Clinical Papers

Radiofrequency (RF) technology has ushered in a new paradigm in body contouring for patients with mild to moderate skin laxity who desire fat removal without exacerbating skin laxity issues. A bipolar internal RF device, used as an adjunct to liposuction, has been found to be simpler and more accurate than previous technologies. The aim of this study was to review the authors' clinical experience with bipolar RF-assisted liposuction (RFAL). DOWNLOAD PAPER

Increasingly, patients are seeking minimally invasive methods to tighten skin and remodel adipose tissue. A large treatment gap exists among 3 types of patients: the younger demographic, who desire soft tissue tightening without traditional operations, scars, and downtime; patients with soft tissue laxity who are not “severe enough” to justify an excisional procedure, but not “mild enough” to rely on liposuction with soft tissue contraction alone; and those with recurrent laxity who already underwent traditional excisional procedure. In these populations, aesthetic surgeons risk undertreating or overtreating with traditional methods. DOWNLOAD PAPER

Radiofrequency Assisted Lipo-coagulation (RFAL) BodyTite is a contact, impedance, internal and external thermal regulation controlled, internal, minimally invasive, non-excisional procedure providing soft tissue lipo-coagulation and contraction that has been used for over 10 years to optimize skin and soft tissue contraction during liposuction procedures. The device deploys a bipolar applicator inserted into the liposuction zone. The internal, coated, electrode is positively charged and emits a coagulative, ablative injury that results in adipose liquification and Fibroseptal Network (FSN) contraction. The RF flows from the internal electrode after ablation and coagulation up to the external negatively charged return electrode moving on the skin, which heats and tightens the papillary dermis non-ablatively. The body areas that most benefit from this BodyTite technology and procedure include those areas most in need of non-excision contraction include the abdomen, upper arms, inner thighs, bra-line, neck and jaw line. Studies, show, that the combination of BodyTite internal thermal coagulation and external Morpheus8 (see Part 2) at the time of liposuction can result in 40–70% area skin contraction, greatly improving the soft tissue contours and Body shaping outcomes following lipo-contouring procedures. DOWNLOAD PAPER

The new Morpheus8 is a novel external RFAL device that uses the proven softtissue contraction of BodyTite in an external, non-invasive procedure. This external RF applicator, which is also powered by BodyTite, inserts up to 40 positively charged, coated electrodes 8 mm into the subcutaneous, soft tissue envelope. A monopolar ablative lesion is generated from the tip of the electrode, stimulating contraction of the FSN and adipose coagulation. The RF then flows up to the distant negative, return electrodes on the surface of the skin, providing a non ablative thermal stimulation to the papillary dermis. The “burst” feature of the Morpheus8, delivers simultaneous multiple levels of internal coagulation in a single one second pulse, amplifying the adipose ablation and contraction effect. Studies, show, that the combination of BodyTite internal thermal coagulation and external Morpheus8 at the time of liposuction can result in 60–70% area skin contraction, greatly improving the soft tissue contours and Body shaping outcomes following lipocontouring procedures. DOWNLOAD PAPER

Radiofrequency energy thermally induces collagen contraction and remodeling. The resultant dermal tightening is well established. However, facial aging encompasses also deeper layers of collagen-containing tissues. We present a deep layer radiofrequency-based thermo-coagulative technique for cervicofacial contouring and evaluate its efficacy. DOWNLOAD PAPER

Suction-assisted lipectomy has undergone significant improvements in technique, outcomes, and safety. The local anesthetic option has an excellent safety profile, and energy-based modalities such as radiofrequency-assisted liposuction (RFAL) devices were developed to enhance soft-tissue contraction. The purpose of this study was to report a single center’s experience with two surgeons using the second-generation RFAL device compared with the first-generation device in terms of safety and efficacy. DOWNLOAD PAPER

For decades in the senior author’s practice, the most frequent aesthetic surgery request has been for improvement of abdominal contour. Patient presentations vary from thin with wrinkles to obese with a hanging pannus and oversized girth. Additionally, patients are frequently concerned with oversized flanks and backs, and sagging mons pubises and buttocks. Once surgical options, which involve removal of excess skin and fat, are discussed, patients’ responses range from abhorrence to surgery and/or scars to acceptance of whatever incisions it takes to obtain the desired result. Most inquirers for contouring of the torso not only welcome but are intrigued by noninvasive and minimally invasive treatments to supplant or augment anticipated or revision abdominoplasty. DOWNLOAD PAPER

Nonexcisional facial skin tightening has long been an elusive goal in aesthetic surgery. The “treatment gap” includes cases who are not “severe” enough for excisions surgery but not “mild” enough for most traditional noninvasive aesthetic modalities. In this retrospective review, we present the largest evaluation to date of radiofrequency (RF) skin tightening technology combination including bipolar RF (FaceTite; InMode) and fractional bipolar RF (Fractora modified to Morpheus8; InMode). DOWNLOAD PAPER

Minimally invasive or noninvasive skin-tightening procedures have become trends in facial and neck rejuvenation. Radiofrequency-assisted liposuction (RFAL) is a new choice for the treatment of skin relaxation that is more effective than noninvasive surgery without surgical incision. The authors recommend a 2-step method in which radiofrequency is applied after appropriate liposuction is performed. This approach is safer and more effective than traditional RFAL, and the authors detail the safety guidelines, operative techniques, postoperative satisfaction results, and complications. DOWNLOAD PAPER