GFX Procedure


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BOTOX or botulinum toxin injections are currently the most popular treatment for decreasing facial lines and wrinkles; however, could there be a treatment that is longer lasting than BOTOX on the horizon? GFX is a new cosmetic surgical procedure that is currently being evaluated by the Food and Drug Administration (FDA) for use in the reduction of frown lines in the face. The GFX procedure is a minimally invasive technique that targets the nerves that innervate the muscles of the face, similar to BOTOX. Unlike BOTOX though, which interferes with the release of neurotransmitter, the GFX procedure uses a small device to ablate the nerves themselves. Therefore while BOTOX wears off over a few months and creases return, the GFX procedure eliminates the nerve itself. Thus for the time it takes the nerve to grow back and innervate the face once again, the patient can enjoy a face without frown lines.

How is GFX procedure performed?

The GFX procedure is performed under local anesthesia meaning that a drug that blocks nerve function is placed in the skin to completely numb it. A very small incision is made in the skin so that a thin, needle-like GFX probe can be introduced under the skin. Small currents of electricity are sent through the GFX probe to identify the motor nerves, the nerves that cause muscle contraction (and wrinkles) in the face. Once these motor nerves are identified and specifically targeted, an energy called radiofrequency energy is applied to the nerve. The dose of radiofrequency energy is controlled by the GFX probe to damage only to the motor nerve itself. The radiofrequency energy ablates or destroys the motor nerve and, without these motor nerve innervations, the muscle that is causing the frown lines cannot contract and frown lines are much less pronounced.

In addition to being longer acting than BOTOX injections, GFX surgery does not involve the administration of toxin into the body. For many patients that have desired the cosmetic benefits of botulinum toxin injections but were afraid of being injected with a potent neurotoxin, GFX surgery may provide an acceptable alternative. One possible disadvantage of the GFX procedure is that it does require a small incision. BOTOX is administered through a succession of needle injections. Generally the GFX incision is very small, however.

GFX surgery may not be widely available since it is still being evaluated in clinical trials. In theory, the GFX approach should be extremely safe and effective. The radiofrequency energy is the same type of energy that has been used in other forms of surgery since the 1990s. Moreover, the GFX procedure achieves the same functional change in the motor neuron as BOTOX without the administration of toxin.

Given that the GFX procedure is still being investigated by the FDA, it may be necessary to participate in a clinical trial in order to receive this form of treatment right now. On one hand, the GFX procedure may be fully or partially subsidized since it is part of a clinical trial. On the other hand, by participating in a clinical trial, you may be randomly placed in the placebo arm of the trial. The placebo procedure may involve a surgical incision and manipulation of the motor nerve without ablation. In the placebo group you may go through the hassle of having almost all of the GFX procedure without the cosmetic benefit! It is important to discuss these options thoroughly with a plastic surgeon that offers GFX surgery.


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