No abstract

The use of radiofrequency energy to produce collagen matrix contraction is presented. Controlling the depth of energy delivery, the power applied, the target skin temperature, and the duration of application of energy at various soft tissue levels produces soft tissue contraction, which is measurable. This technology allows precise soft tissue modeling at multiple levels to enhance the result achieved over traditional suction-assisted lipectomy as well as other forms of energy such as ultrasonic and laser-generated lipolysis.

Objective: To evaluate the safety and efficacy of a new and novel radiofrequency (RF) device used for focal fat reduction. Materials and methods: 24 female and 1 male patients were enrolled in the study. The age range of the patients was 28-62 years old and an average BMI was 26. All patients underwent focal shape correction, without anticipating any weight reduction and 14/24 patients also had posterior or anterior grade 2 or 3 thigh cellulite treated. The patients underwent a 6-treatment protocol where they were treated with a novel RF device on the abdominal and flank regions once a week over a period of 6 weeks. 14 patients also had cellulite on their posterior or anterior thigh treated with the same device and a 6-treatment, once weekly protocol. Therapeutic thermal end points for each treatment were established and achieved as outlined in the paper. The RF device emits both basic RF and ultra-short High Voltage Pulsing (HVP). All patients and zones were treated once per week for 6 weeks. Results and conclusions: All patients were observed for 3 months following their last treatment to determine the long-term adipose tissue effects and body contour changes. Standard pre and post-operative photography, circumferential measurements were taken. 3 patients who were scheduled for future abdominoplasty surgery had Investigational Review Board compliant lower abdominal subcutaneous biopsies performed at 72 hours and 14 days following their initial RF treatment. The average circumferential reduction was 3.58 cm with range of 1.5 cm-4.4 cm. There were no non-responders observed in the study. Using the modified Nurnberger-Muller 7 stage cellulite grading system, the average cellulite score improved 2 sub-grades. Using the Vectra 3D imaging device and cellulite scoring software, the average starting pit depth was 4.1 mm (range 0.5 mm-7.3 mm). Average Vectra measured improvement in the pit depth or "smoothness score" was 2.9 mm or 60% (range 1.1 mm-6.3 mm). Biopsies revealed histological evidence of the death of proportion fat cells by apoptosis. There were no complications that required medical management. We conclude that the TiteFX appears to offer a safe and effective option for the non-invasive management of both focal fat excess and cellulite. The basic RF and High Voltage pulses appear to result in a long-term, proportional death of fat tissue, presumably through adipocyte apoptosis.

The method for laser and light assisted hair removal is based on the theory of selective photothermolysis. Selective absorption of hair chromophores from lasers and broad band light sources results in destruction of hair follicles while leaving the skin undamaged. A discussion of the basic principles of selective photothermolysis as it applies to hair removal by lasers and light sources is presented, followed by a comparative review of three melanin target based systems: Ruby laser, Alexandrite laser, and a broad band intense pulsed light. These systems are efficient and safe with proper patient selection. Multiple treatments are necessary due to the nature of the hair growth cycle.

This chapter summarizes the basic science of radiofrequency (RF) and its application in aesthetic medicine. The main parameters of RF including RF frequency, waveform, power, pulse duration, and penetration depth are described, and its application for treatment is analyzed. Monopolar and bipolar devices are described in detail for different clinical applications. The effect of RF electrode geometry on tissue heating is shown, and tissue-specific electrical parameters are summarized. The chapter discusses which RF parameters are required to reach therapeutic temperatures for tissue ablation, coagulation, or subnecrotic heating. RF parameters used for noninvasive, minimally invasive, and fractional treatment are compared. Finally, the chapter explains the main safety concerns associated with RF treatments and details the most common causes of adverse events.The term radiofrequency (RF) was first introduced with the invention of radio and was applied to electromagnetic radiation or current ranging from 3 kHz to 300 GHz. Since then, the field of medicine has used the relatively narrow band of this spectrum from 200 kHz to 40 MHz in many different applications. The main advantage of RF energy in medicine is a low or negligible reaction of nerves to high-frequency alternating current (AC) in comparison to lower frequencies.William T. Bovie invented the first electrosurgical device while working at Harvard [1]. This device was used by Dr. Harvey Williams Cushing on October 1, 1926, at Peter Bent Brigham Hospital in Boston, Mass., to remove a tissue mass from a patient's head [2]. Since then, RF electrosurgical devices have become one of the most useful surgical instruments. Recently, RF has experienced a resurgence in aesthetic medicine with applications for ablative and nonablative applications. RF energy has become an