In recent years, fractional radio frequency microneedling (FRM) has become a widely recognized and highly effective nonsurgical facelift treatment [1-3]. Studies have shown that it is a useful modality for skin tightening and dermal remodeling without the risks associated with invasive surgery [1-3]. For FRM, controlled thermal energy via microneedles is delivered into the dermis, inducing microinjury to stimulate neocollagenesis and elastin production [1-3]. Although its clinical efficacy and tolerability have been well documented, postprocedural erythema, edema, bruising, and discomfort are common and may persist for up to several days [4]. Other rare but serious complications that have been observed include prolonged swelling, persistent grid marks, burns, infection, and hypo- or hyperpigmentation [4].

Currently, no standardized postprocedural care protocol has been established to accelerate recovery and reduce downtime [4], underscoring the unmet clinical need for biologically active adjuncts that support tissue repair and reduce inflammation. Recombinant human collagen is an emerging innovative biomaterial that has shown promising potential for improving wound healing while minimizing inflammation [5-8], which could be harnessed for post-FRM recovery following energy-based facial rejuvenation procedures. To our knowledge, the use of topical recombinant collagen in the immediate post-FRM setting has not been described in the medical literature. Herein, we describe an innovative postprocedure approach using topical recombinant collagen in two patients who underwent a nonsurgical facelift with FRM.

This novel case report has shown that topical recombinant collagen applied immediately post FRM was associated with clinically apparent reduction in erythema, edema, and discomfort within 1 to 2 hours post treatment as compared to the expected 1 to 3 days [1-3]. The temporal relationship between the application of topical recombinant collagen and the earlier-than-expected postprocedural reduction in erythema and inflammation could represent a plausible effect superimposed on the normal recovery process. The reduction in skin erythema was apparent to the attending clinician, which was notably different from the typical recovery trajectory of FRM. The observed objective and subjective improvements suggest that topical recombinant collagen may be a feasible adjunct for postprocedural care following FRM. Collagen-based biomaterials have been shown to promote wound healing, stabilize the extracellular matrix, and reduce inflammation in both acute and chronic wounds [5-7]. While previous studies have largely focused on burns or surgical wounds [5-7], our findings have extended the potential application of recombinant collagen to aesthetic procedures involving controlled dermal injury from FRM. This early clinical experience corroborated with known in-vitro dermal repair and anti-inflammatory mechanisms of recombinant collagen, including the modulation of inflammatory cytokines such as inducible nitric oxide synthase, interleukin 1β (IL-1β), IL-10, and tumor necrosis factor α [9]. Postprocedural downtime is an important consideration. These preliminary observations warrant further investigation into strategies to support recovery following FRM.

Nevertheless, this report has several limitations. Only two patients were included with short-term follow-up. There was no control group for comparison. No standardized scoring systems for erythema, swelling, or patient-reported outcomes were used, as this was not part of routine clinical documentation. Randomized controlled studies will be required to confirm treatment safety and efficacy while optimizing treatment protocols before routine implementation.

In summary, topical recombinant collagen may represent a potential adjunct in postprocedural care following FRM, warranting further evaluation in prospective clinical trials.