Cosmetic Question: I have heard of a new cosmetic treatment called Neubelle for frown lines. Is it still ok to get Botox?
Cosmetic Answer: Absolutely, you can still get Botox, unless you are one of the few people who do not get a response from Botox.
Neubelle is bi-polar radiofrequency nerve ablation, recently FDA approved for treatment of glabellar frown lines (the ‘elevens’ in between the eyes). It is not new, it was earlier sold as Relaxed Expressions by Merz Esthetics.
What is radiofrequency? It is a heat-creating energy wave. The heat from radio frequency can slightly tighten the skin, reduce fat and treat chronic pain.
Neubelle involves a minor office procedure requiring local anesthetic. A needle probe goes through the numbed skin and then a nerve stimulator is used to identify the nerves to the glabella. The nerve is then heated at various points to the temperature of 185 degrees, usually for 14 seconds. This causes a temporary nerve injury and the muscle stops working temporarily.
In the past eight years it is said that approximately 500 patients have had Neubelle to treat their glabellar lines. However, I can only find the PubMed reports for 51 patients: In a study of 29 patients, a third had significant bruising. In a study of 27 patients, one had a second degree burn of the skin and two had abnormal sensations for several weeks. In both groups, results lasted a little longer than Botox: four months in 30%, six months in 60% and a year or more in 10%. But in 2016, a report was published on one patient treated for 70 seconds and it seems to have created a permanent result.
Permanent results sound great but they may not be if you get an unwanted effect. One advantage of Botox is that it wears off. It is usually gone in 3 months and certainly within a year. This is an advantage because balancing facial muscles to get a natural result is not easy. Treating the glabellar muscles (‘elevens’) can make the forehead muscles pull more. Treating the forehead muscles can make the outer brow droop. What if this happens after a permanent Neubelle glabellar treatment? Either you have to live with the look or get Botox to improve it. You may even have to have another Neubelle treatment, which may leave you with a frozen look.
Neubelle , like other radio frequency devices, is going to be useful, but there are problems with all new advances. These problems usually get worked out. At this time it seems useful chiefly for people who do not respond to Botox. Exciting as Neubelle is, Botox remains the safe, predictable, effective treatment for facial lines caused by our over-active muscles.
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