Percentage of Lower Face Area Healed
percentage of lower facial area healedProcedure With the Renuvion APR System in Lower Facelift Area
D117.5 ± 16.6
D740.0 ± 28.9
D1447.5 ± 28.9
D4570.8 ± 17.4
D9092.1 ± 6.4
D18099.8 ± 0.4
PrimaryBleeding

Analysis of bleeding during surgery measured in cubic centimeter. The reported data is for the lower face treatment area only; the control area was not evaluated for bleeding.

Time frame:
During Procedure (Day 0)
Reported as:
Count of participants · Participants
Bleeding
ParticipantsProcedure With the Renuvion APR System in Lower Facelift Area
15cc Blood Loss2
20cc Blood Loss2
70cc Blood Loss1
75cc Blood Loss1
300cc Blood Loss1
PrimaryThe Principal Investigator Will Complete a PGAIS Assessing Overall Aesthetic Improvement in the Treatment Area at Day 180 Post-treatment.

Global Aesthetic Improvement Scale Evaluation (PGAIS) rating by investigator \[Very much improved, Much improved, Improved, No change, Worse, Much Worse, Very much Worse\]. The reported data is for the lower face treatment area only; the control area was not evaluated for GAIS as it was not treated.

Time frame:
Day 180
Reported as:
Count of participants · Participants
The Principal Investigator Will Complete a PGAIS Assessing Overall Aesthetic Improvement in the Treatment Area at Day 180 Post-treatment.
ParticipantsProcedure With the Renuvion APR System in Lower Facelift Area
Worse, Much Worse, Very Much Worse0
No Change0
Improved, Much Improved, Very Much Improved6
PrimaryThe Subject Will Complete a SGAIS Assessing Overall Aesthetic Improvement in the Treatment Area at Day 180 Post-treatment.

Subject Global Aesthetic Improvement Scale Evaluation (SGAIS) rating by subject \[Very much improved, Much improved, Improved, No change, Worse, Much Worse, Very much Worse\]. The reported data is for the lower face treatment area only; the control area was not evaluated for GAIS as it was not treated.

Time frame:
Day 180
Reported as:
Count of participants · Participants
The Subject Will Complete a SGAIS Assessing Overall Aesthetic Improvement in the Treatment Area at Day 180 Post-treatment.
ParticipantsProcedure With the Renuvion APR System in Lower Facelift Area
Worse, Much Worse, Very Much Worse0
No Change0
Improved, Much Improved, Very Much Improved6
PrimaryPatient Satisfaction

The subject will complete a Patient Satisfaction Questionnaire (PSQ) while referring to their image in a mirror and current post-treatment photos compared to baseline photos to rate how satisfied they are, and if they note any improvement in the treatment area. The reported data is for the lower face treatment area only; the control area was not evaluated for PSQ as it was not treated.

Time frame:
Day 180
Reported as:
Number · participants
Patient Satisfaction
participantsProcedure With the Renuvion APR System in Lower Facelift Area
Noticed Improvement in the Lower Face6
Satisfied with Procedure6
Would Recommend to Friends & Family6
Noted Improved Skin Dryness1
Noted Improved Elasticity3
Noted Skin Quality Improved2
Noted Skin Appears More Youthful5
Noted Improved Skin Radiance3

Adverse events

Collected over Adverse events (AEs) and expected treatment effects (ETEs) were recorded during treatment and monitored up to the Day 180 visit.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Procedure With the Renuvion APR System in Lower Facelift Area0/7 (0%)0/7 (0%)7/7 (100%)
Untreated Control (Upper Face)0/7 (0%)0/7 (0%)0/7 (0%)
Most frequent other events
Most frequent other events
EventProcedure With the Renuvion APR System in Lower Facelift AreaUntreated Control (Upper Face)
Edema (ETE)Skin and subcutaneous tissue disorders7/70/7
Bruise (ETE)Skin and subcutaneous tissue disorders6/70/7
SeromaSkin and subcutaneous tissue disorders1/70/7
Focal Skin BreakdownSkin and subcutaneous tissue disorders1/70/7

Baseline characteristics

Age, Continuous
Age, Continuous(years)Procedure With the Renuvion APR System in Lower Facelift Area
Mean55.4 ± 6.4
Sex: Female, Male
Sex: Female, Male(Participants)Procedure With the Renuvion APR System in Lower Facelift Area
Female6
Male1
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Procedure With the Renuvion APR System in Lower Facelift Area
Hispanic or Latino1
Not Hispanic or Latino6
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Procedure With the Renuvion APR System in Lower Facelift Area
United States7
07

Study locations

2 sites
  • LA Plastic Surgery and Dermatology
    Bradenton, Florida 34208, United States
  • Holcomb & Kreithen Plastic Surgery and MedSpa
    Sarasota, Florida 34237, United States
08

References and documents

Publications

  • Goldberg SN, Gazelle GS, Halpern EF, Rittman WJ, Mueller PR, Rosenthal DI. Radiofrequency tissue ablation: importance of local temperature along the electrode tip exposure in determining lesion shape and size. Acad Radiol. 1996 Mar;3(3):212-8. doi: 10.1016/s1076-6332(96)80443-0. PubMed 8796667 ↗
  • Thomsen S. Pathologic analysis of photothermal and photomechanical effects of laser-tissue interactions. Photochem Photobiol. 1991 Jun;53(6):825-35. doi: 10.1111/j.1751-1097.1991.tb09897.x. PubMed 1886941 ↗
  • Ross EV, McKinlay JR, Anderson RR. Why does carbon dioxide resurfacing work? A review. Arch Dermatol. 1999 Apr;135(4):444-54. doi: 10.1001/archderm.135.4.444. PubMed 10206052 ↗
  • Gardner ES, Reinisch L, Stricklin GP, Ellis DL. In vitro changes in non-facial human skin following CO2 laser resurfacing: a comparison study. Lasers Surg Med. 1996;19(4):379-87. doi: 10.1002/(SICI)1096-9101(1996)19:43.0.CO;2-P. PubMed 8982996 ↗
  • Doshi SN, Alster TS. Combination radiofrequency and diode laser for treatment of facial rhytides and skin laxity. J Cosmet Laser Ther. 2005 Mar;7(1):11-5. doi: 10.1080/14764170410003075. PubMed 16020210 ↗
  • Fatemi A, Weiss MA, Weiss RA. Short-term histologic effects of nonablative resurfacing: results with a dynamically cooled millisecond-domain 1320 nm Nd:YAG laser. Dermatol Surg. 2002 Feb;28(2):172-6. doi: 10.1046/j.1524-4725.2002.01112.x. PubMed 11860431 ↗
  • Mayoral FA. Skin tightening with a combined unipolar and bipolar radiofrequency device. J Drugs Dermatol. 2007 Feb;6(2):212-5. PubMed 17373181 ↗
  • Alster TS, Doshi SN, Hopping SB. Combination surgical lifting with ablative laser skin resurfacing of facial skin: a retrospective analysis. Dermatol Surg. 2004 Sep;30(9):1191-5. doi: 10.1111/j.1524-4725.2004.30370.x. PubMed 15355357 ↗
  • Zelickson BD, Kist D, Bernstein E, Brown DB, Ksenzenko S, Burns J, Kilmer S, Mehregan D, Pope K. Histological and ultrastructural evaluation of the effects of a radiofrequency-based nonablative dermal remodeling device: a pilot study. Arch Dermatol. 2004 Feb;140(2):204-9. doi: 10.1001/archderm.140.2.204. PubMed 14967794 ↗
  • Hsu TS, Kaminer MS. The use of nonablative radiofrequency technology to tighten the lower face and neck. Semin Cutan Med Surg. 2003 Jun;22(2):115-23. doi: 10.1053/sder.2003.50011. PubMed 12877230 ↗
  • Paul M, Blugerman G, Kreindel M, Mulholland RS. Three-dimensional radiofrequency tissue tightening: a proposed mechanism and applications for body contouring. Aesthetic Plast Surg. 2011 Feb;35(1):87-95. doi: 10.1007/s00266-010-9564-0. Epub 2010 Sep 11. PubMed 20835826 ↗
  • Hurwitz D, Smith D. Treatment of overweight patients by radiofrequency-assisted liposuction (RFAL) for aesthetic reshaping and skin tightening. Aesthetic Plast Surg. 2012 Feb;36(1):62-71. doi: 10.1007/s00266-011-9783-z. Epub 2011 Jul 13. PubMed 21751063 ↗
  • Irvine Duncan D. Nonexcisional tissue tightening: creating skin surface area reduction during abdominal liposuction by adding radiofrequency heating. Aesthet Surg J. 2013 Nov 1;33(8):1154-66. doi: 10.1177/1090820X13505862. PubMed 24335016 ↗
  • Boeni R. Safety of tumescent liposuction under local anesthesia in a series of 4,380 patients. Dermatology. 2011;222(3):278-81. doi: 10.1159/000327375. Epub 2011 May 24. PubMed 21606638 ↗
  • Nakab L, Hee CK, Guetta O. Improvements in Skin Quality Biological Markers in Skin Explants Using Hyaluronic Acid Filler VYC-12L. Plast Reconstr Surg Glob Open. 2020 Mar 27;8(3):e2723. doi: 10.1097/GOX.0000000000002723. eCollection 2020 Mar. PubMed 32537370 ↗
  • van Dongen JA, Langeveld M, van de Lande LS, Harmsen MC, Stevens HP, van der Lei B. The Effects of Facial Lipografting on Skin Quality: A Systematic Review. Plast Reconstr Surg. 2019 Nov;144(5):784e-797e. doi: 10.1097/PRS.0000000000006147. PubMed 31688753 ↗
  • Narins RS, Brandt F, Leyden J, Lorenc ZP, Rubin M, Smith S. A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatol Surg. 2003 Jun;29(6):588-95. doi: 10.1046/j.1524-4725.2003.29150.x. PubMed 12786700 ↗
  • Boroni M, Zonari A, Reis de Oliveira C, Alkatib K, Ochoa Cruz EA, Brace LE, Lott de Carvalho J. Highly accurate skin-specific methylome analysis algorithm as a platform to screen and validate therapeutics for healthy aging. Clin Epigenetics. 2020 Jul 13;12(1):105. doi: 10.1186/s13148-020-00899-1. PubMed 32660606 ↗
  • Fuchshuber P, Schwaitzberg S, Jones D, Jones SB, Feldman L, Munro M, Robinson T, Purcell-Jackson G, Mikami D, Madani A, Brunt M, Dunkin B, Gugliemi C, Groah L, Lim R, Mischna J, Voyles CR. The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose. Surg Endosc. 2018 Jun;32(6):2583-2602. doi: 10.1007/s00464-017-5933-y. Epub 2017 Dec 7. PubMed 29218661 ↗

Study documents

  • Protocol and statistical analysis plan · Mar 19, 2024

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT06243744
Lead sponsor
Apyx Medical
Responsible party
Sponsor
First posted
Feb 6, 2024
Start date
Nov 30, 2023
Primary completion
Jul 10, 2025
Completion
Jul 10, 2025
Results posted
Mar 24, 2026
Last update
Mar 24, 2026

Study contacts

David Holcomb, M.D.
principal investigator · Holcomb & Kreithen Plastic Surgery and MedSpa
Melinda Lacerna, M.D.
principal investigator · LA Plastic Surgery & Dermatology

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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