Clinical papers

Background: The purpose of this study is to report our experience using radio-frequency-assisted liposuction (RFAL) for neck and face contouring. This article details the operative technique, selection, complications, third-party surgeon appraisal, and patient satisfaction survey.

Methods: From November 2009 to November 2013, 55 patients who underwent RFAL treatment were enrolled in the study. Postoperative patient satisfaction surveys were conducted, and 2 independent plastic surgeons evaluated contour and skin quality with randomized preoperative and postoperative photographs at 6 months post operatively. The different parameters recorded involved age, sex, weight, body mass index, operative time, amount of fat aspirated and energy delivered, complications, and aesthetic outcome in 1 and 4 weeks and 3 and 6 months. Our longest follow-up was 4 years. Patients were asked 6 months post operatively to grade their satisfaction as poor, no change, moderate, good, and excellent.

Results: The mean age was 51 years (range, 35–61 years), and the mean amount of fat aspirated was 30 mL (range, 10–200 mL). Five out of 55 patients (9.1%) developed tissue hardness that resolved with massage. All patients were followed up for a minimum of 6 months. Eighty-five percent of patients were satisfied with their contouring result and degree of skin tightening (48/55 patients). Two independent plastic surgeons considered the improvement in contouring and degree of skin tightening good to excellent in 52 of 55 cases.

Conclusions: In appropriately selected patients, RFAL neck and face contouring represent a safe procedure to achieve significant improvement of the skin laxity and fat deposits of the cervicomental zone and jowls.

Conclusions: Radiofrequency-assisted tissue tightening, when applied in conjunction with SAL, is effective in achieving greater skin surface area
reduction.

Introduction
Die Liposuktion ist derzeit die meist angewandte Technik zur Entfernung ?bersch?ssiger und dysmorpher Fettdepots. Aufgrund ihrer derzeitigen Sicherheit und der relativ leichten Durchf?hrbarkeit wird sie weltweit eingesetzt. Im Lauf der Jahre wurden durch verschiedene Innovationen verbesserte Ergebnisse erzielt. Anf?nglich gab es lediglich die trockene Fettabsaugungstechnik [2] mit all ihren Komplikationen, welche durch die Einf?hrung der Tumeszenz-Fettabsaugung abgel?st wurde, die deutlich weniger Komplikationen zur Folge hatte und bessere ?sthetische Ergebnisse erzielte. Neuere Methoden wie der Gebrauch von Vibrationskan?len [5] oder die ultraschallassistierte Fettabsaugung [6, 7, 8] haben zwar Verbesserungen in der Prozedur gebracht, zeigten jedoch keine wesentlichen Ergebnisse in der Straffung der Haut. Auch durch die laserassistierte Fettabsaugung wurden gelegentlich gute Straffungsergebnisse [10, 11, 18, 19] erzielt. Diese Methode ist jedoch sehr zeitaufwendig und eine pr?zise Anwendung hinsichtlich W?rmeentwicklung und Bindegewebsspezifit?t ist nicht m?glich. In letzter Zeit haben nicht-invasive Radiofrequenztechniken Hautstraffungsergebnisse im Rahmen der w?rmeinduzierten Hautbehandlung gezeigt [11, 12]. Die Anwendung von au?en erbrachte jedoch nur moderate Straffungsergebnisse. Das Body-Tite™-System (Invasix Ltd.) ist bis dato die einzige bipolare Anwendung, die genug Radiofrequenzenergie w?hrend der Fettabsaugung erzeugt, um kontrollierte Energie von innen an die Haut und das subdermale Bindegewebe abzugeben und zwar in pr?ziser Tiefe, wobei sowohl eine Lipolyse als auch eine Gef??koagulation stattfindet und zugleich auch eine Straffung der Haut erzielt wird. Die Pilotstudie diente dem Zweck, die Anwendungsm?glichkeit und Sicherheit dieser radiofrequenzassistierten Fettabsaugungstechnik zu pr?fen.

Abstract:

Background: A novel Radiofrequency-Assisted Liposuction (RFAL) technology was evaluated clinically. Parallel original histological studies were conducted to substantiate the technology’s efficacy in skin tightening, and cellulite improvement.

Methods: BodyTiteTM system, utilizing the RFAL technology, was used for treating patients on abdomen, hips, flanks and arms. Clinical results were measured on 53 patients up to 6 months follow-up. Histological and biochemical studies were conducted on 10 donors by using a unique GREDECO model of skin fragments cultured under survival conditions. Fragments from RFAL treated and control areas were examined immediately and after 10 days in culture, representing long-term results. Skin fragments from patients with cellulite were also examined.

Results: Gradual improvement in circumference reduction (3.9 – 4.9 cm) and linear contraction (8% – 38%) was observed until the third month. These results stabilized at 6 months. No adverse events were recorded. Results were graded as excellent by most patients, including the satisfaction from minimal pain, bleeding, and downtime. Histological analysis of skin fragments immediately following RFAL treatment showed hypodermal coagulation of fat and blood vessels, and structural changes in dermal fibers. After 20 days in culture, fibroblast fibers metabolism was stimulated. Histological changes following cellulite treatment were also noted.

Conclusions: The novel RFAL technology offers immediate skin tightening effect that is stable over time. The histological results correlated with the clinical observations of circumference reduction and skin tightening, as expressed by tissue fibers modulation. Moreover, RFAL offers an effective treatment for cellulite by formation of a thick collagen band at the dermal-hypodermal junction.

Introduction:

Recently, LAL, specifically Smartlipo™ has gained a great deal of attention based on expectations of a skin tightening caused by laser thermal effect on collagen and connective tissue. LAL is based on manual scanning of the adipose tissue treatment volume with a cannula delivering laser radiation through a very small fiber with a 600 microns diameter. Due to the manual delivery during LAL and the relatively small size of the laser radiation source questions are raised about treatment uniformity. Hot spots in the treatment area may lead to adermal injury while undertreated areas reduce uniformity of the treatment, potentially compromising the overall result including soft tissue contraction. The development of a Radiofrequency Assisted Liposuction system(Bodytite™,InvasixLtd.), which delivers high power radiofrequency to adipose and connective tissue while continuously monitoring all parameters including temperature allowed an opportunity to compare RFAL heating characteristics with LAL.