Radiofrequncy Dr.F.Iraji. Radiofrequency ablation radiosurgery, high frequency electrosurgery) is a...

Radiofrequncy

Dr.F.Iraji

Radiofrequency ablation

• radiosurgery, high frequency electrosurgery) is a dermatosurgical procedure that aims at the surgical management of benign and malignant skin conditions by using various forms of alternating current at ultra high frequency (500-4000) kHz


It is also popularly known as "poor man's laser" or "cold cautery". The most common form of radiofrequency ablation used in dermatology involves the application of high-voltage electromagnetic energy in the form of a damped sine wave.


• This form of current may be applied by electrofulguration, electrodessication or electrocoagulation. Radiofrequency ablation (RFA) has gained importance in the recent years as it is highly effective in the cutting of the skin lesions with adequate hemostasis at the same time because of good coagulation..


• Radiofrequency can be used for incisional techniques that produce full-thickness excision of nevi, shave techniques that produce partial-thickness removal of superficial lesions and removing vascular lesions such as hemangiomas or pyogenic granulomas

Radiofrequency

• works on the principle of increasing the frequency and voltage while simultaneously decreasing the amperage of alternating current so as to generate oscillating radiowaves. These radiowaves are further modified to produce different waveforms that are passed into the lesion. Modern high-frequency radiosurgical devices transfer electrical energy to human tissue via a treatment electrode that remains cool.

Radiofrequency

• The electrical resistance of human tissue helps in converting this electrical energy into molecular energy; this causes the denaturation of intracellular and extracellular proteins, thereby resulting in coagulation or desiccation effects..

Radiofrequency

• Increasing the temperature of the intracellular water above the boiling point (400-600ºC) causes the cell membrane to rupture, thereby producing a cutting effect. The lateral spread of heat results in the residual thermal damage by causing dehydration and coagulation necrosis of the tissue proteins and carbonization


• The basic equipment comprises a radiosurgical unit with a ground plate (dispersive electrode), foot switch and hand piece. It is provided with tungsten electrodes of various shapes and sizes with bendable shafts that are fitted into hand piece. A suction device for the evacuation of smoke in extensive surgery is also attached to the equipment. Radiofrequency uses various waveforms with the following tissue effects.

Electrosection

• The fully filtered and rectified waveform applied to the tissues in biterminal fashion provides a smooth cutting current resulting in elecrosection. An electrode tip in the shape of a fine needle, wire loop, diamond, ellipse or triangle is advanced slowly through the tissue, causing a steam envelope to advance around the tip and producing a smooth cutting effect.

Electrosection

• The fully rectified current simultaneously produces cutting and coagulation. This waveform produces least amount of lateral heat spread with minimum tissue destruction.

electrocoagulation

• Deep tissue destruction): The partially rectified waveform applied to the tissues in a biterminal fashion causes electrocoagulation. It gives instant homeostasis and is used in the treatment of the vascular lesions in which coagulation is primarily required.

electrodessication and electrofulguration):

Superficial tissue destruction This is achieved by the application of markedly dampened current to tissues in monoterminal or biterminal fashion. Fulguration causes the greatest amount of lateral heat spread and has a potential dehydrating effect. It causes the superficial tissue destruction through dehydration and surface carbonization. The electrode is held at a distance from the skin lesion in fulguration, while the tissue is touched with the electrode in desiccation.

Local anesthetic

• Local anesthetic, i.e., lignocaine is administered before most radiosurgical techniques. The use of lignocaine with epinephrine further reduces blood loss, but the use of epinephrine at the tips of digits and the nose should be avoided. Another alternative is to use a eutectic mixture of local anesthetics (EMLA) cream that contains 2.5% lidocaine and 2.5% prilocaine. It is applied under occlusion to skin at least 1 h before the procedure to achieve topical anesthesia. Anesthesia may not be necessary for the electrosurgery of small lesions such as telangiectasias and small skin tags.

Intensity of the power setting

• : The cutting of the tissue should be brisk and with the smallest electrode and power setting that is required to minimize the tissue damage and bleeding. The correct output power can be determined by starting at a low power and increasing the power until the desired outcome is attained (destruction, coagulation or cutting). In general, coagulation requires higher power settings than cutting, which requires higher power settings than desiccation or fulguration. The power settings for treating cutaneous lesions are generally low (10-20W).

Intensity of the power setting

• Surface area of the electrode and contact time : An electrode of a small size causes less lateral heat spread and requires lower power setting. The cutting current procedures are best accomplished with a fine needle or wire electrodes. Movement of the electrode through the tissue should be continuous and fast to avoid build-up of lateral heat that causes tissue damage.

The type of current selected :

• The selection of the waveform depends upon whether cutting or coagulation is the primary aim. This gives precise results with minimal tissue damage.

• Presence of moisture : The presence of moisture on the surface of the tissue prevents charring. Therefore, the surface should be moistened with saline soaked gauze.

• Waiting period : A waiting period of 10s is ideal between two passages of electrode used for cutting in the same surgical field. It allows adequate cooling and prevents cumulative heat damage.

•

RFA

• is a simple, safe procedure with wider applications. It causes less lateral heat spread and tissue damage and provides better control in comparison to electric cautery. The cutting mode of radiofrequency is more effective and versatile in comparison to the carbon dioxide laser. As hemostasis occurs simultaneously, the time required for the surgery is less. There are fewer side effects and complications. RFA can be easily combined with other surgical modalities such as cryotherapy and laser for treatment.

Dermatological Indications of RFA

• a. Diagnostic: Skin biopsy, excision of cysts and abscesses.

b. Infections: Verrucae, pyogenic granuloma and molluscum contagiosum.

c. Metabolic: Xanthelasma, xanthomas


• d. Benign skin conditions: Freckles, dermatitis papulosa nigra, acne, skin tags, cherry angiomas, spider angiomas, naevi, trichoepithelioma, syringomas, apocrine hidrocystomas, stucco keratosis, papilloma, neurofibromas, cutaneous horn, keratocanthoma, rhinophyma, sebaceous hyperplasia and keloids.

e. Senile skin conditions: Actinic keratosis, sebborheic keratosis and senile lentigenes.


• f. Malignant skin tumors: Squamous cell carcinoma, basal cell carcinoma, dermatofibroma sarcoma protuberans and carcinoma in situ lesions of the skin and orogenital mucosa.

g. Nail procedures: Nail matrixectomies, surgical hemostasis of ingrown toenail and onychogryphosis.

h. Cosmetic indications: Mole removal, telangiectasia, unwanted hair removal, scar revision, ear-lobe repair, development of flaps, oculoplastic procedures and blepharoplasties.

The ThermaCool™ system

• is a unique monopolar radiofrequency (RF) device. The differentiating factor between the ThermaCool system and other RF devices is a capacitive coupling electrode. Through capacitive coupling, deep, uniform and volumetric heating is deployed to tighten and contour both the skin and underlying tissues; meanwhile, cryogen cooling is concurrently applied to protect the epidermis.

The ThermaCool TC

• has been introduced to induce the tightening of skin via a uniform volumetric heating into the deep dermis tightening, thereby resulting in a "non-surgical facelift." It causes immediate collagen contraction and also produces long-term collagen remodeling. It has been used to improve the neck and cheek laxity and periorbital rhytides and to elevate the eyebrows.

The ThermaCool TC

• ThermaCool TC RF system represents a promising noninvasive method of obtaining moderate facial rejuvenation in the appropriately selected patient.

RFA in Combination with Other Physical Modalities

a. RFA with cryotherapy: Liquid nitrogen spray followed by light electrodesiccation treatment is helpful in the management of flat warts, small skin tags, seborrheic keratoses and cherry angiomas.

RFA with laser

• The combination of diode laser and RF energy is reported to decrease the appearance of wrinkles and improve the skin texture. Diode laser using a fluence of 30-50 J/cm 2 and RF energy of 80-100 J/cm 3 , has been used for nonablative wrinkle treatment of the face and neck. The combination of 900 nm diode laser light and radiofrequency energy is also found to be effective for the treatment of facial venous malformations. It provides additional heating of the vessels without increasing the laser intensity. The side effects are minimal.

RFA and combined RF:

• light source technologies are safe and effective for treatment of several dermatological procedures, including skin tightening, hair removal, acne scarring, skin rejuvenation and wrinkle reduction.

RFA

• RFA should be avoided in unstable cardiac patients and in the treatment of the lesions of the skin overlying a pacemaker. Special care should be taken while performing radiosurgery near eye. RFA should not be done in presence of oxygen as there is risk of explosion. It should be made sure that patient is in contact with the ground plate during procedure. The operator should consider wearing a surgical mask and eye protection when working on lesions containing HPV.

Side Effects and Complications

• The common side effects that occur with radiofrequency are pain, tissue edema, bleeding, infection, post inflammatory hypo/hyper or depigmentation, scarring and keloid formation. The bacterial transference of Staphylococcus aureus through electrode from one patient to another is possible; however, it is much more possible during electrodessication than during electrocoagulation.

Mono and Bipolar Radiofrequency (Accent™) for a non-surgical facelift

History of RF

RF has been a well known technology for more than RF has been a well known technology for more than 70 years70 years

In the field of surgery it is generally known as In the field of surgery it is generally known as diathermiadiathermia

The RF energy is also used in cosmetic applications The RF energy is also used in cosmetic applications (electrolysis) and approved by the FDA for (electrolysis) and approved by the FDA for permanent hair reduction by aestheticianpermanent hair reduction by aesthetician

There are two types of diathermia – Monopolar and There are two types of diathermia – Monopolar and BipolarBipolar

RADIOFREQUENCY: Electromagnetic Radiation

Alternate current modified emitter of electromagnetic radiations : *long wave and frequency

cms.

Diagram of an electromagnetic wave

-1,5

-1

-0,5

0

0,5

1

1,5

TIEMPO

VO

LT

IOS

0

Vp

f sec

T=1/f

Velocity = light 300.000 KM/SEC

SEC

λ

1 sec

0

SPACE

Electromagnetic Radiation.Parameters to take into account:

Impedance of the tissue (Ohms)Power (Watts)Exposition Time (Seconds)Electrode configuration

Radiofrequency

PARIS-2005PARIS-2005

There are two types of diathermia – There are two types of diathermia – Monopolar and Monopolar and BipolarBipolar

The Monopolar uses a return electrode with a much The Monopolar uses a return electrode with a much larger surface than that of the treatment electrode, larger surface than that of the treatment electrode, placed outside the treatment whilst the bipolar placed outside the treatment whilst the bipolar applies both electrodes in the treatment area and applies both electrodes in the treatment area and the heat and electrical energy are localised in a the heat and electrical energy are localised in a small area small area

Bipolar energy is safer, although it penetrates less, Bipolar energy is safer, although it penetrates less, as it only effects the area between the electrodes.as it only effects the area between the electrodes.

Radiofrequency


Produces heat by:Rotational movement of the water

molecules = production of electromagnetic waves

Resistance of the tissues to the currents conduction

Radiofrequency: Action Mechanism


Action Mechanism


Dermis

Subcutaneous tissue

Muscle -

+

-

Polarisation

Differences between Monopolar – Bipolar RF currents


RF Heating Technology

Bipolar

EarthRF

The electrical field is created between the The electrical field is created between the electrodes: Very superficialelectrodes: Very superficial

Skin

Earth

RF



Mono-polar

Tissue

RF

EarthDeep heatingDeep heating


Heating Technology with RF

Monopolar Radiant

Tissue

Deep heatingDeep heating

RF Antenna



Monopolar Bipolar



Action MechanismIMMEDIATE EFFECT

Contraction of the collagen fibres increasing and retracting the cutaneous tissue

Tensing the septum fiber


Action MechanismPROGRESSIVE EFFECT

The heat generated by RF in the dermis progressively triggers an increase of new collagen ⇨cutaneous remodelling and continuous stretching

6 MONTHS

MO: Epidermis: without change ME: Dermis: • Disperse and diffuse changes in the fibril

architecture of the collagen = increase in fibre size and loss in definition of the borders with the joining areas of fusion of fibres.

• The fibril alteration was observed in disperse areas affecting up to 25 % of the fibres present

• The maximum effect was seen at a depth of 2-3 mm.

• The changes were doses dependent and decreased with time

A.MOLECULAR: increase of the RNAm type I collagen, HSP-47(Heat Shock Protein).

IMMEDIATE

MO:

• No significant changes in the epidermis, dermis and essential substances

• G. Sebaceous: ↓ size. Normal structure.

• C. Epithelial G. Sebaceous disperse moderate changes

Morphological cutaneous changes


DENATURALIZATION

SHORTENING

HSP-47(Heat Shock Protein)

INCREASE RNAm

NEOCOLAGENESIS

Collagen partially denaturaliseddepth 3-4 mm

Morphological changes in the collagen at M.O and M.E

Study by Brian Zelickson, MD and Karl Pope


Accent RF System

Excellent designExcellent design Transportable (30 Kg)Transportable (30 Kg) Comfortable for the user Comfortable for the user

and the patient optimum and the patient optimum resultsresults

2 hand pieces 2 hand pieces (Monopolar and Bipolar)(Monopolar and Bipolar)

RF Tissue Connection Technology

BenefitsBenefits Doesn’t require contact gel.Doesn’t require contact gel. Doesn’t require return electrodes.Doesn’t require return electrodes. Doesn’t need good contact (pressure)Doesn’t need good contact (pressure) Can be used in movementCan be used in movement Without changing fluencyWithout changing fluency Without consumablesWithout consumables Choice of Monopolar or Bipolar treatmentsChoice of Monopolar or Bipolar treatments

Radiant Connection Radiant Connection


Benefits of the Accent vs. other RFs

Wider radiofrequency : 40.6MHz instead of 6MHz

Better contact technology: moving instead of stationary

Contact terminal refrigerated at 4ºCLess painfulConfiguration with two headsWithout return electrodesWithout consumables


Accent hand pieces

MonopolarMonopolarBipolarBipolarOne sole interrupterOne sole interrupterDesigned to carryout Designed to carryout

efficient manipulationsefficient manipulationsMinimising the tiring of Minimising the tiring of

the userthe user


Effects of the Accent

Produces the heating of the fat and the skinProduces the heating of the fat and the skinStimulates the collagenesis of the dermis, Stimulates the collagenesis of the dermis,

tensing the skintensing the skinStimulating collagenesis in the septum fibresStimulating collagenesis in the septum fibresStimulates blood circulation at a cutaneous Stimulates blood circulation at a cutaneous

level, improving the quality of the skinlevel, improving the quality of the skinDrains the lymphatic excess of the fat, Drains the lymphatic excess of the fat,

diminishing the orange peel look, diminishing diminishing the orange peel look, diminishing body massbody mass

Increasing Lymphatic Drainage it diminishes Increasing Lymphatic Drainage it diminishes the adiposities fluids and toxins and reduces the adiposities fluids and toxins and reduces volume.volume.

Increasing the circulation and blood flow it Increasing the circulation and blood flow it improves the texture of the skin.improves the texture of the skin.

Increasing the collagenesis, (dermis and Increasing the collagenesis, (dermis and septum fibre) increasing the firmness of the septum fibre) increasing the firmness of the skinskin

¿LIPOLITIC ACTION?¿LIPOLITIC ACTION?

Effects of the Accent


Effects of the AccentFacial rejuvenation

treatment.

Treatment for face and neck

Improving quality of skin and flaccidity

Improving superficial wrinkles

Use of Monopolar and bipolar

4 sessions every 15 days

Body remodelling treatment. Cellulite

Treatment to any area of the body:1.-Arms2.-Legs3.-Abdomen

Improvement in flaccidity and cellulite

Decrease in perimeters Monopolar use 4-8 sessions every 15

days


Theory of the Accent Radiofrequency

MonopolarMonopolarAccent


Radiation through the air

RF without cold vs. RF with protection for cold

SIN PROTECCIÓN POR FRÍO CON PROTECCIÓN POR FRÍO

EPIDERMISepidermolisis completa capa epidérmica PRESERVACIÓN COMPLETA

DERMIScoagulación de vasos superficiales no evidencia de alteraciones vascularesnecrosis infundibular folículos en dermis reticular y/o papilarnecrosis canales sudoríparos no alteraciones en sustancia fundamental, ni

glándulas papilaresefectos neg. dosis dependiente RF dosis controladas de RF sin efectos negativos

COLÁGENA COLÁGENAcoagulación pobre de colágena dosis contracción colágena fibra inmediata post RFdependiente en rangos de dosis progresiva aparición de nueva colágenaterapéuticasmuy bajas de RF

OBSERVACIÓN: MO OBSERV: MO-ME-ANÁLISIS MOLECULAR

WITHOUT COLD PROTECTION WITH COLD PROTECTION

EPIDERMIS

Complete epidermis Epidermis layer COMPLETE PROTECTION

DERMIS

Coagulation of superficial blood vessels No evidence of vascular alterations

Infundibular follicular necrosis In dermis reticular and/or papilla

Sudoriferous channel necrosis No alterations in essential substances, nor papilla glands

Controlled doses of RF without negative effects

Negative effects depending on doses of RF

COLLAGEN

Poor coagulation of collagen doses Immediate contraction of collagen fibre after RF

Depending on level of doses Progressive appearance of new collagen

Very low therapeutics RF

OBSERVATION: MO OBSERVATION: MO-ME- MOLECULAR ANALYSIS

Rejuvenation of face and neck

Radiofrequency with Accent

Patients who want to improve the quality of skin and laxity or flaccidity

Not effective in pigmented lesions Note – tensing effect NOT LIFTING!. “More compact skin”

“Firmer skin” Increases luminosity and diminishes wrinkles Best results on thick and well hydrated skins rather than thin

and dehydrated Notable improvement in 90% of cases, 10% obtain no result The impedance of the skin will mean more or less resistance

to the increase in temperature on carrying out each treatment

RF Facial: Selection of patient


Prior to treatment: No makeup 24hours before No IPL nor peeling 7 days before antes No Botulinum toxin 15 days before

Day of treatment: Take off all metal items Cleaning of area with isopropyl alcohol Marking of the are with a dermografic pen Application of oil to avoid friction

After treatment: Remove remaining oil Apply calming cream and photo protector Don’t sunbath for 7 days

Accent Method


RF Face and NeckMethod used

Use of Bipolar and Monopolar

Division by anatomic areas Application in zigzag and

circular movements Rapid non-stop movement Taking metabolism

temperature = 34-36º C Reaches 38.5-40º C 3 passes per area


Bipolar

Monopolar





temperature = 34-36º C Reaches 39-40º C 3 passes per area






temperature = 34-36º C Reaches 39-40º C 3 passes per area


RF Face and NeckParameters

Monopolar: 140watts 20sec 3 passes 40ºC

Bipolar: 60watts 10sec 3 passes 38.5ºC


Bipolar

Monopolar

PregnancyLatencyPacemakerMetal plaques or screwsNot to be applied against permanent fillingsSerious heart conditionsIllnesses to do with connective tissue and

muscles

RF Facial: Contraindications


RF Facial: Secondary Effects


Pain:Very tolerabledoses depends

Inflammation: discrete edema-erythema discrete,

clearing up within hours Ecchymosis and Purpura: Thin skins

1st and 2nd degree burns (1st case)Later on: none

RF Images


RF Images

Get the photographic station Get the photographic station startedstarted

Adjust the camera and angle of Adjust the camera and angle of the flashes for optimum resultsthe flashes for optimum results

Standardize the parametersStandardize the parametersAdjust data, patient number and Adjust data, patient number and

session numbersession number


Why do we take photos?

To document the progress of the To document the progress of the patientspatients

To motivate patientsTo motivate patientsTo control their progress to achieve To control their progress to achieve

resultsresultsTo give new patients evidence that To give new patients evidence that

you achieve resultsyou achieve results


RF Facial with Accent: Conclusions


The choice treatment for flaccid neck and face. Improves quality of skin due to the production of

collagen. Improves crows feet. Possibility of using Monopolar and Bipolar RF. No consumables. Quick and comfortable treatment for users More comfortable for patients than other RFs. Very good results in 20% of cases, good in 70% of

cases and bad in 10%. Better results on faces with thick and greasy or

mixed skins than in faces with fine and dry skin.

• heating in dermis and subcutaneous fat

• with radiofrequency

• •results after one treatment in most cases

• •effects focussed more in tightening, less in wrinkles

• •anaesthesia necessary

• •sides effects: erythema, blisters, oedema

Thermage™Radiofrequency -Thermage

What is Scarlet RF?

• Scarlet is minimal invasive fractional bi-polar Radio Frequency with micro-needle electrodes. It provides direct heat with both epidermis and dermis through precise depth control from 0.5-3.5mm.

What is Scarlet RF?

• Its efficient fractional radio frequency enables capability of achieving fractional and continuous treatment patterns. It expends your practice by offering efficacious minimal risk of downtime and pain regardless of skin type

Why 55°C~60°C?• Can stimulate the regeneration of collagen,

but without the risk of altering the cell structure1. Early Stage: Fibrous tissue contraction and shrink pores can be seen.2. Later Stage: After 2-3 weeks, can significantly see the regeneration of collagen, and the restore of skin elasticity.3. Protein and collagen within the skin tissue did not altered or degenerated

Why 55°C~60°C?

• What areas can be treated by Scarlet RF?

• Improve droopy eyelid and smoothen fine lines around the eye area

• Smoothen fine lines and wrinkles

Face Lifting

• What are the advantages of Scarlet RF?

• Treatment areas can be used beyond hair lines and ears, improve the appearance of fine lines and wrinkles

Face Lifting

• Less Downtime, can back to normal activities after 2 hours after treatment. (Actual downtime may differs from different body condition)

Face Lifting

• During the treatment, a temporary lift might be visible due to the reaction by the RF wave. After the regeneration of collagen and elastic tissues under skin, a more long lasting and compact lifting effect can be seen

Is the procedure painful?

• There is minimal pain as it uses not spring to move electrodes but micro robot motor, a technology named Dynamic Linear Motor Technology, for smooth movement

What is interval of treatment?

• It depends on patient but mostly with 2-3 session they can have the best result and interval of treatment is one month

Is there complication?

• It secures safe RF energy field so it does not have any kind of complication

• How to mix and match with other treatments and Scarlet RF?

• Suggested interval of 2 weeks required between different treatments.

Scarlet RF Features

• Volumetric Tightening

• - Unique effect from direct heating RF, with invasive micro electrodes

• True Fractional RF

• - Focused on strong RF energy to maximize RF effect

• Fractional Laser + Deep Dermal RF Effect

• Target both epidermis (Fractional Laser target field) and deep dermis (RF target field), control depth 0.5-3.5mm with 0.1mm increment

How long is downtime?

• How long does the procedure take?

• Treatment time is about 30-50 minutes

• Scarlet treatment needs minimal Downtime which is about 1 day with normal skin type

No Side Effect

• Less Pain, Less Downtime, No Side Effect• - Sophisticated control by using Shock

Free Needle Technology to deliver effective results with minimal downtime

• Scarlet RF – Recommended treatements• Once a month for three consecutive

months, thereafter once every six months to maintain the collagen level and skin elasticity

Neocollagenesis- Fractional Microneedle Radiofrequency

• As we age our skin changes with time. This is natural but is affecting both the topmost and mid layers of the skin. Noticeable changes not only on our face and neck but also on various body areas just think about the back of hands.

• The topmost layer of skin called the epidermis develops sun damage and pigmentation, enlarged pores, fine wrinkles, and superficial thread veins as the time goes.

• Under the epidermis, in the dermis collagen fibers degrade, loosing elasticity resulting in volume loss and sagging. Sagging is obviously visible on the jaw line, and under the jaw on the neck as we age.

• Everybody wants to look and feel young. Aging is an option. Is there a way to restore youthful appearance without invasive surgery?

• refreshed collagen structures, visible wrinkle reduction, effective plumping and lifting without surgery, volumetric tightening and flawless skin! Even one treatment can fix you up with true rejuvenation and visible results.

• Rejuvenate your skin today and restore that youthful complexion!

• Neocollagenesis fractional microneedle RF therapy turns back the clock on aging or damaged skin!

• Neocollagenesis fractional microneedle radiofrequency helps to achieve your esthetic goals without pain or downtime!

A new esthetic treatment?

• What is the science behind the Fractional Microneedle RF Neocollagenesis ?

• Fractional RF microneedle treatment is an innovative approach to ascending RF technology.

Theory:

• warming up collagen fibers in a precise and controlled manner, result in changes in the collagen structures. The fibroblasts producing collagen and elastin activate and stimulate regeneration processes in the skin. Thus the skin lifts and responds in volumetric tightening. Different skin blemishes are in different skin layers.

• What is revolutionary about this fractional RF technology is that the esthetician expert performing the treatment can so precisely send the RF energy in the appropriate skin layers as never before.

• As the handpiece directs the rejuvenating RF energy targeting precisely selected skin layers in order to stimulate the body’s natural restoration processes and collagen, elastin production it treats many kinds of blemishes at once.

• How does Fractional Microneedle RF Neocollagenesis treatment work?

• For every treatment new, sterile handpieces are used! The sterile handpiece tips contain an array of gold plated insulated or non-insulated microdiameter need

• shaped electrodes. These electrodes are rapidly inserted in the skin (without causing extensive damage to the epidermis) to selected skin depth while focused RF energy pulses create controlled thermolysis. Thus resulting in rapid contraction of the skin as denaturing occurs.

• Collagen denaturation is followed by neocollagenesis, collagen re-modelling. Fibroblasts are stimulated and new collagen and elastin fibers are produced while growth factors are naturally released as the skin heals, resulting in a new refreshed appearance.

What is the Fractional RF

• Our special machine is installed with various functions for face and off the face applications. So it is able to treat the face, neck, décolleté, back of hands, body and even the sensitive eye area safely providing outstanding results. Anti –aging treatment invigorating the skin

• Non surgical facelift

Volumetric tightening of the skin

• Eyelid tightening without surgery

• Treating facial wrinkles and skin laxity, treats sagging skin

• Improving skin tone and texture

• Lifting and tightening jaw line and double chin

• Plumping nasolabial fold

• Decreasing lip lines

Microneedling treatment good for?

• Acne condition treatment

• Sebum control treatment for oily skin

• Acne scars, Surgical scars, Burn scars, Chicken pox scars

• Large pores treatment

• Pigmentation treatment, Skin whitening

• Hyperhidrosis treatment (treatment for excessive sweating NO Botox)

• Body tightening: such as belly, arm, thighs etc. Hand rejuvenation

• Stretch marks, Striae treatment• Keratosis pilaris Facial veins, rosacea,

nevus flammeus, flushing, fading up to a level Hair removal of white hairs up to a level

• What skin types can benefit from Fractional Radiofrequency Microneedling treatment? Fractional RF Microneedle treatment since it is not light based and not laser treatment is able to effectively treat all skin colors, even darker skin types and also safe treatment for sensitive skin types.

Can I have this treatment in the summer time?

• Sure! Since it is a radiofrequency and not a laser treatment, the epidermal injury is so minimal the treatment is safe all year round!

How is this treatment unique?

• Visible results after the initial treatment, Additional treatment results add up (cumulative effect), Non surgical, minimally invasive, gentle treatment, Short procedure with minimal to no downtime, Volumetric tightening of skin, Result a natural complexion.

How long does a single treatment take?

• A treatment usually takes 25-30 minutes. If treating sensitive skin and there is need for topical anesthesia, the numbing cream requires 30 minutes to take effect prior to treatment. Cooling and aftercare (serum, mask) can take up to a good 30 minutes. In order to boost treatment results we use moisturizing and firming active serums/masks.

• In order for these enriched serums and masks to be beneficial, they need to be left on the skin to react. Therefore each session requires approximately 1-1,5 hours. How will my skin look after the treatment is there any downtime associated?

• After the treatment the skin develops transient erythema and edema which can last approximately 3-4 hours. Skin will have tight and slightly warm feel and can be pinkish.

• Depending on the treatment parameters and microneedle types, in some cases signs of microthermal zones, scab formation and flaking can be noticed for 1-2 days, which is part of the healing process. You can wear makeup the next day (after 24 hours).

• How often should I have Fractional Microneedle Radiofrequency treatment for good results?

• Best is to have a treatment package of 3-5 sessions.

• During your initial consultation you will receive a treatment plan custom tailored to your needs. The waiting time between treatments varies, depending on what body area and indication is to be treated. To keep long lasting results yearly maintenance can be recommended depending on skin

• To maintain treatment resultsit is essential to use good quality skincare products at home in between treatments, use good sunscreen and follow the aftercare instructions!

• Our staff is happy to introduce you to home care cosmetic products which can further help boost treatment results.

• Does it hurt? Generally, treating up to 1mm depth anesthesia is not needed (you can barely feel anything).

• If treating sensitive skin or performing a deeper treatment, topical anesthesia cream can be applied prior for more comfort so the treatment can be virtually painless. Our state of the art machine is complemented with strong built in cooling to provide more comfortable treatment.

• Who are good candidates for Fractional Microneedle Radiofrequency treatment? Adults between the ages of 18 - 65 and in good health are candidates for this treatment.

pre treatment instructions?

• On your scheduled consultation a trained professional will fully examine and evaluate your skin. Please arrive to your consultation not wearing makeup. Men are advised to shave if the face to be treated. Do not wear antiperspirant, perfume, cosmetics, body lotions, self tanning lotions on the area to be treated.

pre treatment instructions?

• Pre treatment you should not drink alcoholic beverages, because alcohol can draw water away from cells thus elongating healing process. Regeneration of cells can be enhanced by taking Vitamin C (500mg) daily, and homeopathy products may also help.

Can this treatment help with acne condition skin?

• Yes! Excessive sebaceous glands can be decreased with this treatment.

Can this treatment help with stretch marks and striae?

• Yes! Neocollagenesis treatment is suitable for stretch mark treatment. As a result the lines begin to fade, and eventually be more even to the surrounding skin, becoming less visible.

help with excessive underarm sweating?

• Yes! Fractional Radiofrequency Microneedle treatment is suitable for axillary hyperhydrosis treatment. As a result sweat glands show decreased activity.

Aftercare instructions:

• During your initial consultation you will receive detailed information of pre care and aftercare instructions. Make sure to protect your skin with a sunscreen with at least SPF 30 for a month to prevent sun damage.

Aftercare instructions:

• The aftercare instructions will guide your healing and help to minimize the occurrence of side effects. Good to know that upon irritation of treated site (any harm to epidermis) germs bacteria can enter the skin, therefore avoid mechanical irritation! Avoid scratching rubbing and picking the skin, since it can cause permanent scarring. Also can higher the risk of complications.

The microneedle fractional RF

• Needles are inserted into the skin by a specially designed electronically controlled smooth motion motor minimizing patient discomfort. When the needles reach the pre defined insertion depth the RF is emitted selectively heating the dermis while sparing the epidermis. RF emission delivered over the whole dermal

The microneedle fractional RF

• handpiece used in our study (Intensif handpiece ,is a novel handpieces that uses a tip with 25 noninsulated gold plated microneedle electrodes. (max diameter of 300 micron at their base gradually tapered to an extra sharp edge)..

Methods

• The study included 23 patients treated for atrophic acne scars or skin rejuvenation. We used the EndyMed PRO

• platform system equipped with the Intensif™ micro-needles handpiece. The micro-needle treatments were performed once a month, (3 to 4 sessions).

specific technology:

• •Handpiece with 25 micro-needles •penetrate up to 3.5 mm •Needles:: High quality, Super sharp, gold plated

• •Customized smooth insertion by unique

• step motor for reduced discomfort insertion Constant measurement of impedance •enhanced volumetric heating mode •hardware and software allow constant energy delivery independent of individual tissue impedance full hemostasis in contrast to other RF Micro-needle systems

Results

• 23 patients with moderate to deep skin lesions were treated 1-2 sessions using the Intensif handpiece

•

Before and after

• photos, were graded according to standard evaluation methods. Dedicated Questionnaires evaluated treatment comfort, safety and effectiveness. Analysis of the questionnaires showed Improvement of > 70% . treatment comfort, was very good in > 90%,. Effectiveness very good in > 90%. There were no side effects.

Conclusion• demonstrate the safety and efficacy of the

novel RF microneedles skin remodeling handpiece for Acne Scars improvement and skin rejuvenation. This modality gives clear advantages over traditional skin resurfacing lasers such as lower level of adverse effects downtime and downtime, complete control of the depth of effect, volumetric heating and the ability to treat all skin types.

Date post:	29-Jan-2016
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