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Radio-frequency energy
medical aesthetics
body language - The UK Journal of Medical Aesthetics and Anti-Ageing

Consumers are increasingly seeking less-invasive aesthetic treatments with minimal downtime
and consistent results. Dr Michael Kreindel and Dr Stephen Mulholland assess the benefits of
using radio-frequency energy for non-invasive procedures

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Radio-frequency energy

  1. 1. medical aesthetics Radio-frequency energy Consumers are increasingly seeking less-invasive aesthetic treatments with minimal downtime and consistent results. Dr Michael Kreindel and Dr Stephen Mulholland assess the benefits of using radio-frequency energy for non-invasive procedures R adio-frequency energy has been used reliably in most frequently for cutting where RF energy is focused near medical and cosmetic applications for almost 100 a needle-type electrode, creating tissue ablation and a second years. Its use through various procedures and large-area return electrode is used to close the current loop. devices has demonstrated its consistency, efficacy and Bi-polar devices are mainly used for coagulation of blood ves- safety. RF energy used in medical applications is applied sels and tissue, and heat is generated between two electrodes to the tissue by alternating high frequency electrical cur- positioned within the treatment area. rent. This creates a thermal effect in the tissue in the area Many versatile RF energy devices are available, and it has of the RF electrode. At frequencies higher than 100kHz, become common practice to use RF electrosurgical devices the electrical current creates a pure thermal effect with- in plastic and dermatological surgery for skin and tissue cut- out affecting local nerve and muscle tissue, thereby ena- ting and blood coagulation. Simultaneous tissue cutting and bling the RF energy to become an effective instrument blood coagulation make it an effective tool for face-lifting, for safe tissue treatment. By controlling RF current den- blepharoplasty, abdominoplasty and other excisional and in- sity through optimising output power and electrode size, cisional surgeries. In the last decade, RF energy has become physicians can heat, coagulate and ablate tissue. incorporated in non-invasive cosmetic treatments alone or The simplicity, versatil- in combination with laser ity and efficiency of the RF or intense pulsed light. The devices, such as the electro- leading companies in this surgical device, developed by RF aesthetic market are Harvard University professor Solta Medical Inc (formerly Dr Bovie and first used by Dr Thermage Inc) and Syneron Harvey Cushing in surgery, Medical Ltd. The biggest have made RF energy the advantage of RF versus la- most popular thermal treat- ser energy is its unlimited ment modality in a variety penetration depth. Laser ra- of medical applications. The diation can penetrate to the big advantage of RF energy depth of only a few millime- over laser, cryotherapy and tres, requires a specific target other treatment modalities chromophore for absorption is the ability to monitor tis- and must often respect skin sue electrical parameters sim- type. ply and reliably through the However, RF energy ef- direct measurements of its fectively penetrates into impedance. Practitioners can and through the subdermal adjust output power accord- layer into the subcutaneous ing to local properties of the tissue. RF energy is indif- treated tissue. ferent to chromophore and There are many hand- is skin-type independent. SKINCENTRAL piece designs that allow the These unique features makes optimal delivery of RF en- RF energy efficient for skin ergy according to applica- The main advantages of non-invasive treatments are their simplicity, tightening, body contouring tion. Mono-polar RF is used safety and quick recovery. Shown is Thermage monopolar RF energy and subcutaneous fat treat- body language The UK Journal of Medical Aesthetics and Anti-Ageing 23
  2. 2. medical aesthetics ment, which are the fastest-growing segments in the aesthetic heating of the superficial dermal layer. Developed by Invasix industry, even during the recent economic downturn. Inc, the BodyTite RFAL system is gaining awareness among As with electrosurgery, both monopolar and bipolar con- cosmetic physicians by creating a new approach in aesthetic figurations of applicators and handpieces are used for non-in- medicine. The first use of RFAL is focused on improvement vasive procedures. Non-ablative cosmetic treatments are usu- of body contour and cellulite, but there is also a big poten- ally based on remodelling of collagen and ground substances, tial of this minimally invasive RF technology for face-lifting, whereas heating adipocytes to sub-necrotic levels contours blepharoplasty and tightening of loose skin in areas such as fat. Large electrode surface areas allow the delivery of energy the knees and arms. in a uniform manner to a large treatment area. RF energy continues to be the most popular aesthetic en- The main advantages of non-invasive treatments are their ergy used in invasive aesthetic medicine and now we see a RF simplicity, safety and minimal recovery time—often making renaissance for a new minimally invasive treatment to address them lunch-time procedures. However, non-invasive RF or the consumer desire for dramatic and consistent results with laser therapy requires multiple treatments, demonstrating di- less downtime and risk. minished efficacy and consistency in comparison to invasive The use of RF energy in minimally invasive aesthetic treatments. treatments allows the physician to develop procedures for While some patients have good results following a series of heavier patients, older patients and those with decreased skin non-invasive procedures, the majority will often report minor elasticity. Therefore, the unique properties of RF energy, improvement. The inherent limitation of a non-invasive ap- which include unlimited penetration depth, good control of proach is based on the concept in which RF energy is deliv- parameters and versatility of electrode configurations, make ered through the skin to affect the subdermal layer without it one of the most important instruments in the hands of aes- epidermal damage. thetic medical professionals. The most recent application of aesthetic RF energy is radio frequency assisted liposuction (RFAL), which deploys both Dr Stephen Mulholland is a consultant plastic surgeon and direc- the advantages of electro-surgical and non-invasive technolo- tor of SpaMedica Infinite Vitality Clinic in Toronto, Canada. gies, combining aggressive coagulation of internal adipose, W:; Dr Michael Kreindel is chief technical vascular and fibrous tissue and gentle, uniform and safe officer of Invasix Ltd . W: RF electrosurgical device used during abdominoplasty. Simultaneous tissue cutting and blood coagulation makes it an effective tool for face- lifting, blepharoplasty, abdominoplasty and other excisional and incisional surgeries 24 body language The UK Journal of Medical Aesthetics and Anti-Ageing