New Study Supports Safety and Efficacy of Radiofrequency in Aesthetic Applications

Radiofrequency (RF) has been shown to be safe and effective in a variety of medical applications. RF use also gained momentum in aesthetic surgery in the 2000s when the Food and Drug Administration (FDA) first approved it for facial wrinkle reduction. RF devices are widely lauded for their efficacy in treating skin and soft tissue laxity in a variety of body areas, with high patient satisfaction rates. A new study looked into the effect of thermal energy in RF treatments – this is an area that has not been sufficiently explored to date, according to the authors.

Spero J. Theodorou, MD (bodySCULPT plastic surgeon) is one of the authors of this recently published study titled “Aesthetic Applications of Radiofrequency: Lymphatic and Perfusion Assessment” published in Plastic and Reconstructive Surgery – Global Open2020 Oct 26;8 (10):e3193. The study aimed to objectively evaluate perfusion and lymphatic assessment tools pre and post bipolar and fractional RF treatment. The findings support the safety of radiofrequency (RF) treatment in terms of preservation of tissue perfusion and lymphatic drainage.

RF energy is delivered via various methods such as monopolar, bipolar and fractional and each delivers different thermal effects. All of these RF application methods generate thermal injury to tighten existing collagen and encourage production of new collagen over the subsequent 3-4 months. One of the major clinical concerns with RF is its ability to control temperatures and avoid injury to soft tissue elements. The depth and degree of energy transferred depends on several factors, including the size and configuration of the treatment device, energy settings, time of treatment, and inherent conductive properties of the tissue. The retrospective IRB-approved study was conducted between January 2019 and April 2019 to evaluate this soft tissue perfusion and lymphatic function after treatment with bipolar and fractional radiofrequency treatment.

For the study, a total of 63 patients were treated with bipolar ((Accutite/BodyTite/FaceTite, InMode, Lake Forest, Calif.) and/or fractional radiofrequency (Morpheus8 InMode, Lake Forest, Calif.), or both depending on the evaluating plastic surgeon’s clinical assessment of soft tissue laxity. Three types of patients were treated. They are:

1. patients who had a prior excisional procedure with recurrent laxity
2. patients whose skin laxity was not severe enough for an excisional procedure or
3. patients who preferred to not undergo traditional surgery and were willing to accept a more modest result with RF

Patients with more severe soft tissue laxity were typically treated with both RF modalities. All procedures were performed by a single surgeon to control for technique variation.

The study found that both lymphatic function and soft tissue perfusion was not significantly impacted by electromagnetic RF induced heat to 68°C internally and 38°C externally. Evaluations of bipolar and fractional RF independently and in combination demonstrated no demonstrable impairment on lymphatic function.

“The results of this study demonstrate that bipolar and fractional bipolar radiofrequency do not appear to impact subdermal lymphatic flow or perfusion either in isolation or in combination”, the researchers concluded. They also said that more studies are needed on these increasingly popular technologies to ensure safety and efficacy.

Study author Dr Spero J. Theodorou is bodySCULPT® plastic surgeon, and has extensive training in radiofrequency-assisted and other power-assisted liposuction procedures. He is responsible for the development of all of InMode’s procedures, clinical studies and training. Dr Theodorou was instrumental in the development and introduction of EmbraceRF, the innovative facial contouring solution that blends InMode’s FaceTite and Morpheus8.