Thermo-Mechanical Fractional Injury Therapy for Facial Skin Rejuvenation in Skin Types II to V: A Retrospective Double-Center Chart Review

Danny Daniely*, Harryono Judodihardjo, Sajjad F. Rajpar, Joseph N. Mehrabi, Ofir Artzi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background and Objectives: Thermo-mechanical fractional injury (TMFI) therapy (Tixel®; Novoxel®, Netanya, Israel) is an innovative technology. Along with its drug delivery enhancement features, it is widely used for facial skin rejuvenation. Our study explores the beneficial effect of the Tixel® on the different features of facial skin rejuvenation along with patients′ satisfaction rate, aiming to suggest practical recommendations for an optimal aesthetic result. Study Design/Materials and Methods: A retrospective chart review of 24 patients (20 women, 4 men, average age 56 years old) with skin types II–V who received 2 or 3 Tixel® treatments, 3–5 weeks apart in two medical centers (12 from Israel, 12 from the United Kingdom). Four experienced dermatologists compared standardized clinical photographs taken before each treatment and 3 months after the final treatment based on seven parameters that were set by 10 physicians and rated the difference on a scale of −1 to 4. Furthermore, epidemiology, treatment data, satisfaction, and safety were reviewed. Results: Out of the seven parameters that were compared (blood vessels and erythema, skin complexion, periorbital wrinkles, pigmentation and toning, pore size, vitality, wrinkles, and laxity), all features demonstrated an overall improvement, with the greatest improvement demonstrated in skin complexion (2.1 ± 0.49) and periorbital wrinkling (2.09 ± 0.65) followed by vitality (1.7 ± 0.49). Side effects were transient, including erythema and hyperpigmentation, and the average downtime was 1.7 days. Conclusion: TMFI is a safe and effective method for improving facial skin quality. Addressing patient′s expectations while maximizing the benefits of this novel technology will provide superior aesthetical results.

Original languageEnglish
Pages (from-to)1152-1157
Number of pages6
JournalLasers in Surgery and Medicine
Issue number9
StatePublished - Nov 2021


  • Skin Rejuvenation
  • TMFI
  • Tixel


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