Before we start, let’s just say, this is difficult reading. But we thought it was important to bring you as much technical research as possible on the amazing tools we use at Essential Feeling to deliver your bipolar radiofrequency sessions in Essex.
Before going into too many details, it is useful to understand the basics of how to manipulate high-frequency energy for aesthetic treatments. RF (radiofrequency) energy is often supplied to the target treatment area through an applicator applied to the surface of the skin.
The applicator emits high-frequency energy, which penetrates deep into the skin, into the deep and subdermal dermis layers, turning into thermal heat in the target tissue. When collagen heats, it causes the treated skin to react by stimulation and producing more collagen to improve texture and elasticity. When fat cells heat, high-frequency energy induces apoptosis of selected fat cells to reduce the overall circumference improving the recipient’s figure with efficacy of many formal assessments within the field of medicine.
Since high-frequency energy is more electrical than light based, melanin is unaffected and post-inflammatory hyperpigmentation is of little importance. The devices differ in the number and configuration of electrodes in applicators, as well as in the different electromagnetic fields used to supply RF energy. Here we will focus on the variations of electrodes that can be classified as monopolar, bipolar radiofrequency or multipolar.
We use bipolar radiofrequency in our facial radio frequency and vacuum massage. We set it at 2mhz.
Bipolar RF devices have two electrodes in the same applicator. The energy moves from one electrode to the skin and back to the second electrode in the same handpiece.
Bipolar applicators better control and distribute energy between electrodes and provide the enhanced ability to attack more specific skin structures to improve effectiveness compared to monopolar and unipolar devices. This is why we use bipolar radiofrequency on the face area, because this is how the machine targets visible areas, often multiple, and how we see the best improvement in our client’s outcomes.
Some bipolar devices use vacuum technology, which can improve the reached heating depth.
Tripolar radiofrequency is the type that we also use in our facial radiofrequency handsets which use three electrodes (see below).
We use multipolar RF therapy in the bigger applicators, like the handpieces we’ll use on the torso for instance. The protocol for these is for them to be set at 1mhz.
This radio frequency uses three or more electrodes that use a pattern that allows handling of active and inactive electrode pairs for better operator control and efficiency.
The penetration depth within the dermal layers for multi-polished RF devices changes depending on the distance between the sensory electrodes; the greater the distance between the electrodes in the applicator, the greater the penetration depth.
Bipolar and multipolar radiofrequency therapies
According to a collection of studies, bipolar and multipolar devices are considered the most versatile option for improving the effectiveness and comfort of the patient, as well as minimal downtime compared to monopolar devices.
You may also hear monopolar radiofrequency banded around, but they consider this a slightly older and more outdated therapy which we don’t use in our ProMax Lipo machine which is used by the NHS and developed by Lynton’s who work closely with the University of Manchester.
Fractional RF is a variant of bipolar HF in which they structure an electrode matrix in such a way as to divide the treatment field into several RF thermozones (RFZs) with dazzling areas of untreated tissue. The application of these technologies includes tightening the skin, reducing ritis, reducing stretch marks, as well as warming the adipose tissue used in the body contour and reducing cellulite. Fractional bipolar RF produces superficial RFZs and is now most often used for skin rejuvenation. Since RF devices work independently of chromophores, we can use them on all skin types with little or no risk of pigment change.
What is radiofrequency?
Radio frequency refers to oscillating electromagnetic waves in the range from 3 kHz to 300 GHz. To provide a perspective, mobile phone signals work from 800 MHz to 2.69 GHz, and there is rarely a time when a person in the industrialized world does not infinitely radiate from one or another source such as these cellular, WiFi or Bluetooth signals. They typically remove these signals from the transmitter and have a low power density and therefore an insignificant biological effect. At higher power densities achieved with an RF emitter, abundant physical interactions can occur.
The conductivity of the material determines the reaction. In RF devices, for example, the dry epidermis can evaporate, while the dermis experiences less heating, so cooling units are needed. The EMF pattern is determined by the geometry of the electrodes, their size, shape, placement and metal can be designed to optimize fields for a particular application, and voltage, current and frequency are parameters that change the effect on the fabric. Monopolar RF devices use a single electrode with a remote ground platform or plate connected to the patient. The most used application in dermatology was electrosurgery. However, in recent years, devices with cosmetic applications have been released to tighten the lax skin, reduce wrinkles, improve the appearance of cellulite and contour the body through thermal effects on adipocytes
Unipolar v’s bipolar radio frequency
Unipolar RF unipolar versus bipolar devices have a single electrode without mass, where the current is driven solely by the voltage difference between the electrode and organic tissue. These devices emit omnidirectional, similar to what a bulb does, and can also reach the subcutaneous tissue, similar to monopolar devices. Common applications include non-invasive skin tightening in larger tissue areas such as the soft skin of the abdomen, thighs, arms, cellulite reduction, and body contour.
We can also use these devices for fallen banks and elastosis/ wrinkle reduction. Accent (Alma Lasers) uses both unipolar RF for volumetric heating of adipose tissue and bipolar RF for more superficial non-volumetric heating. The bipolar RF supply mode uses two electrodes, one positive and negative; alternating current flows back and forth between these points. The effective depth of the field, and therefore the depth of the heated tissue, is determined by the distance of the electrodes from each other, although the degree of heating is still determined by the electrical parameters of the EMF.
Fractional bipolar radiofrequency
Practical differences Fractional bipolar RF techniques migrate the concept of fractional photothermolysis (FP) from laser to RF technologies, with some practical differences. Fractional photothermolysis was originally introduced in 2003, which is based on a conceptual change from the treatment of a continuous tissue level to the use of a series of microscopic columns with spatially limited thermal lesions.
1The concept that untreated tissue areas of reservoirs in subjects. Histology subsequently demonstrated observation of the skin hardening of fractional bipolar RF.
2. A histological study with fractional RF (FRF), carried observation of cutaneous tensioning in fractional bipolar RF out which showed significant neoelastogenesis and neocolagenesi after the operation.
3. Microneedle electrodes in abdominal skin in subjects; They maintained tissue temperature at 72 degrees Celsius for four seconds. In the reticular dermis zones of denatured collagen, the analysis showed them as RF thermozones (RFTZ) with interrupted dermis. The RFTZ persisted after 28 days, but were replaced by new tissue after 10 weeks. The reticular dermis showed an increase in volume, cellularity, hyaluronic acid and elastin. They observed immediate increases in IL-1B, TNF-A and MMP-13, followed by a two-day increase in MMP-1, HSP72, HSP47 and TGF-B.
On day 28 of the procedure protocol there were notable response. There were significant increases in tropoelastin, fibrillin, and procollagen 1 and 3. A significant difference between the bipolar patterns of FRF tissue lesion and those arising from FP is the form of RFTZ. When FP causes a thermal injury to skin columns that narrow when sinking; FRF produces a distinct pattern, which depends on the configuration of the radio frequency.
Surface electrode arrangements create the narrowest areas of skin lesion on the epidermis, which, when subdivided, increase conically until attenuation cuts the pattern.
When using a fixed electrode, the penetration depth depends on energy, with a maximum depth of 450 µm achieved by a power change of 10 J to 20 J with a bipolar device.
Non Surgical Postoperative Evaluations
Here’s the review of the combined cases performed in the article. Most studies using FRF bipolar equipment report clinical improvement in photoaging and skin laxity, measured by pretreatment photographic evaluation after three treatments, and patient satisfaction evaluated using a regular questionnaire.
Hruza et al found that more than half of the 3 patients with II-IV skin types had an improvement in texture by over 40 percent, and 80% of patients were satisfied.
Seung Lee et al. reported moderate (26-50 percent) and incremental improvement in 26 Asian women in areas of skin tension, brightness and general occurrence.
Man and Goldberg reported significant improvement in most 15 patients with darker V-VI skin types, with no, not even slight post-inflammatory pigment change.
Recovery post treatment was excellent for all with no or minimal discomfort and there was no rehabilitation. Risks are minimal to none when the therapy is delivered by a trained professional.
Many other small studies not described in detail reflect the results of moderate clinical improvement after a three-treatment regimen. They based the assessment on the satisfaction of most patients, safety in Asian and African American patients, and the absence of significant adverse events.
This was their baseline for measurement of the procedures.
The 50 W RF bipolar system (Infini, Lutronic) with 49 proximally isolated needles was found in a pig model to induce coakic zones of thermal coagulation that increase with increased energy levels and conduction times of RF6. Another study using this device found a sebosuppressive effect of a single treatment at a depth of 1.5 mm in Korean patients.
High-frequency devices have become an important contribution to the weaponry of devices that are available to treat light ages. The ability to tighten and rejuvenate both inside and outside the face for all skin types ensures a prominent position for these devices in the aesthetic field. Furthermore, the investigator in these and further studies recommend recurrent treatments after the initial pulsed heat treatment. This will help the effects of chronic situations.
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