The future is now. Plastic surgery is evolving before our very eyes. The trend is toward noninvasive procedures, such as injectables, neurotoxins, IPL, and laser resurfacing. Don’t get me wrong, plastic surgical procedures are not dying out by any means. Augmentation, facelifts, and body contouring are still very popular, but patients prefer local anesthesia, minimal scarring, and a quick return to work and an active lifestyle.
Over the years, there have been a number of new “mouse traps”, all claiming to be the next big thing in noninvasive skin tightening. Radiofrequency has been around for years, but just recently have we seen significant improvements in its use for tightening skin. Radiofrequency works by creating heat, which in turn delivers energy to the tissue. This energy leads to liquefaction of the fat as well as
fibrous coagulation, which leads to skin contraction. The treatment of the more superficial layers leads to heating of the dermis, which causes new collagen formation and further skin contraction. The end result is an improvement in the quality and tone of sagging skin.
Some of the newer technology has both an internal and external probe in the same handpiece. In the past, heating of the tissue has come either from the outside in, using an external probe, or the inside out, using an internal probe. Now, with both internal and external probes in one handpiece, we can treat the fat and fibrous septa internally, as well as the subdermal layer of the skin externally. The best results occur if we can maximize therapeutic temperatures internally in the deep tissue, as well as externally at the skin. Results are also dependent on the amount of total energy applied to a given area, and vary, depending on patient’s skin quality, fat content, and area treated.
What areas can be treated?
This technology can be used in many areas where there is loose, sagging skin, with or without underlying fat. Treatment of the lower face, jowls, and neck has produced very good results. Most physicians feel they can achieve 40-50% of the result typically seen with a facelift. Body areas include upper arms, breasts, abdomen, thighs, knees and back/bra rolls. These areas will often require liposuction in conjunction with radio-frequency application. Multiple areas can be treated in the same surgery, and the treatment can also be combined with other cosmetic procedures.
Who is a good candidate?
Radiofrequency works best for patients who are generally healthy, not significantly overweight, and who have stubborn areas of loose skin and fat that are not responding to diet and exercise. The ideal candidate will have mild to moderate skin laxity and realistic expectations of what the treatment can achieve.
Is it safe?
Radiofrequency has been around for many years and is very safe. The newest technology has sensors on both the internal and external probes which communicate with each other and cut off when maximum temperatures are reached. This allows the surgeon to achieve and maintain therapeutic endpoints and minimize the risk of thermal injury from overheating the tissue.
Is it painful?
The procedures can often be performed under local anesthesia, in addition to oral pain medication and muscle relaxers. The most uncomfortable part of the procedure is the infusion of the tumescent/numbing solution. Once the area is anesthetized, most patients feel no pain during the application of the radiofrequency. Treatment of more than one area usually requires general anesthesia.
Most patients will experience some pain for up to two days after the procedure. However, this can be easily controlled with oral pain medication.
What is the Recovery?
Mild bruising and swelling may last up to three weeks. All treatment areas will require a compression garment to be worn for one to three weeks. Patients should allow two to three days before returning to work, and two to three weeks before resuming strenuous activity and exercise.
In conclusion, radiofrequency is not going to eliminate the need for facelifts or body contouring procedures. These procedures offer very dramatic results, but these results come with a higher price. Radiofrequency offers a noninvasive alternative with a lower cost, minimal scarring, little time off work, and a quick return to an active lifestyle.