Radio Frequency as a non surgical option for body reshaping
Radiofrequency is the number of oscillations (or waves) per second of the electric and magnetic fields within the radio waves portion of the electromagnetic spectrum. It is the lowest of the electromagnetic radiation frequencies within the spectrum, which itself spans from radio waves, microwaves, infrared, optical (visible light), ultraviolet, x-rays, to gamma rays. By feeding an alternating current (AC) or voltage through an antenna or electrode, electromagnetic waves can be generated that radiate through space at the speed of light; called radio waves. Radiofrequencies, or radio waves, have wavelengths ranging from less than a centimetre to as long as 100 kilometres.
Contact with electric current can cause very undesirable effects such as electrocution and uncontrolled neuromuscular (nerve and muscle) stimulation. However, if the frequency of the alternating current is raised above the response time of neuromuscular structures, we find the radiofrequency range which can safely be used for medical/surgical applications. By applying RF energy to the human body, which can conduct current and therefore act as part of the electrical circuit, any resistance encountered by the energy flow will cause heat to be produced at the site of maximum resistance, which can be used to cut or coagulate tissue. When comparing non-ablative (procedures that do not involve the destruction of the outer layer of the skin) techniques, RF energy differs from laser (light) energy in that light energy tends to scatter or absorb into the upper layers of the skin, making it difficult to deliver sufficient heat into the deeper layers without damaging the skin's surface. Lasers therefore affect collagen in the upper dermis, improving fine lines, wrinkles and skin texture, while RF energy is able to penetrate deeper into the skin and affect the deeper dermis and subcutaneous layers, causing tightening and improvements to the underlying tissue structure, but with little change in skin texture.
There are 2 types of radiofrequency delivered, Monopolar (also called Unipolar) and Bipolar. With monopolar delivery, the current from the generating machine flows through the body from a single electrode (handpiece) and meets maximum resistance in the area around the tip of the handpiece, where tissue heating in the subdermal layers then occurs. A grounding, or return pad may also be used, attached to the patients lower back or abdomen, to provide a low resistance path for the current to flow back to the generating machine, to complete the electrical circuit. With bipolar delivery, the current from the generating machine flows only through the tissue which is between the two electrodes on the handpiece; these electrodes start and complete the electrical circuit. Hence, with bipolar delivery, no current flows through the rest of the body, so no grounding or return pad is needed.
In all cases of radiofrequency delivery types, it is the resistance to the current flow in the tissue, not the electrode that generates the heating effect.
Types of devices
Thermage and Thermacool. These are monopolar RF devices that use patented technology within its ThermaTip device to deliver RF energy deep into dermal tissues. This heating action causes deep collagen structures in the skin to immediately tighten. Over time, new collagen is produced by the body to further tighten the skin. This device has been used mainly for facial rejuvenation but has now been expanded for use on other areas of the body.
Accent. The Accent system boasts dual handpieces: a bipolar handpiece for volumetric dermal heating, aimed primarily at skin tightening treatments; and a monopolar one for a deep controlled penetration depth of the RF energy for fat reduction and cellulite treatment.
The procedure
Before the treatment you should try to avoid doing anything that will irritate your skin. A medical history will be taken to make sure that there are no reasons why you shouldnít undertake treatment and you will sign a consent form which means that you have understood the potential benefits and risks associated with the procedure. Photographs may also be taken by the practitioner for a "before and after" comparison at a later date. Depending on the device being used and your practitioner, a treatment grid may then be drawn over the treatment area to assist the practitioner in navigating whilst delivering the RF energy; helping to assure an even application of the RF. A lubricating oil, gel or cream will then also be applied over the area to be treated which acts as an additional barrier between the surface layers of your skin and the handpiece of the device, mainly to avoid skin chafing. Your clinician will then commence the RF treatment working across the treatment area. Once completed a soothing gel/lotion or cold pack may be applied to your skin.
Some people experience mild redness immediately following treatment (similar to a sunburnt look), but this usually disappears quickly. Most people find that they can return to work and normal activities immediately after treatment. Depending on your practitioner you may be advised to use certain soothing lotions, creams or gels to lightly apply to the treatment area, or possibly cool, moisturising mists to apply as you feel necessary.
Depending on the device being used it may be recommended to have a session twice weekly with an average of 8 - 10 sessions in a treatment programme, or a session once every 1 - 2 weeks with an average of 8 sessions in a programme, however with all devices ongoing monthly maintenance will be required; your practitioner will be able to determine a course of treatments specific to you and your needs.
As each person's pain tolerance and threshold varies, it is difficult to quantify how painful or uncomfortable the treatment is. It also depends on the device used and the power settings for the treatment. Your clinician may offer you anaesthetic options, such as a topical anaesthetic cream applied to your skin prior to treatment, or relaxants and pain management drugs, that can minimize your discomfort. The most frequently reported side effects of treatment with RF energy are swelling, redness or bruising on or around the treated area, which typically disappear in a few days or weeks. There are also reports of a feeling of dry skin in the treated area for a couple of days, lubrication with aloe-vera can be helpful for this. Some people may notice a slight increase in urine output following treatment. This is because any excessive fluid build up in between cells in the area treated is drained through the lymphatic system via the treatment process which then gets excreted in the urine. In very rare circumstances and if the correct instructions are not followed by the practitioner, it is possible to suffer from a skin burn.
