Radiofrequency for the treatment of skin laxity: mith or truth

Abstract

The nonablative radiofrequency is a procedure commonly used for the treatment of skin laxity from an increase in tissue temperature. The goal is to induce thermal damage to thus stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue. However, many of these devices haven't been tested and their parameters are still not accepted by the scientific community. Because of this, it is necessary to review the literature regarding the physiological effects and parameters for application of radiofrequency and methodological quality and level of evidence of studies. A literature search was performed in MEDLINE, PEDro, SciELO, PubMed, LILACS and CAPES and experimental studies in humans, which used radiofrequency devices as treatment for facial or body laxity, were selected. The results showed that the main physiological effect is to stimulate collagen synthesis. There was no homogeneity between studies in relation to most of the parameters used and the methodological quality of studies and level of evidence for using radiofrequency are low. This fact complicates the determination of effective parameters for clinical use of this device in the treatment of skin laxity. The analyzed studies suggest that radiofrequency is effective, however the physiological mechanisms and the required parameters are not clear in the literature.

Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat

“…Radiofrequency is an electromagnetic wave that was initially used for treating periorbital wrinkles, rhytids and skin laxity (29, 30). Today, RF is extensively used for body contouring, skin tightening and cellulite reduction (31).…”

“…It is not only used as an efficient method for contracting or inducing skin tightening but also as an effective method for reducing fat in repetition (31, 32). However, there is no standard protocol for treatment time with RF, and the range of therapeutic sessions were widespread between 1 and 24 weeks (30). However, higher temperature at shorter time could be lethal for adipose tissue but it is not necessarily comfortable for patients; longer time, for example eight to ten minutes, with lower temperature, leads to intended adipose cells damage (32).…”

“…However, higher temperature at shorter time could be lethal for adipose tissue but it is not necessarily comfortable for patients; longer time, for example eight to ten minutes, with lower temperature, leads to intended adipose cells damage (32). Former researchers insisted that different parameters in addition to time are related to the success of RF, such as power and the frequency of treatment sessions, yet the exact protocols in this area are unavailable (30). …”

“…These data were collected by before and after exposure pictures, patient’s questionnaires, biopsy, etc. (30). Satisfaction for subcutaneous fat reduction with RF was approximately 71 - 97%, according to patients’ self-reported data (4).…”

“…Satisfaction for subcutaneous fat reduction with RF was approximately 71 - 97%, according to patients’ self-reported data (4). However, significant statistical outcomes about the effects of RF on skin laxity and cellulite treatment were low and limited (30, 37). …”